多学科团队协作诊疗引导下的团队教学模式在ICU临床教学中的实践探索

李祚涛; 钟志宏; 刘彦权; 郭灵; 许庆林; 王钇力

doi:10.16766/j.cnki.issn.1674-4152.003308

多学科团队协作诊疗引导下的团队教学模式在ICU临床教学中的实践探索

doi: 10.16766/j.cnki.issn.1674-4152.003308

1.
赣南医学院第一附属医院重症医学科(综合ICU)，江西赣州 341000
2.
赣南医学院发展规划与学科建设处，江西赣州 341000
3.
赣南医学院第一临床医学院，江西赣州 341000

基金项目:

江西省高校人文社会科学重点研究基地项目 JD19014

详细信息

通讯作者:
王钇力，E-mail：wyllzt@aliyun.com

中图分类号: R192
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- 文章访问数: 116
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2023-02-15
- 网络出版日期: 2024-01-29

The practical exploration of the team-based learning model in ICU clinical teaching under the guidance of multidisciplinary team collaboration

1.
Department of Intensive Medicine (Comprehensive Intensive Care Unit), the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, China

摘要

摘要: 目的分析和探讨基于多学科团队协作诊疗(MDT)引导下的团队教学模式(TBL)在ICU临床教学实践中的应用效果，为ICU临床教学改革探索新路径。方法选择2019年7月—2022年6月在赣南医学院第一附属医院重症医学科轮转的87名住院医师规范化培训学员为研究对象，按照随机数字表法分为对照组(42名)及试验组(45名)。对照组采用传统住院医师床旁带教模式，试验组采用MDT引导下的TBL模式法予以临床教学。考核与比较2组教学法的实践效果，并通过《ICU轮转带教满意度调查问卷》调查教学满意度。结果试验组ICU理论考核、技能操作考核以及临床危急重症案例处置成绩均高于对照组[(88.24±3.57)分、(93.16±4.95)分、(84.09±5.12)分vs.(81.08±2.92)分、(86.43±3.31)分、(79.83±3.96)分]，2组比较差异有统计学意义(均P<0.05)。问卷调查结果显示，试验组在ICU的学习目标及兴趣、ICU理论知识与操作技能、团队精神培养、人文关怀能力、医患沟通能力、文献检索能力、批判思维培养方面均优于对照组(均P<0.05)。结论在ICU临床教学实践中引入MDT联合TBL教学法，能切实提升年轻住院医师的专业水平与技能，在培养团队精神、提升科研素质的同时，亦有助于医患关系和谐，进而提高ICU临床教学满意度。
- 多学科团队协作诊疗 /
- 以团队为基础的学习 /
- 重症监护室 /
- 重症医学 /
- 临床教学
Abstract: Objective To analyze and explore the application effect of team-based learning (TBL) under the guidance of multi-disciplinary team (MDT) in intensive care unit (ICU) clinical teaching practice, and to explore a new way for ICU clinical teaching reform. Methods A total of 87 resident physicians in the Department of Intensive Medicine of the First Affiliated Hospital of Gannan Medical University from July 2019 to June 2022 were selected as the study subjects, and randomly divided into control group (n=42) and experimental group (n=45) according to the random number table method. The control group was treated with the traditional bedside teaching mode by residents and the experimental group was treated with the TBL mode under the guidance of the MDT for clinical teaching. To compare the practical effectiveness and satisfaction of the two groups of teaching methods. Evaluate and compare the practical effects of the two groups of teaching methods and investigate the teaching satisfaction using the ICU teaching satisfaction questionnaire. Results The scores of the test group were higher than those of the control group [(88.24±3.57) points, (93.16±4.95) points, (84.09±5.12) points vs. (81.08±2.92) points, (86.43±3.31) points, (79.83±3.96) points], the differences between the two groups were statistically significant (all P<0.05). The results of the questionnaire survey showed that the experimental group in the ICU was superior to the control group in terms of learning goals and interests in the ICU, ICU theoretical knowledge and operational skills, training of team spirit, humanistic care ability, doctor-patient communication ability, document retrieval ability, training of critical thinking (all P<0.05). Conclusion The model of MDT combined with TBL teaching method in ICU clinical teaching practice can effectively improve the professional level and skills of young residents, cultivate team spirit and improve the quality of scientific research, but also contribute to the harmonious relationship between doctors and patients, and improve the satisfaction of ICU clinical teaching.
- Multi-disciplinary team /
- Team-based learning /
- Intensive care unit /
- Intensive medicine /
- Clinical teaching

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图 1 MDT引导下的TBL在ICU临床教学中的实践应用模式

Figure 1. Diagram of team-based learning model application in ICU clinical teaching, guided by multidisciplinary team collaboration

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表 1 2组住院医师规范化培训学员一般资料比较

Table 1. Comparison of general baseline data indicators among resident physician in two groups

组别	人数	性别(男性/女性，人)	年龄(x±s，岁)	规培前考试成绩(x±s，分)	具备医师资格证(是/否，人)	学历背景(本科/硕士，人)
试验组	45	24/21	25.47±2.23	83.32±5.23	31/14	26/19
对照组	42	24/18	24.39±2.94	81.96±6.14	25/17	30/12
统计量		0.127^a	1.920^b	1.115^b	0.831^a	1.765^a
P值		0.721	0.059	0.268	0.362	0.184
注：^a为χ²值，^b为t值。

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表 2 2组住院医师规范化培训学员考核成绩比较(x±s，分)

Table 2. Comparison of assessment results between two groups in resident physician (x±s, points)

组别	人数	ICU理论知识	ICU临床思维与技能考核	临床危急重症案例处置
试验组	45	88.24±3.57	93.16±4.95	84.09±5.12
对照组	42	81.08±2.92	86.43±3.31	79.83±3.96
t值		6.291	7.124	4.673
P值		<0.001	<0.001	<0.001

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表 3 2组住院医师规范化培训学员ICU轮转带教满意度情况[人(%)]

Table 3. The satisfaction of resident physicians with ICU teaching training in two groups [people(%)]

组别	人数	培训目的清晰明确	ICU操作技能提升	ICU理论知识提升	培养团队协作精神	人文关怀能力提升	医患沟通能力提高	文献检索能力提高	批判性思维培养	分析解决问题能力提升	对带教老师满意度
试验组	45	41(91.11)	43(95.56)	40(88.89)	44(97.78)	42(93.33)	41(91.11)	37(82.22)	42(93.33)	44(97.78)	43(95.56)
对照组	42	31(73.81)	31(73.81)	30(71.43)	32(76.19)	31(73.81)	30(71.43)	26(61.90)	30(71.43)	35(83.33)	34(80.95)
χ²值		4.558	8.083	4.212	9.166	6.133	5.607	4.489	7.305	3.836	3.232
P值		0.033	0.004	0.040	0.002	0.013	0.018	0.034	0.007	0.050	0.072

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