多学科协作的情境模拟教学法在全科医生综合诊疗能力培养中的应用研究
Application of Multi-disciplinary Team-based Situational Simulation Teaching Method in Cultivating Comprehensive Diagnostic and Therapeutic Competencies of General Practitioners
周媚琼 1王燕 1倪明2
作者信息
- 1. 201299 上海市浦东新区人民医院教学部
- 2. 200025 上海市，上海交通大学医学院附属瑞金医院科技发展处
- 折叠
摘要
背景 全科医生的综合诊疗能力对基层医疗质量至关重要，但我国当前的培养模式偏重专科知识，难以应对复杂的健康需求。如何创新教学模式，提升全科医生岗位胜任力，已成为医学教育改革的重点议题。目的 探讨多学科协作（MDT）的情境模拟教学法对全科医生综合诊疗能力的提升效果及应用价值。方法 选取2021年7月—2024年7月于急诊与重症医学科培训的66名全科住院医师为研究对象，按培训批次，采用随机数字表法分为传统教学组（n=20）、情境模拟教学组（n=23）和MDT+情境模拟教学组(n=23)，同一批次教学方法相同。采用理论考核、客观结构化临床技能考核（OSCE）、迷你临床演练评估（Mini-CEX）比较教学效果。采用自主设计的满意度调查问卷对三组全科医生进行教学满意度调查。结果 MDT+情境模拟教学组理论考核成绩、OSCE评分及Mini-CEX各维度得分均优于传统教学组和情境模拟教学组（P<0.05）。教学效果满意度：MDT+情境模拟教学组案例真实性、跨学科融合度、师资引导效果、教师复盘深度、提升临床思维能力、提升团队协作能力、提升人文关怀与医患沟通能力以及对未来临床工作的信心提升得分均高于传统教学组和情境模拟教学组（P<0.05）。结论 MDT的情境模拟教学法能够有效提升全科医生的理论水平、临床技能及跨学科整合能力，对增强岗位胜任力具有显著效果，值得在规范化培训中推广应用。
Abstract
Background The comprehensive diagnostic and therapeutic competency of general practitioners (GPs) is crucial to the quality of primary healthcare. However, the current training model in China tends to focus on specialized knowledge, which is inadequate for addressing complex health needs. Therefore, innovating teaching methods to enhance the job competency of GPs has become a priority in medical education reform.Objective To explore the effectiveness and application value of a Multi-disciplinary Team (MDT)-based situational simulation teaching method in improving the comprehensive diagnostic and therapeutic competencies of general practitioners.Methods A total of 66 GP residents trained in the Department of Emergency and Critical Care Medicine from July 2021 to July 2024 were enrolled. According to the training batches, the participants were divided into a traditional teaching group (n=20), a situational simulation teaching group (n=23), and an MDT + situational simulation teaching group (n=23) using the random number table method, with the same teaching approach applied within each batch.Teaching outcomes were compared using theoretical assessments, objective structured clinical examinations (OSCE), and Mini-Clinical Evaluation Exercises (Mini-CEX). A self-designed satisfaction questionnaire was administered to evaluate the teaching satisfaction of residents in the three groups.Results The MDT (multi-disciplinary team) +Situational Simulation Teaching Group achieved significantly higher scores than both the Traditional Teaching Group and the Situational Simulation Teaching Group in theoretical assessments, OSCE, and all dimensions of the Mini-CEX (P<0.05). Regarding teaching satisfaction, the MDT + Situational Simulation Teaching Group also scored significantly higher in multiple dimensions, including case authenticity, interdisciplinary integration, effectiveness of faculty guidance, depth of instructor debriefing, enhancement of clinical thinking and teamwork skills,improvement in humanistic care and doctor-patient communication, and boosted confidence for future clinical work (all P<0.05). Conclusion The MDT-based situational simulation teaching method can effectively enhance the theoretical knowledge, clinical skills, and interdisciplinary integration abilities of general practitioners, demonstrating significant effects in improving their job competency. It is worth promoting and applying in standardized training programs.关键词
多学科协作/情境模拟教学/全科医生/综合诊疗能力/规范化培训引用本文复制引用
周媚琼,王燕,倪明.多学科协作的情境模拟教学法在全科医生综合诊疗能力培养中的应用研究[EB/OL].(2025-12-29)[2025-12-31].https://chinaxiv.org/abs/202512.00245.学科分类
医学研究方法/教育
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