2024 , Vol. 21 >Issue 08: 809 - 813
DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2024.08.010
北京协和医院超声医学科住院医师读片会教学效果研究
Copy editor: 汪荣
收稿日期: 2024-05-29
网络出版日期: 2024-09-11
基金资助
国家卫生健康委员会科技教育司委托项目(FW-QYQT2022091301622)
版权
Teaching effectiveness of residents' case learning meetings in Department of Ultrasound Medicine of Peking Union Medical College Hospital
Received date: 2024-05-29
Online published: 2024-09-11
Copyright
分析北京协和医院超声医学科住院医师规范化培训学员对读片会教学的反馈意见,探讨住院医师读片会的教学效果和提升方向。
纳入2021年9月至2023年9月进入北京协和医院超声医学科的规范化培训住院医师共计40人。每周一次的读片会上,由2名住院医师分别针对一个病例或一个临床问题进行汇报,督导教师进行点评并引导全体住院医师进行自由讨论。采用问卷调查对教学活动效果进行评估,分析问卷结果并比较不同年级住院医师之间的差异。
共有40名住院医师参加调查,其中一年级14人、二年级13人、三年级13人。对于读片会教学整体满意率为95%(38/40);对读片会举办频率、举办时间和线上-线下结合的会议形式认同率高(分别为85%、85%、100%)。随年级增高,读片会参会频率下降,3组间比较差异有统计学意义(χ2=16.765,P=0.00215)。病例选择方面,相比于肿瘤性疾病和多系统/脏器受累综合征,选择急诊来源病例(95%)、罕见/疑难病例(82.5%)和常见/基础病例(75%)的比例更高。具体地,一年级更倾向于急诊和常见病(26/44,59.1%),二年级对于急诊和疑难罕见病例更感兴趣(24/43,55.8%),三年级对急诊、罕见病、常见基础病、肿瘤性病变和多系统综合征等各类疾病均有学习需求。在各系统性疾病中,相比于消化系统、泌尿系统、心血管系统及其他(5%),更多学员认为读片会教学在妇产科病例(57.5%)和浅表器官病例(37.5%)两方面帮助更大。
北京协和医院超声医学科读片会对于住院医师能力提升具有积极意义,未来应在教学内容、教学模式以及分级教学等方面作出改进,适应住院医师培训需求,帮助其提高职业胜任力。
刘真真 , 葛志通 , 赵瑞娜 , 彭思婷 , 董一凡 , 王欣 , 张睿 , 朱庆莉 , 李建初 , 杨筱 . 北京协和医院超声医学科住院医师读片会教学效果研究[J]. 中华医学超声杂志(电子版), 2024 , 21(08) : 809 -813 . DOI: 10.3877/cma.j.issn.1672-6448.2024.08.010
To explore the direction of improving the teaching effectiveness of residents' case learning meetings based on the feedback from the specialty training residents in the Ultrasound Medicine Department of Peking Union Medical College Hospital.
A total of 40 residents who underwent specialty training at the Department of Ultrasound Medicine of Peking Union Medical College Hospital from September 2021 to September 2023 were included. During each weekly case learning meeting, two physicians each reported one case or discussed around one clinical issue separately. The supervising teacher provided feedback and guided all attending residents to have free discussions. We designed a survey questionnaire to assess the effectiveness of this teaching form, including the differences between physicians from different grades.
A total of 40 resident physicians participated in the survey, including 14, 13, and 13 in the first, second, and third grade, separately. The overall satisfaction rate with the case learning meetings was 95% (38/40). The agreement rates for meeting frequency and duration, and the combination of online and offline forms were satisfactory (85%, 85%, and 100%, respectively). There were differences in the participation frequency and learning needs among students of different grades. As the grade increased, the participation frequency decreased. In terms of learning needs, the first grade students tended to focus on emergency and common basic diseases (number of votes 26/44, 59.1%), the second grade students were more interested in emergencies and difficult or rare cases (number of votes 24/43, 55.8%), and the third grade students had learning needs for various types of diseases including emergencies, difficult or rare diseases, common basic diseases, tumor lesions, and multiple system syndromes. Compared to the digestive system, urinary system, and cardiovascular system (total voting rate 5%), more students believed that it was more helpful to discuss obstetrics and gynecology cases (57.5%) and superficial organs (37.5%).
