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1.上海交通大学医学院公共卫生学院,上海 200025
2.上海交通大学医学院附属仁济医院临床医学院,上海 200127
3.上海交通大学医学院教务处,上海 200025
袁蕙芸,Email: yuanhuiyun@hotmail.com
纸质出版日期:2023-12-20,
收稿日期:2023-09-13,
扫 描 看 全 文
江晓, 邵莉, 陈燕, 等. 序贯制临床技能课程体系在住培阶段的应用效果[J]. 中华医学教育探索杂志, 2023, 22(12): 1796-1801.
Jiang Xiao, Shao Li, Chen Yan, et al. Application effect of a sequential clinical skill curriculum system in standardized residency training[J]. Chinese Journal of Medical Education Research, 2023,22(12):1796-1801.
江晓, 邵莉, 陈燕, 等. 序贯制临床技能课程体系在住培阶段的应用效果[J]. 中华医学教育探索杂志, 2023, 22(12): 1796-1801. DOI: 10.3760/cma.j.cn116021-20230913-01526.
Jiang Xiao, Shao Li, Chen Yan, et al. Application effect of a sequential clinical skill curriculum system in standardized residency training[J]. Chinese Journal of Medical Education Research, 2023,22(12):1796-1801. DOI: 10.3760/cma.j.cn116021-20230913-01526.
目的
2
评价序贯制临床技能课程体系在住院医师规范化培训(以下简称“住培”)中的应用效果。
方法
2
选取2020至2022年参加某临床医学院住培的300名住院医师为研究对象,其中试验组(46人)本科阶段接受过该临床医学院临床技能培养课程,对照组(254人)本科阶段未接受过该课程培养,观察进入住培基地共同经该课程体系培养后第一到第三年两组的教学效果。采用SPSS 24.0统计软件进行数据分析,主要统计方法有描述性分析、Kolmogorov-Smirnov检验、Mann-Whitney
U
检验和卡方检验。
结果
2
进入住培基地前,2020级[60.0(52.0,60.0)分 vs. 51.0(48.0,53.0)分]、2021级[54.0(52.0,56.0)分 vs. 51.0(48.0,53.0)分]
和2022级[53.0(51.0,55.0)分 vs. 50.0(47.0,51.0)分]试验组住院医师的入基地成绩与对照组相比,差异有统计学意义(
P
<
0.05)。住培满36个月,2020级试验组住院医师与对照组在结业考试通过率方面,差异不具有统计学意义(
χ
2
=1.20,
P
=0.273)。住培满12个月,试验组住院医师理论考核[124.0(123.8,125.0)分vs. 115.0(101.0,125.0)分]和病史采集[92.0(91.0,95.0)分vs. 85.1(79.3,94.5)分]
成绩与对照组相比,差异有统计学意义(
P
<
0.05)。住培满6个月、18个月、24个月,差异均无统计学意义(
P
>
0.05)。住培满6个月[93.0(90.0,97.0)分vs. 89.0(86.3,95.0)分]、12个月[94.0(92.0,95.0)分vs. 89.0(87.0,92.0)分]
和18个月[90.0(86.5,93.5)分vs. 81.0(69.0,91.0)分],试验组住院医师体格检查成绩与对照组相比,差异有统计学意义(
P
<
0.05)。住培满24个月,2020级[92.0(87.5,95.3)分vs. 85.0(79.0,92.0)分]和2021级[94.0(87.0,96.0)分vs. 90.0(84.0,95.0)分]
试验组住院医师体格检查成绩与对照组相比,差异无统计学意义(
P
>
0.05)。
结论
2
该临床技能课程体系有助于住院医师临床综合能力的提升,应当进一步优化体格检查教学内容和方法,注重住院医师医患沟通技能和人文素养培养。
Objective
2
To investigate the application effect of a sequential clinical skill curriculum system in standardized residency training.
Methods
2
A total of 300 residents who participated in the residency training of a clinical medical school from 2020 to 2022 were selected as the research subjects
among whom 46 residents in the experimental group had received the clinical skill training course of the clinical medical school in the undergraduate stage
and 254 in the control group had not received such training in the undergraduate stage. The teaching effect of the two groups was observed from the first year to the third year after they entered the residency training base and were trained together based on the curriculum system. SPSS 24.0 statistical software was used for data analysis
and the main statistical methods included descriptive analysis
the Kolmogorov-Smirnov test
the Mann-Whitney
U
test
and the chi-square test.
Results
2
Before the residents entered the residency base
class 2020 [60.0(52.0
60.0) vs. 51.0(48.0
53.0)]
class 2021 [54.0(52.0
56.0) vs. 51.0(48.0
53.0)]
and class 2022 [53.0(51.0
55.0) vs. 50.0(47.0
51.0)] The difference between the entry base grades of the residents in the experimental group compared to the control group was statistically significant (
P
<
0.05). After 36 months of residency training
the difference between the residents in the trial group and the control group in the 2020 class was not statistically significant when it came to the passing rate of the final exam (
χ
2
=1.20
P
=0.273). At the end of 12 months of residency training
there was a statistically significant difference (
P
<
0.05) between the scores of residents in the experimental group compared with the control group in the theoretical examination [124.0 (123.8
125.0) vs. 115.0 (101.0
125.0)] and medical history taking [92.0 (91.0
95.0) vs. 85.1 (79.3
94.5)]
. The differences were not statistically significant (
P
>
0.05) at the end of 6
18
and 24 months of residency training. At the end of 6 months [93.0(90.0
97.0) vs. 89.0(86.3
95.0)]
12 months [94.0(92.0
95.0) vs. 89.0(87.0
92.0)]
and 18 months [90.0(86.5
93.5) vs. 81.0(69.0
91.0)] of residency training
residents in the experimental group Physical examination scores were statistically significant compared to the control group (
P
<
0.05). At the end of 24 months of residency training
there was no statistically significant difference (
P
>
0.05) between the physical examination scores of residents in the experimental group compared with the control group in the classes of 2020 [92.0(87.5
95.3) vs. 85.0(79.0
92.0)] and 2021 [94.0(87.0
96.0) vs. 90.0(84.0
95.0)]
.
Conclusions
2
The clinical skill curriculum system can help to improve the comprehensive clinical ability of residents
and the teaching contents and methods of physical examination should be further optimized
with a focus on the training of doctor-patient communication skills and humanistic literacy among residents in the future.
序贯制临床技能课程应用研究住院医师规范化培训
Sequential trainingClinical skill curriculumApplication researchStandardized residency training
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