目的 探讨改良Peyton四步教学法在儿科住院医师基本技能操作培训中的应用效果。方法 采用试验对照方法。2021年1月至2022年12月,选取在深圳市儿童医院接受规范化培训的儿科第一年住院医师83人为研究对象,以2022年41名住院医师为试验组,采用改良Peyton四步教学法,以2021年42名住院医师为对照组,采用传统模拟教学方法。通过两组住院医师的理论知识和技能操作考核成绩、首次执业医师资格考试通过率、培训后1年的操作技能直接观察评估和问卷调查结果进行教学效果评价。采用t检验和卡方检验分析相关数据。结果 两组住院医师的理论知识考核成绩分别为(82.22±4.60)分、(81.81±5.31)分,差异无统计学意义(P=0.712)。试验组的技能操作考核成绩、首次执业医师资格考试通过率、培训后1年操作技能直接观察评估整体表现均高于对照组[(88.27±4.97)分比(81.88±3.99)分,100.0%(41/41)比85.7%(36/42),(7.73±1.00)分比(6.64±1.19)分];试验组住院医师的教学满意度评分高于对照组[(4.71±0.46)分比(4.24±0.73)分],以上差异均具有统计学意义(均P<0.05)。结论 改良Peyton四步教学法有助于儿科住院医师临床基本技能操作的即时习得和长期保留效果,提升了教学成效和满意度。

Objective To explore the application of modified Peyton′s four-step teaching in the basic skills training for pediatric resident physicians. Methods Experimental control methods was used. A total of 83 pediatric first-year residents who received standardized training at Shenzhen Children′s Hospital were selected as the research subjects, among whom 41 residents in 2022 were selected as the experimental group using modified Peyton′s four-step teaching, whereas 42 residents in 2021 were selected as the control group using traditional simulation teaching methods. The teaching effectiveness was evaluated through the theoretical knowledge and skill operation assessment scores of two groups, the pass rate of the first licensed physician qualification exam, direct observation of procedural skills one year after training, and questionnaire survey results. Student t-test and chi square test were used to analyze relevant data. Results There was no significant difference between the two groups in the scores of knowledge tests [(82.22±4.60) vs. (81.81±5.31), P=0.712]. The overall performance of the experimental group in skill operation assessment, passing rate of the first licensed physician qualification exam, and direct observation of procedural skills after one year of training were higher than those of the control group [(88.27±4.97) vs. (81.88±3.99), 100.0%(41/41) vs. 85.7%(36/42), (7.73±1.00) vs. (6.64±1.19)]; satisfaction scores of resident physicians in the experimental group were higher than those in the control group [(4.71±0.46) vs. (4.24±0.73)], and the above differences were statistically significant (all P<0.05). Conclusions The modified Peyton′s four-step approach is helpful to the immediate acquisition and long-term retention of the basic clinical skills for pediatric resident physicians, and improve the teaching effectiveness and satisfaction.