培养并提升全科思维一直是口腔全科医师培养的重点和难点,而目前采取的在口腔全科范围内各亚专业科室轮转的形式难以满足口腔全科医师的培养需求。牙外伤教育具有涉及多个亚专业的特点,这使其成为口腔全科综合思维能力训练的有效手段之一。本研究选择2023年1至12月在首都医科大学附属北京友谊医院口腔科参加口腔全科住院医师规范化培训的39名住院医师进行“牙外伤+”整合课程培训,其内容包括牙外伤理论教学(每周1讲,共3讲)和“牙外伤+”为主题的病例精讲(每周1讲,共10讲)。采用理论考试、病例分析和问卷调查等方式评价“牙外伤+”整合课程在提升口腔全科住院医师综合思维能力中的作用。采用独立样本t检验、Fisher精确检验对考核结果进行统计学分析。课程教学结束后,共有33名住院医师参加考试和问卷调查。结果显示,课程实施前后口腔全科住院医师牙外伤认知水平评分从(66.41±13.42)分提高至(80.50±12.24)分,其差异具有统计学意义(P<0.001);牙外伤病例诊断正确率从64.1%(25/39)提升到100.0%(33/33),其差异具有统计学意义(P<0.001);90.9%(30/33)的住院医师认为“牙外伤+”整合课程对提升其牙外伤的诊治能力以及综合诊疗思维很有帮助。“牙外伤+”整合课程从不同角度整合了多个口腔亚专业教学内容,有助于提高口腔全科住院医师对复杂病情的临床诊疗能力和综合思维能力。

Cultivating and enhancing integrative cognitive competence has long been a key focus and challenge in the training of dental generalists. However, the traditional discipline-specific teaching model in stomatology is increasingly falling short of meeting the educational demands for cultivating dental generalists. Dental trauma education, characterized by their involvement of multiple sub-disciplines, have emerged as effective approaches for training integrative cognitive competence in general dentistry. The study conducted the ″Dental Trauma+″ serial courses for 39 residents who participated in the standardized training of dental general practice in the Department of Stomatology, Beijing Friendship Hospital, Capital Medical University from January 2023 to December 2023, including theoretical teaching of dental trauma (1 lecture per week, 3 lectures in total) and case lectures with the theme of ″Dental Trauma+″ (1 lecture per week, 10 lectures in total). The residents' cognitive level of dental trauma diagnosis and treatment ability before and after the training was compared through theoretical test, cases analysis test and questionnaires, and statistical analysis was performed to evaluate the role of the ″Dental Trauma+″ serial courses in improving the integrative cognitive competence of the residents. The independent sample t test and Fisher's exact test were used to statistically analyze the assessment results. After the courses,a total of 33 residents participated in the examination and questionnaire survey. The residents' dental trauma cognitive level scores were significantly increased from (66.41±13.42) points to (80.50±12.24) points (P<0.001). The diagnostic accuracy of dental trauma cases increased from 64.1%(25/39) to 100.0%(33/33), and the difference was statistically significant (Fisher's exact test, P<0.001), and 90.9%(30/33) of the residents believed that these ″Dental Trauma+″ serial courses were very helpful in improving their dental trauma diagnosis and treatment ability and integrative cognitive competence of dental general practice. The ″Dental Trauma+″ serial courses integrate the teaching contents of multiple sub-specialties of stomatology to improve residents' clinical reasoning ability when facing complex conditions, resulting in a positive significance for improving the integrative cognitive competence of dental generalists.