目的 探讨结构化问诊在妇产科学临床实习教学中的应用效果。方法 采用试验对照方法,选取2021年9月至2023年9月在武汉大学第一临床学院妇产科实习的2017级和2018级临床医学专业共206名学生为研究对象,采用随机数字表法将其分为两组,其中试验组98名学生接受结构化问诊教学,对照组108名学生接受常规问诊教学。采用问诊考核和患者满意度问卷调查评价两组学生的教学效果。采用t检验和χ²检验分析数据。结果 试验组学生问诊考核成绩[(80.34±3.18)分]高于对照组学生[(77.39±3.23)分],差异具有统计学意义(P＜0.001),主要体现在试验组学生现病史评分[(33.49±1.23)分]高于对照组学生[(32.60±1.92)分];月经婚育史评分[(12.54±1.73)分]高于[(11.38±1.11)分],其差异均具有统计学意义(均P＜0.05);对照组学生的问诊时长[(12.34±1.71)分钟]少于试验组学生[(14.89±2.04)分钟],其差异具有统计学意义(P＜0.001);试验组学生的患者满意度评分[(15.35± 1.42)分]高于对照组学生[(14.50±1.58)分],其差异具有统计学意义(P＜0.001);试验组学生的打断次数(3.05±0.81)次少于对照组学生的(3.92±0.94)次,其差异具有统计学意义(P＜0.001)。结论 结构化问诊有助于提高妇产科学实习生的问诊技巧和患者满意度,有助于提升学生医患沟通能力,可以进一步推广。

Objective This study aims to investigate the impact of implementing structured questioning techniques in the clinical internship education of obstetrics and gynecology. Methods Utilizing a trial-control methodology, this study selected 206 clinical medicine students from the 2017 and 2018 cohorts who interned in the Department of Obstetrics and Gynecology at the First Clinical College of Wuhan University between September 2021 and September 2023. The participants were randomly assigned into two groups using a random number table. The experimental group, comprising 98 students, received instruction in structured questioning and diagnosis, whereas the control group, consisting of 108 students, was taught using conventional questioning and diagnosis techniques. A questioning assessment and a patient satisfaction questionnaire were employed to evaluate the educational outcomes of the two student groups. Statistical analyses were conducted using the t test and χ² test to interpret the data. Results The test group students′ scores on the diagnostic examination (80.34±3.18) were higher than those of the control group students (77.39±3.23), and the difference was statistically significant (P<0.001), which was mainly reflected in the fact that the test group students′ scores on the history of current illnesses (33.49±1.23) were higher than that of the test group students (32.60±1.92), and that the scores on the history of menstruation and marriage and parenthood (12.54±1.73) were higher than that of the control group students (11.38±1.11), all P<0.05. The length of consultation of the control group students (12.34±1.71) minutes was less than that of the experimental group students (14.89±2.04) minutes, and the difference was statistically significant (P<0.001); and the patient satisfaction scores of the experimental group students (15.35±1.42) were higher than that of the control group students ( 14.50±1.58), the difference was statistically significant (P<0.001), mainly reflected in the number of interruptions of students in the experimental group (3.05±0.81) was significantly less than that of students in the control group (3.92±0.94), and the difference was statistically significant (P<0.001). Conclusions The implementation of structured questioning techniques enhances the questioning abilities and patient satisfaction levels among obstetrics and gynecology interns, while also advancing students′ doctor-patient communication skills, which can be further developed.