朋辈联合CBL导入情境模拟教学在胸心外科住院医师规范化培训中的应用

王高祥; 吴明胜; 徐广文; 吴汉然; 孙效辉; 柳常青; 解明然

doi:10.16766/j.cnki.issn.1674-4152.003391

朋辈联合CBL导入情境模拟教学在胸心外科住院医师规范化培训中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003391

中国科学技术大学附属第一医院(安徽省立医院)胸外科，安徽合肥 230001

基金项目:

国家自然科学基金项目 81973643

安徽省重点研究与开发项目 202004j07020017

安徽省高等学校教学研究项目 2020xjyxm089

详细信息

通讯作者:
解明然，E-mail：xmr1981@ustc.edu.cn

中图分类号: R192 R655
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- 文章访问数: 47
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-05
- 网络出版日期: 2024-03-27

Application of peer combined with CBL into situational simulation teaching in standardized training of thoracic surgery residents

Department of Thoracic Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China

摘要

摘要: 目的探讨胸心外科住院医师规范化培训(简称住培)教学中使用朋辈联合案例教学法(CBL)导入情境模拟教学的效果及可行性。方法选取2021年1月—2022年4月在中国科学技术大学附属第一医院胸外科参加住培的60位住院医师作为研究对象，按照随机数字表法随机分为传统教学法组(A组)和朋辈联合基于CBL导入情境模拟教学组(B组)，每组30人。全部教学结束时行迷你临床演练评估(Mini-CEX)和操作技能直接观察评估(DOPS)。培训结束时需要进行理论与技能考核及对教学的满意度调查。结果 2组住培医师在年龄、性别、最高学历、专业、参加规培时间方面差异无统计学意义(P＞0.05)。B组出科理论成绩和技能成绩均明显高于A组，差异有统计学意义(t=4.977，P＜0.001；t=3.607，P=0.001)。B组Mini-CEX评价等级中优秀的占比高于A组，差异有统计学意义(P < 0.05)。B组Mini-CEX分数高于A组，差异有统计学意义(t=2.670，P=0.010)。2组在DOPS评价等级及分数方面差异无统计学意义(Z=-0.869，P=0.385；t=0.405，P=0.687)。B组满意度等级中比较满意的占比高于A组，差异有统计学意义(P < 0.05)。B组满意度评分高于A组，差异有统计学意义(t=5.007，P＜0.001)。结论朋辈联合CBL导入情景模拟教学模式在胸心外科教学方面能够很好地营造良好的学习氛围，提高住培医师自主学习和临床思维能力，具有一定的推广意义。
- 朋辈教学 /
- 案例学习 /
- 住院医师规范化培训 /
- 临床基础能力考核 /
- 胸外科
Abstract: Objective The aimed explore the effectiveness and feasibility of introducing case-based learning (CBL) for situational simulation teaching in the standardized training of thoracic and cardiac surgery residents. Methods Sixty residents who underwent residential training in the Department of Thoracic Surgery at the First Affiliated Hospital of University of Science and Technology of China, from January 2021 to April 2022, were selected as participants. They were randomly divided into two groups: the group A, which received traditional teaching method group, and the group B, which received CBL-based situational simulation teaching group, according to the admission order. The teaching methods included mini-clinical evaluation exercise(mini-CEX), direct observation, and direct observation of procedural skill (DOPS). At the end of the training, theory and skill assessment, as well as teaching satisfaction survey, were conducted. Results There were no significant differences between the two groups in terms of age, sex, highest education, major, and time of participation in training (P>0.05). The theoretical and skill scores of the group B were significantly higher than those of the group A (t=4.977, P < 0.001; t=3.607, P=0.001). The proportion of excellent Mini-CEX rating in the group B was higher than that in the group A (P < 0.05). Additionally, the Mini-CEX score in the group B was higher than that in the group A (t=2.670, P=0.010). There were no significant difference in DOPS rating and scores between the two groups (Z=-0.869, P=0.385; t=0.405, P=0.687). The satisfaction level of the group B was significantly higher than that of the group A (P < 0.05). Similarly, the satisfaction score of the group B was significantly higher than that of the group A (t=5.007, P < 0.001). Conclusion The implementation of peer and CBL-based situational simulation teaching mode has the potential to creat a conductive learning atmosphere, improve the independent learning and clinical thinking skills of resident physicians, and hold significant promise for advancement.
- Peer teaching /
- Case-based learning /
- Standardized residency training /
- Mini-clinical evaluation exercise /
- Thoracic surgery

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表 1 2组住培医师一般资料比较

Table 1. Comparison of general information between two groups of resident training physicians

组别	人数	性别[人(%)]		年龄 (x±s，岁)	最高学历[人(%)]		专业[人(%)]			规培时间[人(%)]
组别	人数	男性	女性	年龄 (x±s，岁)	本科	研究生	胸心外科	其他外科	其他	一年级	二年级
A组	30	28(93.3)	2(6.7)	25.23±1.68	10(33.3)	20(66.7)	12(40.0)	16(53.3)	2(6.7)	12(40.0)	18(60.0)
B组	30	27(90.0)	3(10.0)	24.93±1.62	13(43.3)	17(56.7)	10(33.3)	19(63.3)	1(3.3)	9(30.0)	21(70.0)
统计量		＜0.001^a		0.706^b	0.635^a		0.779^a			0.659^a
P值		0.999		0.483	0.426		0.677			0.417
注：^a为χ²值，^b为t值。研究生包括博士研究生及硕士研究生；其他外科为除胸心外科其他外科学专业学生，其他为外科学以外专业学生。

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表 2 2组住培医师出科考试成绩比较(x±s，分)

Table 2. Comparison of exam scores between two groups of resident training physicians (x±s, points)

组别	人数	理论成绩	技能成绩
A组	30	85.13±2.92	84.00±3.33
B组	30	88.80±2.78	87.20±3.54
t值		4.977	3.607
P值		＜0.001	0.001

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表 3 2组住培医师培训情况比较

Table 3. Comparison of training status between two groups of resident training physicians

组别	人数	Mini-CEX评价等级[人(%)]			Mini-CEX分数 (x±s，分)	DOPS评价等级[人(%)]			DOPS分数 (x±s，分)
组别	人数	有待改进	合格	优秀	Mini-CEX分数 (x±s，分)	不合格	合格	优秀	DOPS分数 (x±s，分)
A组	30	2(6.7)	15(50.0)	13(43.3)	6.03±1.52	1(3.3)	14(46.7)	15(50.0)	6.63±1.19
B组	30	0	9(30.0)	21(70.0)	6.93±1.05	0	12(40.0)	18(60.0)	6.77±1.36
统计量		-2.196^a			2.670^b	-0.869^a			0.405^b
P值		0.028			0.010	0.385			0.687
注：^a为Z值，^b为t值。

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表 4 2组住培医师满意度比较

Table 4. Comparison of satisfaction between two groups of resident training physicians

组别	人数	问卷调查表评价等级[人(%)]				问卷调查表分数 (x±s，分)
组别	人数	非常不满意	不太满意	比较满意	非常满意	问卷调查表分数 (x±s，分)
A组	30	0	8(26.7)	22(73.3)	0	7.27±1.08
B组	30	0	0	29(96.7)	1(3.3)	8.43±0.68
统计量		-3.127^a				5.007^b
P值		0.002				＜0.001
注：^a为Z值，^b为t值。

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