目的 探讨单病种模块化教学方式在泌尿外科住院医师规范化培训(简称住培)中的应用效果。方法 采用试验对照方法。通过连续抽样法,选取在天津医科大学第二医院泌尿外科轮转的84名住院医师为研究对象。将2022年44名住院医师设为试验组,采用单病种模块化教学方式;2021年40名住院医师设为对照组,采用传统教学方式。培训结束后1个月,通过理论考试、临床技能与临床思维考核及问卷调查评价培训效果。采用独立样本t检验和χ²检验分析相关数据。结果 试验组住院医师的理论考试成绩和临床技能考核成绩均高于对照组住院医师[(87.66±4.47)分比(81.78±5.61)分,(88.95±3.63)分比(80.18±4.62)分, 均P<0.05];试验组住院医师的病历书写规范、临床思维能力、医患沟通技能评分均高于对照组住院医师[(88.80±3.42)分比(82.88±4.01)分,(88.39±3.61分比(81.65±4.69)分,(16.30±2.12分比(13.93±1.86)分],其差异均具有统计学意义(均P<0.001)。教学满意度调查结果显示,试验组住院医师在教学内容的实用性[(4.52±0.59)分比(3.95±0.50)分]、教师的授课能力[(4.50±0.59)分比(3.80±0.56)分]、教学方式的多样性[(4.48±0.55)分比(3.65±0.58)分]、对学习兴趣的激发[(4.52±0.51)分比(3.80±0.52)分]、自主学习能力的提升[(4.16±0.37)分比(3.68±0.53)分]、临床技能的掌握程度[(4.07±0.26)分比(3.63±0.49)分]、病历书写规范的提高[(4.02±0.34)分比(3.75±0.44)分]、临床思维能力的提升[(4.07±0.40)分比(3.55±0.60)分]、医患沟通技巧的提高[(4.11±0.44)分比(3.75±0.59)分]、对此次培训的总体满意度[(4.18±0.50)分比(3.88±0.52)分]等方面的评分均高于对照组住院医师(均P<0.05);指导医师对试验组住院医师的综合评价(91.48±3.23分)高于对照组住院医师(85.83±3.73)分,其差异具有统计学意义(P<0.001)。结论 单病种模块化教学方式有助于泌尿外科住院医师理解和掌握理论知识,提高其临床技能、临床思维和教学满意度。

Objective To explore the application of single-disease modular teaching in the standardized training of resident physicians in urology (referred to as residency training). Methods A controlled trial was conducted. Through consecutive sampling, 84 residents rotating in the Department of Urology, the Second Hospital of Tianjin Medical University enrolled in the study. Among them, 44 residents in 2022 were assigned to the experimental group, receiving single-disease modular teaching; 40 residents in 2021 served as the control group, undergoing traditional teaching. One month after training, the training effect was evaluated through knowledge examinations, clinical skills and clinical thinking assessments, and questionnaires. Independent sample t-test and χ² test were used for data analysis. Results The experimental group showed significantly higher scores than the control group in knowledge examination [(87.66±4.47) vs. (81.78±5.61)] and clinical skills assessment [(88.95±3.63) vs. (80.18±4.62)] (all P<0.05). In terms of medical record writing standardization [(88.80±3.42) vs. (82.88±4.01)], clinical thinking ability [(88.39±3.61) vs. (81.65±4.69)], and doctor-patient communication skills [(16.30±2.12) vs. (13.93±1.86)], the experimental group also achieved significantly higher scores (all P<0.001). Teaching satisfaction survey showed that the experimental group scored higher in all dimensions: practicality of teaching content [(4.52±0.59) vs. (3.95±0.50)], teaching ability of instructors [(4.50±0.59) vs. (3.80±0.56)], diversity of teaching methods [(4.48±0.55) vs. (3.65±0.58)], stimulation of learning interest [(4.52±0.51) vs. (3.80±0.52)], improvement of autonomous learning ability [(4.16±0.37) vs. (3.68±0.53)], mastery of clinical skills [(4.07±0.26) vs. (3.63±0.49)], standardization of medical record writing [(4.02±0.34) vs. (3.75±0.44)], enhancement of clinical thinking [(4.07±0.40) vs. (3.55±0.60)], improvement of doctor-patient communication [(4.11±0.44) vs. (3.75±0.59)], and overall satisfaction [(4.18±0.50) vs. (3.88±0.52)] (all P<0.05). Additionally, the comprehensive evaluation of the experimental group by instructors was significantly higher than the control group [(91.48±3.23) vs. (85.83±3.73)] , and the difference was statistically significant (P<0.001). Conclusions Single-disease modular teaching helps urology residents understand and master theoretical knowledge, and improves their clinical skills, clinical thinking, and teaching satisfaction.