Standardized residency training in emergency medicine is crucial for a high-quality clinical physician workforce. As a frontline dedicated to the treatment of ill patients, the emergency medicine serves as a critical training ground for exemplary resident. Medical skills training is an integral component of residency education, and emergency medicine core skills training numerous modules. However, in the of specific training modules between the teachers and students can impact the training's efficacy and quality.

To investigate and analyze the cognitive differences between teachers and residents of emergency professional skills training in standardized resident training in Hebei Province.

On 18 October 2021, a total of 103 teachers and residents from 15 emergency bases in Hebei Province who were prepared to participate in the standardized training skills competition for residents were selected, including 37 teachers and 66 residents. According to the "Clinical Skill Operation Refinement Process and Scoring Criteria", an electronic questionnaire was developed for 13 emergency core skill training projects according to the operation steps of the refinement process, and the scores were divided into "difficulty degree" and "omission during operation".

In terms of "difficulty", teachers and students exhibited differing of for seven gram (53.85%) : electrocardiography, arterial puncture, abdominal puncture, single-chamber cardiopulmonary (CPR), central venous puncture, tracheal intubation, and three-cavity-two-lung tube placemen, the cognitive differences were observed in 25 steps (16.45%), where teachers rated as less mark than students (P<0.05). In terms of "omissions during operation", teachers and students also differed in their cognitive of nine (69.23%) : electrocardiography, abdominal puncture, single-chamber CPR, central venous puncture, tracheal intubation, three-cavity-two-lung tube placement, lumbar puncture, noninvasive ventilation, and thoracic puncture, the cognitive differences were observed in 24 steps (15.79%) cognitive, with teachers generally a lower mark compared to students (P<0.05). There are no differences were observed between teachers and students in terms of "difficulty" and "omissions during operation" for the remaining three: pericardium puncture, cardioversion, and bone marrow puncture (P>0.05) .

This study confirmed that there are differences between teachers and trainees in the "difficulty" and "omissions in operation" of core skills training in emergency department. On the one hand, it can promote the improvement of clinical skills training curriculum, improve training efficiency, and provide methodological basis for training high-level, high-level and application-oriented medical talents. On the other hand, this study suggests that in the future similar studies on standardized training of residents, the possible differences between teachers and trainees should be taken into account in order to reflect and explore the problems related to residential training more objectively.

住院医师规范化培训是培养高素质临床医师队伍的关键，急诊医学科是救治急危重症患者的前沿阵地，更是培养优秀临床住院医师的重要训练营。医学技能培训是住院医师规范化培训的重要内容，急诊核心技能培训涵盖的项目较多，教师和学员对具体培训项目的认知存在差异，会影响技能培训的效率和质量。

调查分析河北省住院医师规范化培训急诊专业技能培训中教师和学员对培训项目的认知差异。

2021年10月，选取来自河北省15家急诊住院医师规范化培训基地，准备参加河北省住院医师规范化培训技能大赛的教师和学员共103名作为调查对象，其中教师37名、学员66名。依据《临床技能操作细化流程及评分标准》，对13个急诊核心技能培训项目，按细化流程操作步骤制定电子调查问卷，进行"难易度"和"操作时遗漏情况"评分调查。

教师和学员在"难易度"方面，对7个项目（53.85%）：心电图采集术、动脉穿刺术、腹腔穿刺术、单人心肺复苏术、中心静脉穿刺术、气管插管术、三腔两囊管置入术，25个步骤（16.45%）的认知存在差异，教师的"难易度"认知评分低于学员（P<0.05）。教师和学员在"操作时遗漏情况"方面，对9个项目（69.23%）：心电图采集术、腹腔穿刺术、单人心肺复苏术、中心静脉穿刺术、气管插管术、三腔两囊管置入术、腰椎穿刺术、无创通气术、胸腔穿刺术，和24个步骤（15.79%）认知存在差异，教师的"操作时遗漏情况"认知评分低于学员（P<0.05）；其余3个培训项目（环甲膜穿刺术、同步电复律术、骨髓穿刺术）教师和学员在操作各步骤"难易度""操作时遗漏情况"方面的认知比较，差异均无统计学意义（P>0.05）。

教师和学员对急诊核心技能培训"难易度"和"操作时遗漏情况"方面确实存在差异，一方面可促进临床技能培训课程设置的改进，提高培训效率，为培养高层次、高水平、应用型的医学人才提供方法学基础；另一方面，提示在今后住院医师规范化培训的类似相关研究中，在涉及教师和学员两个群体时，要考虑到二者之间可能存在差异，以期更客观地反映和探究住院医师规范化培训相关问题。