基于多学科协作的 CBL 教学法对提高全科医师临床应诊能力的影响研究
he Impact of MDT-based CBL Education Mode on Improving Clinical Practice Skills of General Practitioners
背景 培养高质量的全科医学人才是维护人民群众身体健康的核心，但我国现有的全科医生培养方式仍存在不足，致使全科医生在基层医疗服务中岗位胜任力不足，故如何提高全科医生的岗位胜任力是目前全科医学教学的重中之重。目的 探索基于多学科协作的 CBL 教学法对提高全科医师临床应诊能力的影响。方法 选取 2020 年7 月—2023 年 7 月在呼吸与危重症医学科培训的 26 名全科医生为研究对象，均签署知情同意书，按批次分为三组：传统教学组，CBL 教学组和多学科写作诊疗（MDT）+CBL 教学组，同一批次教学方法相同。分别采用传统教学方法、CBL 教学法和 MDT+CBL 教学法，采用莱斯特评估套件（LAP）对学员临床应诊能力进行评价，并采用自主设计的匿名调查问卷进行教学满意度调查。结果 理论考核成绩：MDT+CBL 教学组考试成绩优于传统教学组和单纯 CBL 教学组（P<0.05）。临床应诊能力考核：MDT+CBL 教学组 LAP 总分高于传统教学组和 CBL 教学组（P<0.05），MDT+CBL教学组在接诊和病史采集、患者管理、解决问题、医生行为和与患者的关系及预防性治疗方面的得分均高于传统教学组和 CBL 教学组（P<0.05）。教学效果的满意度：三种教学模式中 MDT+CBL 教学模式总体满意度得分高于 CBL 教学组和传统教学组（P<0.05），且 MDT+CBL 教学组学员的知识外延能力、指导健康生活方式能力、处理合并症能力、指导患者康复能力和社区合理用药能力得分更高（P<0.05）。结论 基于多学科协作的 CBL 教学法有助于提高全科医师的临床应诊能力，提升岗位胜任力，是全科医学教学新模式。
BackgroundThe development of excellent general practitioners is essential to preserving people's health. Unfortunatelythe general practitioner training model in place today is insufficientwhich leaves them unqualified to provide primary medical services. Consequentlyenhancing clinical competency should be the main goal of general practitioners' training. ObjectiveTo investigate how general practitioners' clinical practice abilities are affected by MDT-based CBL education. MethodsFrom July 2020 to July 202326 trainee general practitioners received training at the department of pulmonary and critical care medicine as part of their residency programme. As research subjectsthey all signed informed consent. They were divided three groups and trained with different modeltraditional modelCBL model and MDT-based CBL modelrespectively. Leicester Assessment PackageLAP was used to assess their clinical practice skills by the end. Self-designed questionnaire was used for satisfaction survey anonymously. The results were analyzed statistically. ResultsThe MDT-based CBL teaching group outperformed the traditional teaching group and the CBL teaching group in the theoretical examination. The MDT-based CBL teaching group had a significantly higher total LAP score P<0.05 in comparison to either the conventional teaching group or CBL teaching group. Further investigation revealed that the MDT-based CBL teaching group performed betterP<0.05 in the part of patient admissionscollecting medical historiespatient managementproblem solvingphysician behavior patient relationshipand preventive therapy. The students from the MDT-based CBL model had the best overall satisfaction with a significant difference comparing the students from the CBL and traditional teaching groupsP<0.05. Additionally the MDT-based CBL teaching group showed a significant improvement in their capacity to guide healthy lifestyledeal with commoditiesguide patient recoveryand use medications after dischargeP<0.05. ConclusionA novel training approach for general practitionerthe MDT-based CBL teaching mode may enhance the clinical practice abilities and competency of general practitioners.
陈炼、李静、姬路鹏、杨士芳、陈雪莹、李晓明、赵满芝、黄国华、崔景华
10.12114/j.issn.1007-9572.2023.0796
临床医学教育
全科医师岗位胜任力多学科协作BL 教学法临床应诊能力
陈炼,李静,姬路鹏,杨士芳,陈雪莹,李晓明,赵满芝,黄国华,崔景华.基于多学科协作的 CBL 教学法对提高全科医师临床应诊能力的影响研究[EB/OL].(2024-07-02)[2025-08-05].https://chinaxiv.org/abs/202407.00047.点此复制
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