基于柯氏四级评估模型对情景模拟教学在全科教学门诊中的评价分析

周帅; 王琦; 潘碧云; 王少津; 杨坤

doi:10.16766/j.cnki.issn.1674-4152.004309

基于柯氏四级评估模型对情景模拟教学在全科教学门诊中的评价分析

doi: 10.16766/j.cnki.issn.1674-4152.004309

周帅¹,
王琦^2, ,,
潘碧云²,
王少津²,
杨坤²

1.
中南大学湘雅医学院附属海口医院肝胆外科，海南海口 570208
2.
中南大学湘雅医学院附属海口医院全科医学科

基金项目:

海南省卫生健康行业科研项目 22A200113

详细信息

通讯作者:
王琦, E-mail: 86764427@qq.com

中图分类号: R192.3 R499
计量
- 文章访问数: 9
- HTML全文浏览量: 2
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-10-07
- 网络出版日期: 2026-03-13

The effect analysis of applying medical scenario simulation in General Practice teaching clinics based on Kirkpatrick's four-level training evaluation model

1.
Department of Hepatobiliary Surgery, Haikou Hospital Affiliated to Xiangya Medical College of Central South University, Haikou, Hainan 570208, China

摘要

摘要: 目的应用柯氏评估模型评价情景模拟教学在全科教学门诊的应用效果，以期探索全科教学门诊带教新模式。方法选取2021年1月—2023年12月于中南大学湘雅医学院附属海口医院全科门诊轮转的60名住培医师，采用随机数表法分为2组。实验组(30名)采用情景模拟结合传统教学门诊进行教学，对照组(30名)采用传统教学门诊带教。通过柯氏四级评估模型，分别在反应层、学习层、行为层、结果层对结果进行分析。结果反应层：在参与度及掌握度的满意度实验组[4.50(4.00, 5.00)分、4.50(4.00, 5.00)分]优于对照组[4.00(3.00, 5.00)分、4.00(3.75, 5.00)分], P=0.029，P=0.038；学习层：培训后，临床思维与治疗、沟通能力评分实验组[3.00(3.00, 4.00)分、4.00(3.00, 4.00)分]优于对照组[3.00(3.00, 3.00)分、3.00(3.00, 3.25)分, P=0.021、0.024]；行为层：培训后，自主学习能力评分实验组[(156.33±9.82)分]优于对照组[(148.57±11.33)分，P=0.006]；结果层：年度考核中全科接诊得分实验组[(95.60±9.09)分]优于对照组[(90.10±10.98)分, P=0.039]。结论通过柯氏四级模型评估，情景模拟教学作为全科教学门诊的补充，可提高教学质量。
- 情景模拟教学 /
- 全科教学门诊 /
- 柯氏四级评估模型
Abstract: Objective To evaluate the effectiveness of scenario simulation teaching in general practice teaching clinics using the Kirkpatrick evaluation model, aiming to explore a new teaching mode for general practice teaching clinics. Methods A total of sixty resident physicians rotating through the General Practice Outpatient Department of Haikou Hospital Affiliated to Xiangya Medical College of Central South University from January 2021 to December 2023 were selected and randomly divided into two groups using a random number table. The experimental group (n=30) received teaching incorporating scenario simulation combined with traditional teaching-clinic methods, while the control group (n=30) received traditional teaching-clinic methods. The outcomes were analyzed assessed according to the four levels of the Kirkpatrick Model: reaction, learning, behavior, and results. Results Reaction Level: Satisfaction with participation and mastery in the experimental group [4.50 (4.00, 5.00) points, 4.50 (4.00, 5.00) points] were significantly higher than in the control group [4.00 (3.00, 5.00) points, 4.00 (3.75, 5.00) points, P=0.029, 0.038]. Learning Level: After training, scores for clinical thinking & treatment and communication skills in the experimental group [3.00 (3.00, 4.00) points, 4.00 (3.00, 4.00) points] were higher than in the control group [3.00 (3.00, 3.00) points, 3.00 (3.00, 3.25) points, P=0.021, 0.024]. Behavior Level: After training, the self-directed learning ability score in the experimental group [(156.33±9.82) points] was higher than that in the control group [(148.57±11.33) points, P=0.006]. Results Level: In the annual assessment, the general practice consultation score in the experimental group [(95.60±9.09) points] was higher than that of the control group [(90.10±10.98) points, P=0.039]. Conclusion Evaluation using the Kirkpatrick four-level model demonstrates that scenario simulation teaching, when incorporated into general practice teaching clinics, enhances teaching quality and provides an effective supplement to traditional instructional approaches.
- Scenario simulation /
- General Practice teaching clinic /
- Kirkpatrick four-level training evaluation

