督导式门诊教学在全科医师血液科规范化培训中的应用效果研究

doi:10.12114/j.issn.1007-9572.2019.00.323

摘要/Abstract

摘要： 背景　门诊教学在医学教育中的地位变得越来越重要，但常规的全科医学门诊教学模式存在局限性，使得全科医师很难将知识积累转化为临床实践，亟待新的教学模式解决这一困难。目的　探讨督导式门诊教学在全科医师血液科规范化培训中的有效性和可行性。方法　选取2017年12月—2018年8月于某医院血液内科进行规范化培训的全科医师共45人。使用随机数字法将其分为两组，其中对照组22人、研究组23人。对照组医师在血液内科病房进行常规规范化培训，包括常规接诊患者、问诊查体以及制定初步诊疗方案，并监测治疗中的病情变化等；研究组医师在接受病房培训的同时，完成每周2次上午半日的血液内科督导式门诊教学培训。比较两组医师入科、出科考核成绩以及对带教效果的评价。结果　血液内科培训2个月结束后，研究组出科临床理论考试成绩为（91.4±2.3）分，高于对照组的（87.8±3.7）分（t=3.933，P<0.05）；研究组临床实践技能测试成绩为（88.4±2.4）分，亦高于对照组的（84.5±3.7）分（t=4.267，P<0.05）。研究组在提高学习主动性、加强医患沟通能力等方面的带教效果评价明显优于对照组（P<0.05）。结论　血液内科督导式门诊教学能够提高全科医师规范化培训的效果，提高学生对常见病的诊疗思维能力，有助于其全面了解慢性病整体病程，调动学生的学习兴趣，增进师生交流。

关键词: 全科医生；住院医师规范化培训；教育, 医学；血液病；督导式门诊教学

Abstract: Background　Outpatient teaching plays an ever-growing role in medical education.However，limitations of the routine general practice teaching mode restrict the transform of learned medical knowledge into clinical practice，so a novel better teaching model is urgently needed.Objective　To explore the effectiveness and feasibility of supervised outpatient teaching model in standardized hematology training for general practitioners（GPs）．Methods　A total of 45 GPs who received standardized training in the hematology department of a hospital from December 2017 to August 2018 were enrolled.They were randomly divided into the control group（n=22）and the study group（n=23），receiving the training about standardized routine care for hematology inpatients（including regular encountering，inquiry，physical examination，development of preliminary diagnosis and treatment plan，monitoring of the condition changes in the treatment，and so on），the training about standardized routine care for hematology inpatients plus the care training for hematology outpatients taught in the morning，twice a week，in a supervised model，respectively.Pre- and post-training clinical theoretical and skills evaluation results，and subjective-assessed teaching effectiveness in both groups were compared.Results　After the 2-month training，GPs in the study group obtained a higher mean score in the clinical theoretical examination〔（91.4±2.3）vs（87.8±3.7）〕（t=3.933，P<0.05）than those of the control group，and also achieved a higher mean score in the clinical skill examination〔（88.4±2.4）vs（84.5±3.7）〕（t=4.267，P<0.05）．The overall teaching effectiveness score in improving learning initiative and strengthening doctor-patient communication ability and so on assessed by the study group was much better than that assessed by the control group（P<0.05）．Conclusion　The supervised outpatient teaching model used in standardized hematology training for GPs may improve the training effectiveness，enhance the clinical diagnostic and therapeutic ideas and performance for common diseases，promote the comprehensive understanding of the whole course of a chronic disease，arouse the learning interest，and facilitate the ommunications between trainers and trainees.

Key words: General practitioners；Standardized resident training；Education, medical；Hematology；Supervised outpatient teaching

田颖,张之尧,陈文明. 督导式门诊教学在全科医师血液科规范化培训中的应用效果研究[J]. 中国全科医学, 2019, 22(19): 2380-2383. DOI: 10.12114/j.issn.1007-9572.2019.00.323.
TIAN Ying,ZHANG Zhiyao,CHEN Wenming. Effectiveness of Supervised Outpatient Teaching Model in Standardized Hematology Training for General Practitioners　[J]. Chinese General Practice, 2019, 22(19): 2380-2383. DOI: 10.12114/j.issn.1007-9572.2019.00.323.

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