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同济大学附属第十人民医院普外科,上海 200072
陈磊,Email:trillen@163.com
收稿:2025-01-01,
纸质出版:2025-10-20
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黄毅祥, 王刚, 黄嫣妮, 等. SPARK学习模式联合五步疑问法在甲乳外科住院医师规范化培训教学中的应用研究[J]. 中华医学教育探索杂志, 2025, 24(10): 1350-1356.
Huang Yixiang, Wang Gang, Huang Yanni, et al. Application of SPARK learning model combined with five-step questioning method in standardized training of residents in the department of thyroid and breast surgery[J]. Chinese journal of medical education research, 2025, 24(10): 1350-1356.
黄毅祥, 王刚, 黄嫣妮, 等. SPARK学习模式联合五步疑问法在甲乳外科住院医师规范化培训教学中的应用研究[J]. 中华医学教育探索杂志, 2025, 24(10): 1350-1356. DOI: 10.3760/cma.j.cn116021-20250101-02126.
Huang Yixiang, Wang Gang, Huang Yanni, et al. Application of SPARK learning model combined with five-step questioning method in standardized training of residents in the department of thyroid and breast surgery[J]. Chinese journal of medical education research, 2025, 24(10): 1350-1356. DOI: 10.3760/cma.j.cn116021-20250101-02126.
目的
2
将SPARK学习模式与五步疑问法相结合,构建新的教学方案,并评估其在甲乳外科住培教学中的应用效果,以期为优化专科医师培训模式提供理论依据和实践参考。
方法
2
选取2022年12月至2024年12月参与规培的104名甲乳外科临床医师为研究对象,以教改时间为截点(2024年1月),将2022年12月至2023年12月参与规培的甲乳外科52名临床医师纳入对照组,给予常规教学(主要基于“理论授课-临床示教-技能训练-病例讨论”的线性
教学流程,强调知识传授和技能模仿);将2024年1月至2024年12月规培的52名临床医师纳入试验组,予以SPARK学习模式联合五步疑问的教学法。教学评价包括基础理论考核、临床技能考核、临床思维考核以及对教学的满意度评价。使用SPSS 26.0进行
t
检验和卡方检验。
结果
2
试验组学员基础理论考核、临床技能考核均高于对照组,差异有统计学意义。试验组学员各思维能力维度评分均高于对照组[诊断决策:(21.85±1.15) vs. (18.35±3.42);治疗规划:(24.62±1.52) vs. (20.28±4.13);并发症管理:(14.82±0.73 )vs.(12.17±2.53);循证医学应用:(15.18±0.92) vs. (12.48±2.85);多学科协作:(14.95±0.83) vs.(12.73±3.08);成本效益分析:(8.25±0.42) vs. (6.82±1.53)],差异有统计学意义。试验组学员教学满意度评分均高于对照组,差异有统计学意义。
结论
2
SPARK学习模式与五步疑问法联合开展教学,通过系统化知识建构与批判性思维训练的有机结合,显著提升了甲乳外科住培医师的专科核心胜任力和应对复杂临床场景的决策能力。
Objective
2
To combine the SPARK learning model with five-step questioning method
construct a new teaching regimen
and evaluate its effectiveness in the resident training in the department of thyroid and breast surgery
and to provide theoretical basis and practical reference for optimizing the training model of specialist physicians.
Methods
2
A total of 104 clinicians in the department of thyroid and breast surgery who participated in standardized training from December 2022 to December 2024 were selected as research subjects. Based on the time of teaching reform (January 2024)
52 clinicians who participated in standardized training from December 2022 to December 2023 were included in the control group; they received the routine teaching method mainly based on the linear teaching process of "theory teaching
clinical demonstration
skill training
and case discussion"
which emphasized knowledge transmission and skill imitation. The 52 clinicians who participated in standardized training from January to December 2024 were assigned to the experimental group; they received SPARK learning model combined with the five-step question teaching method. Teaching evaluation included assessment of basic theory
clinical skills
and clinical thinking as well as satisfaction with teaching. The
t
test and chi-square test were performed using SPSS 26.0.
Results
2
The basic theory assessment and clinical skill assessment scores were significantly higher in the experimental group than in the control group. The scores of all thinking ability dimensions were significantly higher in the experimental group than in the control group [diagnostic decision-making: (21.85±1.15) vs. (18.35±3.42); treatment plan: (24.62±1.52) vs. (20.28±4.13); complication management: (14.82±0.73) vs. (12.17±2.53); evidence-based medicine application: (15.18±0.92) vs. (12.48±2.85); multidisciplinary collaboration: (14.95±0.83) vs. (12.73±3.08); and cost benefit analysis: (8.25±0.42) vs. (6.82±1.53)]. The satisfaction scores were significantly higher in the experimental group than in the control group.
Conclusions
2
Through the organic combination of systematic knowledge construction and critical thinking training
the teaching method integrating SPARK learning model and five-step questioning method can significantly enhance the specialized core competence of residents in the department of thyroid and breast surgery and their decision-making ability to cope with complex clinical scenarios.
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