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表 1 2组全科住培医师一般资料比较

Table 1. Comparison of general data between the two groups of general practice residents

组别	人数	年龄(x±s，岁)	性别(男/女，例)	入培成绩(x±s，分)
对照组	30	24.07±1.20	14/16	358.53±63.83
实验组	30	23.93±1.20	15/15	356.97±62.98
统计量		0.430^a	0.067^b	0.096^a
P值		0.669	0.796	0.924
注：^a为t值，^b为χ²值。

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表 2 2组全科住培医师培训后在反应层满意度比较[M(P₂₅, P₇₅)，分]

Table 2. Comparison of satisfaction between the two groups of general practice residents after training in the reaction layer [M(P₂₅, P₇₅), points]

组别	人数	形式	内容	参与度	掌握度	总分
对照组	30	4.00(4.00, 5.00)	4.00(4.00, 5.00)	4.00(3.00, 5.00)	4.00(3.75, 5.00)	16.00(14.75, 20.00)
实验组	30	5.00(4.00, 5.00)	4.00(4.00, 5.00)	4.50(4.00, 5.00)	4.50(4.00, 5.00)	18.00(16.00, 20.00)
U值		420.000	384.000	313.500	322.500	345.500
P值		0.609	0.283	0.029	0.038	0.106

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表 3 2组全科住培医师培训前后在学习层接诊能力比较[M(P₂₅, P₇₅)，分]

Table 3. Comparison of the ability of outpatient visiting between the two groups of general practice residents before and after training in the learning layer [M(P₂₅, P₇₅), points]

组别	人数	问诊		体格检查			临床思维			专业能力综合评价
组别	人数	培训前	培训后	培训前	培训后		培训前	培训后		培训前	培训后
对照组	30	5.00(5.00, 6.25)	6.50(5.00, 8.00)	5.00(4.00, 6.00)	5.00(5.00, 6.25)		3.00(3.00, 4.00)	3.00(3.00, 3.00)		4.00(3.00, 4.00)	3.00(3.00, 4.00)
实验组	30	5.50(5.00, 7.00)	7.00(6.00, 8.00)	5.00(4.00, 6.00)	5.50(5.00, 7.00)		4.00(3.00, 4.00)	3.00(3.00, 4.00)		4.00(3.00, 4.00)	4.00(3.00, 4.00)
U值		435.000	384.500	446.500	426.500		430.000	301.000		435.500	409.000
P值		0.816	0.322	0.957	0.717		0.751	0.021		0.821	0.520

组别	人数	沟通能力人文关怀			总体表现			总分
组别	人数	培训前	培训后		培训前	培训后		培训前	培训后
对照组	30	3.00(3.00, 4.00)	3.00(3.00, 3.25)		4.00(3.00, 4.00)	3.00(3.00, 4.00)		22.00(18.00, 24.00)	20.00(18.00, 22.25)
实验组	30	4.00(3.00, 4.00)	4.00(3.00, 4.00)		4.00(3.75, 4.00)	4.00(3.75, 4.00)		23.50(20.50, 24.00)	23.00(19.75, 24.00)
U值		432.000	317.000		415.500	355.500		438.000	344.500
P值		0.770	0.024		0.587	0.140		0.859	0.118

