“山海”提升工程背景下县域医共体超声实践调查及PBL超声培训模式的探索

  目的  通过“山海”提升工程省级医院与县级医院的合作帮扶模式，调查县域医共体的超声实践能力，探索超声基于问题式学习培训模式的成效。  方法  下沉专家于2021年4—10月在仙居县人民医院进行帮扶，针对127名超声医学专科医生采用基于问题式学习(PBL)，以问题为基础，基层医院超声医生为主体，小组讨论为形式，下沉专家为导向的教学方法，将心脏超声作为重点培训内容，分析专家在仙居帮扶期间与专家结束后的相关数据，分别与2020、2021年同期心脏超声检查数据进行比较。  结果  基层临床医生对超声解决实际工作认可度较高，有94.49%(120/127)的临床医生认为超声可以基本解决临床问题; 不同学历的基层医生对科研的兴趣也不同; 在基于问题式学习的培训模式下，专家帮扶期间心脏超声检查例数、复杂心脏病的诊断例数较2020年同期增多，检查总例数增长率为7.40%，复杂阳性病例增长率为162.86%;专家帮扶结束后(2021年11月—2022年2月)心脏超声检查例数、复杂心脏病的诊断例数较2020—2021年同期增多，检查总例数增长率为10.63%，复杂阳性病例增长率为10.18%。  结论  医疗卫生“山海”提升工程是一项将帮扶工作落到实处的惠民工程，充分发挥省级医院优势学科，不断提高基层医生的医、教、研水平，也使基层百姓能获得省级医院“同质化”的医疗资源。 

Under the background of "Mountain and Sea" promotion project,the investigation of county doctors'common ultrasound practice and the preliminary exploration of PBL ultrasonic training mode

  Objective  To investigate the ultrasound-practice ability of county doctors and explore the effectiveness of ultrasonic problem-based learning-training mode through the "Mountain and Sea" project, which improved the cooperative assistance mode between provincial hospitals and county-level hospitals.  Methods  Experts were assisted in Xianju County People's Hospital from April to October 2021. Problem-based learning (PBL) was adopted for ultrasound medical specialists. The teaching method was problem-based, with 127 ultrasound doctors in basic hospitals as the main body, in the form of group discussion and the expert as the guidance. Taking cardiac ultrasound as a key training content, the relevant data of experts during and after Xianju assistance were analysed and compared with the cardiac ultrasound data of the same period in 2020 and 2021.  Results  Grassroots clinicians had a high recognition of ultrasound to solve the practical work. About 94.49% (120/127) of clinicians believed that ultrasound can basically solve clinical problems. Doctors had different interests in scientific research to different degrees. In the training mode based on PBL, during the period of expert assistance, the number of cases of cardiac ultrasound examination and the diagnosis of complex heart disease increased compared with the same period in 2020. The growth rate of the total cases was 7.40%, and the growth rate of complex positive cases was 162.86%. After the end of expert assistance (November 2021 to February 2022), the number of cases of cardiac ultrasound examination and the diagnosis of complex heart disease increased compared with the same period of 2020-2021. The growth rate of the total number of cases examined was 10.63%, and that of complex positive cases was 10.18%.  Conclusion  The medical and health "Mountain and Sea" promotion project is a project to help the people and put the work into practice. It gives full play to the superior disciplines of provincial hospitals, thereby constantly improving the medical, teaching, and research level of grassroot doctors and also enabling grassroot people to avail of the "homogenised" medical resources of provincial hospitals.