目的 探讨情景模拟教学方法在妇产科住院医师规范化培训(简称住培)中的应用效果。方法 选取2016至2021年福建医科大学附属第一医院妇产科住培学员61名为研究对象,采用随机数字表法将其分为试验组和对照组,试验组31名学员采用情景模拟教学,对照组30名学员采用传统教学。采用客观结构化临床考试(objective structural clinical examination,OSCE)、教育环境评估量表和调查问卷评价教学效果。采用χ²检验和t检验比较两组学员考试成绩差异。结果 试验组学员OSCE总成绩为[(370.16±6.19)分],高于对照组学员[(343.63±8.94)分],其差异具有统计学意义(t=13.51,P＜0.001);试验组学员对学习、教师、学术和教育环境4方面知觉评分分别为(29.35±2.15)分、(32.06±2.32)分、(22.13±1.76)分和(31.19±3.08)分,均高于对照组学员的(25.53±1.94)分、(27.90±2.55)分、(19.27±2.52)分和(27.93±2.86)分,其差异均具有统计学意义(均P＜0.05);试验组学员对学习效率、自信心、临床思维能力、分析问题能力、临床操作能力、团队合作能力等6方面满意度评分分别为(4.61±0.49)分、(4.58±0.50)分、(4.71±0.46)分、(4.81±0.40)分、(4.74±0.44)分和(4.74±0.44)分,均高于对照组学员的(4.17±0.59)分、(4.20±0.66)分、(4.13±0.57)分、(4.03±0.40)分、(4.23±0.63)分和(4.07±0.42)分,其差异均具有统计学意义(均P＜0.05)。结论 在妇产科住院医师规范化培训中应用情景模拟教学有助于提高住培学员的OSCE成绩,并得到学员的一致认可,是一种行之有效的教学方式。

Objective To evaluate the teaching effect of scenario simulation in the residents standardized training of obstetrics and gynecology. Methods Sixty-one trainees who joined the program of standardized residential training from 2016 to 2021 in the department of obstetrics and gynecology of the First Affiliated Hospital of Fujian Medical University were randomly divided into experimental group(n=31) and control group(n=30). The experimental group was trained by scenario simulation method and the control group accepted the training by traditional method. Then the objective structured clinical examination(OSCE), educational environment assessment scale and questionnaire survey were used to evaluate the teaching effect. χ² test and t test were used to compare the differences between the two groups. Results The OSCE grade from experimental group (370.16±6.19) and control group (343.63±8.94) were significantly different(t=13.51,P＜0.001). The perception scores of learning,teachers’performance, academic and learning environment from the trainees of experimental group were (29.35±2.15),(32.06±2.32),(22.13±1.76) and (31.19±3.08), respectively, that were significantly higher than those of trainees from control group (25.53±1.94),(27.90±2.55),(19.27±2.52) and (27.93±2.86)(all P＜0.05). The scores of learning efficiency, self-confidence, capacity of clinical reasoning, problem analysis, clinical skill and team cooperation from experimental group were(4.61±0.49),(4.58±0.50),(4.71±0.46),(4.81±0.40),(4.74±0.44)and (4.74±0.44) respectively, which were higher than those from the control group (4.17±0.59),(4.20±0.66),(4.13±0.57)、(4.03±0.40),(4.23±0.63) and(4.07±0.42), the differences were statistically significant (all P＜0.05). Conclusions Scenario simulation is an effective teaching method for the standardized training of obstetrics and gynecology residents, which is proven by improved OSCE performance and well recognized by of the resident trainees.