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表 4 2组全科住培医师培训后在行为层接诊能力的自评及他评比较

Table 4. Comparison of self-evaluation and peer evaluation of the ability between the two groups of general practice residents after training in the behavior layer

组别	人数	自主学习能力测评(x±s, 分)	住培同学评估[M(P₂₅, P₇₅)，分]
组别	人数	自主学习能力测评(x±s, 分)	问诊	体格检查	临床思维	专业能力综合评价	沟通能力人文关怀	总体表现	总分
对照组	30	148.57±11.33	4.00(3.00, 4.00)	4.00(3.00, 4.00)	3.00(3.00, 4.00)	4.00(3.00, 4.00)	3.00(3.00, 4.00)	4.00(3.00, 4.00)	22.00(18.00, 24.00)
实验组	30	156.33±9.82	4.00(3.75, 4.00)	4.00(3.00, 4.00)	4.00(3.00, 4.00)	4.00(3.00, 4.00)	4.00(3.00, 4.00)	4.00(3.75, 4.00)	23.50(20.50, 24.00)
统计量		-2.838^a	389.500^b	435.000^b	392.500^b	427.000^b	238.500^b	413.500^b	354.500^b
P值		0.006	0.310	0.805	0.341	0.706	0.001	0.541	0.153

组别	人数	责任导师评估[M(P₂₅, P₇₅)，分]
组别	人数	问诊		体格检查	临床思维	专业能力综合评价	沟通能力人文关怀	总体表现	总分
对照组	30	4.00(3.00, 4.00)		4.00(3.00, 4.00)	3.00(3.00, 3.00)	3.00(3.00, 4.00)	3.00(3.00, 3.25)	3.00(3.00, 4.00)	20.00(18.00, 22.25)
实验组	30	4.00(3.00, 4.00)		4.00(3.00, 4.00)	3.00(3.00, 4.00)	4.00(3.00, 4.00)	4.00(3.00, 4.00)	4.00(3.75, 4.00)	23.00(19.75, 24.00)
统计量		383.000^b		420.000^b	328.000^b	315.000^b	248.500^b	298.500^b	286.000^b
P值		0.246		0.601	0.030	0.019	0.001	0.012	0.014
注：^a为t值，^b为U值。

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表 5 2组全科住院医师在结果层年度考核技能评分比较(x±s，分)

Table 5. Comparison of skill practice scores of the annual assessment between the two groups of general practice residents in the outcome layer (x±s, points)

组别	例数	医患沟通	全科接诊
对照组	30	22.82±3.00	90.10±10.98
实验组	30	24.62±2.23	95.60±9.09
t值		2.635	2.113
P值		0.011	0.039

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表 6 60名住院医师培训前后接诊能力比较[M(P₂₅, P₇₅)，分]

Table 6. Comparison of the reception ability of 60 general practice residents before and after training [M(P₂₅, P₇₅), points]

组别	问诊	体格检查	临床思维	专业能力综合评价	沟通能力人文关怀	总体表现	总分
培训前	5.00(5.00, 6.75)	5.00(4.00, 6.00)	5.00(5.00, 6.00)	6.00(5.00, 6.75)	6.00(5.00, 6.00)	6.00(5.00, 6.00)	33.00(30.00, 37.50)
培训后	7.00(6.00, 8.00)	5.00(5.00, 6.75)	6.00(5.00, 7.00)	6.00(5.25, 7.00)	6.00(6.00, 7.00)	6.00(5.00, 7.00)	36.50(33.00, 42.50)
U值	926.000	1 383.000	1 325.000	1 587.500	1 102.000	1 355.000	1 160.000
P值	＜0.001	0.023	0.009	0.238	＜0.001	0.014	0.001

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