评估基于进阶式培养和多元化的教学模式对提升住院医师早孕期超声临床胜任力的效果。‌

纳入在北京协和医院超声医学科参加住院医师规范化培训的14名2024级学员，采用理论教学、虚拟仿真教学及临床实践带教的进阶式教学模块，融合病例分析课程如朋辈教学读片、漏误诊病例分析、远程病例会诊等多元化教学模式，开展住院医师早孕期超声培训。采用问卷星网页设计Likert五级量表问卷评估学员早孕期超声认知，在培训实施前和培训结束后发放，以学员对早孕期超声诊断信心自评分和问卷答题正确率为指标评估培训效果，运用χ²检验对比培训前后学员信心水平差异，以P＜0.05为差异有统计学意义。

培训前，绝大多数学员（85.72%，12/14）认为早孕期超声检查为中等及以上难度，仅14.28%（2/14）认为其难度较低。学员对早孕期超声诊断的信心水平普遍偏低，42.86%（6/14）为中等自信，42.86%（6/14）为略微自信，14.28%（2/14）完全不自信。全部学员认为早孕期超声培训重要［35.72%（5/14）同意，64.28%（9/14）强烈同意］，且参训意愿强烈［42.86%（6/14）愿意，57.14%（8/14）非常愿意］。培训后，92.86%（13/14）的学员认为培训对早孕期超声诊断有帮助。学员对早孕期超声诊断信心中等及以上自信率从42.86%（6/14）增至78.57%（11/14，χ²=6.105，P=0.013）。85.71%（12/14）的学员考核答题正确率达80%以上，学员在胚胎发育评估、异位妊娠诊断、双胎绒毛膜性判读等难点存在提升空间。‌

进阶式培养和多元化的教学模式有效提升了住院医师的早孕期超声临床胜任力。

To evaluate the efficacy of stepwise training with a diversified teaching mode in enhancing residents' clinical competency in early pregnancy ultrasound.

This study included 14 first-year residents undergoing standardized training in the ultrasound department at Peking Union Medical College Hospital. An advanced training program was implemented with three progressive modules: theoretical teaching, virtual simulation training, and clinical practice mentorship. The curriculum integrated diversified case-based learning approaches, including peer teaching for image interpretation, analysis of missed and misdiagnosed cases, and remote case consultations. A pre- and post-training Likert-scale questionnaire, designed via Questionnaire Star, was used to assess trainees' understanding of early pregnancy ultrasound. Training efficacy was measured by confidence self-ratings in early pregnancy ultrasound diagnosis and answer accuracy, with χ² tests used to analyze changes in confidence levels.

The majority of trainees (85.72%, 12/14) perceived early pregnancy ultrasound as moderately or highly difficult, with only 14.28% (2/14) rating it as low difficulty. The baseline confidence level of trainees in early pregnancy ultrasound diagnosis was generally low, with 42.86% (6/14) being moderately confident, 42.86% (6/14) slightly confident, and 14.28% (2/14) completely unconfident. All trainees acknowledged the importance of the training [35.72% (5/14) agreed, 64.28% (9/14) strongly agreed], with high participation willingness [42.86% (6/14) willing, 57.14% (8/14) very willing]. Post-training evaluation revealed that 92.86% (13/14) of trainees considered the training helpful for early pregnancy ultrasound diagnosis. The trainees' confidence in early pregnancy ultrasound diagnosis significantly improved, with the moderate-or-higher confidence rate increasing from 42.86% (6/14) to 78.57% (11/14, χ²=6.105, P=0.013). Additionally, 85.71% (12/14) of the trainees achieved an examination answer accuracy rate of 80% or higher. However, challenges remained in embryonic development evaluation, ectopic pregnancy diagnosis, and chorionicity determination for twins.

The stepwise curriculum with diversified teaching mode effectively enhanced residents' clinical competence in early pregnancy ultrasound.