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目的:分析临床路径(CP)联合基于问题学习(PBL)模式用于神经内科住院医师规范化培训的效果,为临床教学提供科学参考。方法:选取2013级、2014级、2015级在神经内科轮转的住院医师100例,随机分为联合教学组(观察组)和传统教学组(对照组)各50例。观察组采用CP、PBL联合教学模式,对照组采用传统教学方法。采取考核和问卷调查等方式,评估培训效果及学员和患者的满意度。结果:观察组理论成绩、病例分析和总成绩显著或非常显著优于对照组(P<0.05,P<0.01);两组参与讨论的成绩差异不显著(P>0.05)。观察组认为神经内科专科知识要点掌握程度较好45例,占90.0%;认为熟悉专科工作42例,占84.0%。对照组认为神经内科专科知识要点掌握程度较好36例,占72.0%;认为熟悉专科工作33例,占66.0%。两组比较,差异显著(P<0.05)。观察组对培训满意46例,占92.0%;对照组为32例,占64.0%。两组比较,差异非常显著(P<0.01)。患者对观察组的满意度为83.5%,显著高于对照组的67.6%(P<0.05)。结论:CP、PBL联合教学模式可提高神经内科住院医师规范化培训的质量及学员与患者的满意度。
OBJECTIVE: To analyze the clinical pathology (CP) combined with the problem-based learning (PBL) model for neurosurgery residency standardization training effect, to provide a scientific reference for clinical teaching. Methods: A total of 100 residents residing in the Department of Neurology, 2013, 2014 and 2015, were randomly divided into two groups: the joint teaching group (observation group) and the traditional teaching group (control group), 50 cases each. Observation group using CP, PBL joint teaching mode, the control group using traditional teaching methods. Take assessment and questionnaires, etc., to assess the effectiveness of training and the satisfaction of students and patients. Results: The results of the observation group, case analysis and total score were significantly better than those of the control group (P <0.05, P <0.01). There was no significant difference between the two groups (P> 0.05). In the observation group, 45 cases (90.0%) had good mastery of neurology specialist knowledge, and 42 (84.0%) were experts in specialization. In the control group, 36 cases (72.0%) had good mastery of neurological specialties, and 33 cases (66.0%) thought they were familiar with specialist work. The difference between the two groups was significant (P <0.05). The observation group was satisfied with training 46 cases, accounting for 92.0%; control group, 32 cases, accounting for 64.0%. The differences between the two groups were significant (P <0.01). Patient satisfaction with the observation group was 83.5%, significantly higher than 67.6% of the control group (P <0.05). Conclusion: The combined teaching mode of CP and PBL can improve the quality of standardized training of residents in neurology and the satisfaction of students and patients.