目的 评价原位模拟和引导性反馈在住院医师规范化培训(以下简称住培)小讲课督导培训中的应用效果。方法 2020年6月至8月,选取18名督导学员,以理论授课、第一轮实践培训、第二轮实践培训、线下练习、第三轮实践培训的流程,综合运用理论授课、原位模拟和引导性反馈的教学方法进行培训。比较每轮培训后督导学员与培训教师对小讲课评分的差异。结果 第一轮～第三轮督导学员与培训教师的总评分差值分别为12.00(5.50,17.00)、4.00(2.00,8.00)、6.00(2.75,11.25),第二轮与第一轮评分差值的差异具有统计学意义(Z=2.49,P=0.01),第二轮与第三轮评分差值的差异无统计学意义(Z=0.78,P=0.44)。结论 综合运用原位模拟与引导性反馈方法能迅速降低督导学员与培训教师对小讲课评分的差异,有助于提高督导学员评分的准确性。

Objective To evaluate in situ simulation and instructive feedback teaching method in the training of supervisor of teaching process for residential training. Methods From June to August 2020, 18 trainees were selected for lecture supervisor training for in situ simulation, instructive feedback and lecturing. The training process included theoretical teaching, two rounds of skill training (demonstration-rating-feedback), offline practice and the third round of practical training (demonstration-rating-feedback). Results The median and quartile of score difference of the three rounds was 12.00(5.50, 17.00) (the first round), 4.00(2.00, 8.00) (the second round) and 6.00(2.75, 11.25) (the third round). Through Wilcoxon Matched-Pairs Signed-Ranks Test to compare with the score difference of the first round, the score difference of the second round (Z=2.49,P=0.01), there is no significant difference between the second and the third round (Z=0.78,P=0.44). Conclusions The method of in situ simulation integrated with instructive feedback effectively minimizes the difference of evaluation results (scores) from supervision experts and that from training consultant, so as to improve the consistency and accuracy of the evaluation results from the lecture supervisors.