目的 探讨临床病理讨论会(clinical pathological conference, CPC)在肾内科住院医师规范化培训中的应用效果。方法 本研究采用试验对照方法,2021年6月至2022年9月,选取北京大学第三医院肾内科接受住院医师规范化培训的81名学员为研究对象,其中47名作为试验组,在肾内科教学中采用CPC;34名因受新型冠状病毒肺炎疫情影响采用传统教学方式,作为对照组。通过肾脏病临床和病理诊断考核、教学满意度调查评估教学效果,组间比较采用t检验和χ2检验。结果 试验组学员考核成绩为(89.36±16.07)分,高于对照组学员的(74.71±25.73)分,差异具有统计学意义(P=0.005)。对各自教学方式的满意度,试验组学员为[93.6%(44/47)]高于对照组学员的[76.5%(26/34)] ,差异具有统计学意义(P=0.026)。试验组学员中,46名(97.9%)认为CPC有助于加深理论知识的理解和记忆,45名(95.7%)认为CPC有助于提高解决临床问题的能力并有更多机会学习不同病例。结论 肾内科住院医师规范化培训中采用CPC有助于住院医师理解和掌握肾脏疾病临床和病理诊断,并且得到住院医师的认可。
Objective To explore the effect of clinical pathological conference (CPC) in standardized residency training in nephrology. Methods The experimental control method was used in this study. From June 2021 to September 2022, 81 residents who underwent standardized residency training inDepartment of Nephrology of Peking University Third Hospital were selected as the research subjects. Among them, 47 residents were assigned to the experimental group to participate in CPC, while 34 residents were assigned to the control group, who received the traditional teaching method due to the COVID-19 pandemic. The teaching effect was evaluated by clinical and pathological examination of kidney disease and satisfaction survey. T-test and χ2 test was used to compare the results of the two groups. Results The scores of clinical and pathological examination from the experimental group (89.36±16.07) was higher than that from the control group (74.71±25.73)(P=0.005). The satisfaction of students in the experimental group [93.6% (44/47)] was higher than that in the control group [76.5% (26/34)](P=0.026). Overall, 46(97.9％) residents from the experimental group believed that CPC contributed to deepening the understanding and memory of theoretical knowledge, and 45(95.7％) residents believed that CPC contributed to improving the ability to solve clinical problems and having more opportunities to learn different cases. Conclusions The application of CPC in standardized resident training in nephrology is helpful for residents to understand and master the clinical and pathological diagnosis of renal disease.
[1] 赵允伍, 王珩, 陈旭林, 等. 我国住院医师规范化培训问题分析与对策探讨[J].卫生经济研究,2019,36(3):12-14.
[2]金华, 王亿平, 张磊, 等. 病例教学法在肾脏病理教学中的应用效果分析[J].中国高等医学教育,2020(7):102-103. DOI: 10.3969/j.issn.1002-1701.2020.07.051.
[3]孙保存. 病理学实验[M].北京:人民卫生出版社, 2007: 274.
[4]陈红, 金木兰. 临床病理讨论在病理住院医师规范化培训中的作用[J].中国病案,2022,23(10):99-101. DOI: 10.3969/j.issn.1672-2566.2022.10.034.
[5]刘海军. 临床病理讨论会在全科医生肾脏科转岗培训中的效果[J].山东医学高等专科学校学报,2014(5):328-330. DOI: 10.3969/j.issn.1674-0947.2014.05.004.
[6]张国艳, 刘艳姝, 隋洪玉. 讨论式教学和传统教学在肾脏内科病理教学中的效果研究[J].医学信息,2018,31(15):12-13. DOI: 10.3969/j.issn.1006-1959.2018.15.006.
[7]Harris C, Kloubec J. Assessment of student experience in a problem-based learning course using the course experience questionnaire[J]. J Nutr Educ Behav, 2014,46(4):315-319. DOI: 10.1016/j.jneb.2013.12.002.
[8]张熙洋, 周凌, 兰学立. 讨论式教学方法在检体诊断学异常体征实习教学中的应用[J].中华医学教育杂志,2020,40(10):762-765. DOI: 10.3760/cma.j.cn115259-20191126-01023.
[9]金晓东. 病理学实验教学中临床病理讨论法的应用分析[J].中国卫生产业,2022,19(3):209-212. DOI: 10.16659/j.cnki.1672-5654.2022.03.209.
[10]张秋菊, 李能莲, 刘靓, 等. 临床病理讨论法在病理学实验教学中的实践与探索[J].中国中医药现代远程教育,2018,16(16):18-20. DOI: 10.3969/j.issn.1672-2779.2018.16.008.
[11]刘玉婷, 尚东浩. 病理学相关课程及教学方法改革的总结及思考[J].医学教育管理,2019,5(z1):3-5. DOI: 10.3969/j.issn.2096-045X.2019.S.002.
[12]唐群, 吴华, 雷久士, 等. 临床病理讨论在病理学教学中的应用和效果[J].中国病案,2016,17(1):84-86.
[13]王妮燕. 临床病理讨论法在病理学实验教学中的应用探究[J].中国卫生产业,2019,16(25):133-134. DOI: 10.16659/j.cnki.1672-5654.2019.25.133.
[14]葛晓雯, 陈伶俐, 刘亚岚, 等. 临床病理专科医师规范化培训中多形式教学模式的运用及初步成效[J].中华病理学杂志,2020,49(8):876-878. DOI: 10.3760/cma.j.cn112151-20191219-00812.