The residents' case learning meeting in the Department of Ultrasound Medicine of Peking Union Medical College Hospital has positive significance in improving the abilities of resident physicians. The organizers should make improvements in teaching content, meeting mode, and graded teaching to accurately adapt to the training needs of resident physicians and help enhance their professional competence.
表1 调查问卷题目 |
序号 | 问题 |
---|---|
学生基本情况 | |
1 | 请问您目前处于规培第几年? |
2 | 请问您的角色是什么? |
参会情况调查 | |
3 | 大约多久能够参加一次读片会? |
4 | 在过去的一年中,您参加了多少次读片会? |
课程时间、上课方式调查 | |
5 | 您认为读片会的频率应该如何调整?(开放式作答) |
6 | 目前读片会安排在每周三中午,请问该时间是否合理? |
7 | 目前为线上、线下结合进行,请问此形式是否为最佳? |
8 | 现有讨论题目数量为2个、由2位医生发言,你认为是否合理? |
课程内容调查 | |
9 | 现有内容包括一线汇报-督导点评-共同讨论,请你对此提出改进建议(开放式作答) |
10 | 你认为哪些病例最适合在读片会中进行分享讨论?(不定项选择) |
11 | 你认为以下哪些方法能够提高该教学活动的效果?(不定项选择) |
效果调查 | |
12 | 作为读片会的参与者,你在哪些方面有收获?(不定项选择) |
13 | 通过读片会你的哪些能力得以加强?(多选) |
14 | 读片会中的哪个环节收获最大 |
15 | 读片会教学对您在哪个系统的影像诊断能力提升帮助最大? |
现有问题和改进建议 | |
16 | 您对读片会的整体满意度是什么? |
17 | 对于超声读片会的组织者,您有什么建议或期望? |
18 | 您认为如何能够更有效地增进参与者之间的交流和讨论? |
表2 读片会调查问卷中关于课程内容和效果的部分题目(多选题)答题分布 |
题目 | 选项 | 人数(例) | 百分比(%) |
---|---|---|---|
你认为哪些病例最适合在读片会中进行分享讨论? | 急诊来源典型急重症影像病例 | 38/40 | 95 |
罕见病例或疑难病例 | 33/40 | 82.5 | |
常见基础病变教学病例 | 30/40 | 75 | |
肿瘤性病变 | 20/40 | 50 | |
多系统或多脏器受累综合征 | 17/40 | 42.5 | |
你认为以下哪些方法能够提高该教学活动的效果? | 邀请相应亚专业组高年资医师参加讨论 | 34/40 | 85 |
督导老师对关键问题进行点名发言和提问 | 15/40 | 37.5 | |
先不给出关键问题的答案,设置提问环节 | 13/40 | 32.5 | |
进行课后小测验 | 4/40 | 10 | |
作为读片会的参与者,你在哪些方面有收获? | 认识罕见病例 | 32/40 | 80 |
构建知识体系 | 30/40 | 75 | |
增进交流、增加学习的兴趣和主动性 | 26/40 | 65 | |
锻炼组织能力、教学相长 | 8/40 | 20 | |
提高文献学习能力 | 6/40 | 15 | |
通过读片会你的哪些能力得以加强? | 相关临床知识、诊疗常规等 | 39/40 | 97.5 |
对疾病图像的理解 | 34/40 | 85 | |
疾病诊断和鉴别诊断 | 32/40 | 80 | |
基础医学知识(解剖、组胚、病理等) | 13/40 | 32.5 | |
医患沟通能力 | 5/40 | 12.5 | |
读片会中的哪个环节收获最大? | 汇报准备阶段 | 18/40 | 45 |
病例汇报过程 | 13/40 | 32.5 | |
督导点评 | 7/40 | 17.5 | |
自由讨论 | 2/40 | 5 | |
读片会教学对您在哪个系统的影像诊断能力提升帮助最大? | 妇产科 | 23/40 | 57.5 |
浅表器官 | 15/40 | 37.5 | |
泌尿系统 | 1/40 | 2.5 | |
消化系统、心脏、大血管 | 0 | 0 | |
其他 | 1/40 | 2.5 |
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