目的 对北京大学第一医院产科开展的阴道助产模拟培训项目进行多维度实效性评价,为优化产科操作培训提供依据。方法 采用问卷调查方法。以2022年 5 月至2024年5月共5期培训班的96名学员为研究对象,通过问卷调查、追踪随访(培训后1年)收集数据,从柯氏四级评估模型的反应层、学习层、行为层3个维度评估培训效果,并引入创新扩散理论描述培训所产生的群体性影响。结果数据采用平均分、例数和百分比描述。结果 反应层:学员满意度均分达19.3~19.7分(满分20分),均为非常满意。学习层:学员对4项课程的预期临床应用率由高到低依次为产钳模拟操作培训[89名(92.7%)]、胎吸模拟培训[80名(83.3%)]、产钳助产技术[74名(77.1%)]和胎吸操作技术[59名(61.5%)]。行为层:培训1年后有41名学员接受随访,其中29名(70.7%)学员在临床工作中应用了培训所学的阴道助产技术,其中产钳助产技术应用最多[23名(79.3%)],6名(20.7%)学员应用了胎吸技术;培训后0~3个月第一次开展胎吸/产钳的有28名(96.5%),是首次应用最集中的时期。41名学员中有32名(78.0%)表示培训后操作流程标准化程度显著提高。在群体性影响方面,培训项目对10家参训医院的产科临床实践产生了积极的扩散效应,初步显现了区域医疗实践改进的潜力。结论 阴道助产模拟培训项目培训满意度高,知识技能掌握成效显著,产钳助产临床行为转化率较高且时效性强。以创新扩散理论为补充,可有效描述培训行为从个体掌握向群体实践的扩散过程,为未来评估长期组织效益奠定了基础。

Objective To conduct a multidimensional effectiveness evaluation of the simulated vaginal operative delivery training program conducted in the Department of Obstetrics and Gynecology, Peking University First Hospital, based on Kirkpatrick's four-level evaluation model and the Diffusion of Innovations Theory, and to provide evidence for optimizing obstetric operative training. Methods A questionnaire survey method was employed. A total of 96 participants from 5 training sessions conducted from May 2022 to May 2024 were included in the study. Data were collected through questionnaires and one-year post-training follow-ups to evaluate training effectiveness from the three dimensions (reaction, learning, and behavior) of Kirkpatrick's four-level evaluation model. The Diffusion of Innovations Theory was introduced to describe the collective impact triggered by the training. Data were described using mean scores, numbers, and percentages. Results Reaction level: The average satisfaction scores ranged from 19.3 to 19.7 (out of 20), all indicating ″very satisfied″. Learning level: The intended clinical application rates for the four courses, from highest to lowest, were forceps delivery simulation [89/96 (92.7%)], vacuum extraction simulation [80/96 (83.3%)], forceps technique [74/96 (77.1%)], and vacuum extraction technique [59/96 (61.5%)]. Behavior level: One year post-training, 41 participants were followed up; 29 (70.7%) had applied the learned techniques. Forceps delivery was most applied [23 (79.3%)], followed by vacuum extraction [6 (20.7%)]. Of these, 28 (96.5%) performed their first procedure within 0-3 months post-training. Furthermore, 32 (78.0%) reported significant improvement in procedural standardization. Regarding collective impact, the training program demonstrated positive diffusion effects on clinical practices across 10 participating hospitals, showing potential for regional practice improvement. Conclusions The training program achieved high satisfaction and significant knowledge/skill improvement, with high and timely behavioral transfer, especially for forceps delivery. Using the Diffusion of Innovations Theory as a complementary framework effectively describes the diffusion of trained behaviors from individual mastery to group practice, laying a foundation for future evaluation of long-term organizational benefits.