Application of formative evaluation based on intelligent high-fidelity simulation and DOPS in the standardized training of ophthalmology residents
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摘要:
目的 探究基于智能化高仿真模拟和操作技能直接观察评估(DOPS)的形成性评价在眼科住院医师规范化培训(简称住培)中的应用效果，以期为眼科医学教育提供参考。 方法 选取2015年7月—2024年7月在蚌埠医科大学第一附属医院眼科培训的38名住院医师为研究对象，按批次分为2组：研究组(基于智能化高仿真模拟和DOPS的形成性评价)19人、对照组(终结性评价)19人，2组学时数及培训内容一致。采用DOPS评估表对研究组进行形成性评价，比较2组理论知识与临床实践能力考核成绩，并采用自制问卷进行满意度调查。 结果 研究组培训终期DOPS评分均高于培训中期(P＜0.05)。研究组理论知识与临床实践能力考核成绩分别为(91.49±3.10)分、(90.85±2.41)分，均高于对照组[(87.92±3.25)分、(86.89±3.47)分, t=3.465、P=0.001, t=4.086、P＜0.001]。研究组住院医师对培训效果满意度各方面评分均高于对照组(P＜0.05)。研究组教师对住院医师满意度各方面评分均高于对照组(P＜0.05)。 结论 基于智能化高仿真模拟和DOPS的形成性评价在眼科住培中的应用效果确切，可增强医师临床综合能力，提升培训质量。 Abstract:Objective To explore the application effect of formative evaluation based on intelligent high-fidelity simulation and direct observation of procedural skills (DOPS) in the standardized training of ophthalmology residential, providing reference for improving ophthalmology education. Methods Thirty-eight residents who received training at the First Affiliated Hospital of Bengbu Medical University from July 2015 to July 2024 were studied. They were divided into the study group (formative evaluation based on intelligent high simulation and DOPS) and the control group (final evaluation) according to training batches. The two groups had the same training hours and training content. The DOPS evaluation form was used for formative evaluation of the study group, while both groups assessed for theoretical knowledge and clinical practice ability. Results DOPS scores in the study group at the end of training were higher than that at the middle of training (P < 0.05). The test scores of theoretical knowledge and clinical practice ability in the study group were higher than those in the control group [(91.49±3.10) points and (90.85±2.41) points vs. (87.92±3.25) points and (86.89±3.47) points, t=3.465, P=0.001 and t=4.086, P < 0.001, respectively]. The satisfaction scores of residents in the study group regarding all aspects of the training effectiveness were also higher than those in the control group (P < 0.05). The satisfaction scores of the instructors toward the residents in the study group were also higher than those in the control group (P < 0.05). Conclusion The integration of intelligent high-fidelity simulation and DOPS formative evaluation in ophthalmology residential training demonstrates significant effectiveness. This approach enhances the clinical comprehensive abilities of physicians and improve the quality of training. -
表 1 研究组住院医师培训中期、终期DOPS评分比较(x±s，分)
Table 1. Comparison of DOPS scores between mid-term and final assessments in the residency training study group (x±s, points)
时间 人数 相关知识 知情同意 准备措施 止痛镇静 技术能力 无菌技巧 适时寻求协助 术后处置 沟通技巧 专业素养 整体能力 培训中期 19 3.85±0.62 4.06±0.77 3.69±0.80 4.09±0.70 3.99±0.59 3.97±0.52 4.01±0.52 4.04±0.49 3.88±0.49 3.94±0.41 4.16±0.42 培训终期 19 5.90±0.34 5.98±0.31 6.01±0.33 5.99±0.34 5.96±0.40 5.99±0.30 5.96±0.47 5.89±0.42 5.99±0.31 5.91±0.33 6.07±0.28 t值 12.637 10.083 11.686 10.642 12.047 14.667 12.127 12.495 15.862 16.316 12.495 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 
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表 2 2组住院医师理论知识与临床实践能力考核成绩比较(x±s，分)
Table 2. Comparison of theoretical knowledge and clinical practice ability of residents in the two groups (x±s, points)
组别 人数 理论知识 临床实践能力 研究组 19 91.49±3.10 90.85±2.41 对照组 19 87.92±3.25 86.89±3.47 t值 3.465 4.086 P值 0.001 ＜0.001
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表 3 2组住院医师对培训效果满意度比较(x±s，分)
Table 3. Comparison of residents ' satisfaction with the training effect between the two groups (x±s, points)
组别 人数 专业知识掌握水平 技能操作能力 医学人文素质 医患沟通能力 团体协作能力 教学方法评价 研究组 19 8.53±1.09 8.15±1.44 7.99±1.15 8.41±1.17 7.95±1.12 8.77±1.03 对照组 19 7.01±1.92 7.02±1.86 6.83±1.71 6.94±1.50 6.91±1.63 6.04±1.62 t值 3.001 2.094 2.454 3.368 2.292 6.199 P值 0.005 0.043 0.019 0.002 0.028 ＜0.001
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表 4 2组教师对住院医师满意度比较(x±s，分)
Table 4. Comparison of teachers ' satisfaction with residents in the two groups (x±s, points)
组别 人数 学习积极性 知识接受程度 技能操作能力 医学人文素质 医患沟通能力 团体协作能力 研究组 19 7.79±1.59 8.01±1.25 7.95±1.31 7.83±1.20 8.10±1.15 8.05±1.13 对照组 19 6.61±1.68 6.96±1.52 6.78±2.01 6.75±1.73 6.99±1.84 6.92±1.84 t值 2.224 2.326 2.126 2.236 2.230 2.281 P值 0.033 0.026 0.040 0.032 0.032 0.029
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