妇产科学案例教学法在全科医生短期培训中的应用效果研究

背景　在全科医生的继续教育中，以提高全科医生临床诊疗能力为目的的短期专项培训占很大比重，但这类培训主要以讲授教学法为主，师生课堂互动少，学员很容易注意力不集中从而影响培训效果。因此，将案例教学法引入全科医生短期培训对增强培训效果具有重要意义。目的　探讨妇产科学案例教学法在全科医生短期培训中的教学效果。方法　选择2018年在重庆市全科医学教育中心参加妇产科常见病与多发病规范化诊断与治疗短期培训班的110例全科医生为研究对象，并在招生时将其随机分为第1期（对照组）和第2期（研究组）。依据纳入、排除标准排除中途请假和未能完成相关考试的学员6例，最终对照组与研究组各纳入52例研究对象。两组均采用相同的教学方案，即相同的教学内容（妇产科常见病与多发病的诊断和治疗）、相同的培训时间（1周）、相同的评估方法（培训前后同等难度的考试、培训效果和满意度的问卷调查）。研究组采用案例教学法，对照组采用传统讲授式教学法，对比两组培训前后的考试成绩，临床诊疗能力、临床思维、基础知识掌握度、学习兴趣的自评得分，培训满意度自评得分。结果　对照组与研究组培训前的考试成绩分别为（62.6±14.6）、（61.6±18.6）分，差异无统计学意义（P>0.05）。培训后两组成绩分别为（86.5±8.7）、（95.6±2.0）分，两组成绩均较培训前提高（P<0.05），且培训后研究组考核成绩明显优于对照组，差异具有统计学意义（P<0.05）。培训后，研究组临床诊疗能力、临床思维、基础知识掌握度、学习兴趣及培训满意度自评得分均高于对照组，差异具有统计学意义（P<0.05）。结论　妇产科学案例教学法在全科医生短期培训中的教学效果更好，更有利于提高全科医生的妇产科学诊治能力。

Case-based Teaching in Short-term Obstetrics and Gynecology Training for General Practitioners

Background　In the continuing education for general practitioners（GPs），short-term specialty trainings for improving GPs' clinical diagnostic and therapeutic skills account for a large proportion.However，difficulties in concentrating energies on learning can easily occur if such trainings are mainly based on traditional teaching.So it is essential to use case-based teaching in such trainings to improve the training effect.Objective　To explore the effect of case-based teaching in short-term obstetrics and gynecology training programs for GPs.Methods　A total of 110 GPs who participated in the short-term training on standardized diagnosis and treatment of common diseases and frequently-occurring diseases in obstetrics and gynecology in Chongqing General Medicine Education Center in 2018 were enrolled.At the time of enrollment，they were randomly divided into the first phase（control group） and the second phase（study group）.According to inclusion and exclusion criteria，six cases who asked for leave during the training and failed to complete the relevant examinations were excluded.Finally，52 cases were included in each of the groups.Both groups received the same training program，namely，the same teaching content（diagnosis and treatment of common and frequently-occurring diseases in obstetrics and gynecology），the same training time（one week），and the same evaluation （an examination of the same difficulty before and after the training，and a questionnaire survey on training effectiveness and satisfaction），but received different teaching mode，case teaching was used in training for the study group，while traditional teaching was used in training for the control group.Pre- and post-training test score，self-rated clinical diagnostic and therapeutic skills，clinical thoughts，mastery of basic knowledge，learning interest and training satisfaction were compared between the two groups.Results　The mean pre-training test scores of the control group and the study group were similar〔（62.6±14.6） vs （61.6±18.6），P>0.05〕.After training，the mean test score increased significantly in both groups（P<0.05），but better improvement was found in the study group instead of the control group〔（95.6±2.0） vs （86.5±8.7），P<0.05〕.Moreover，mean post-training self-rated scores for clinical diagnostic and therapeutic skills，clinical thoughts，mastery degree of basic knowledge，learning interest and training satisfaction of the study group were significantly higher than those of the control group（P<0.05）.Conclusion　In short-term training for GPs with obstetrics and gynecology programs，case-based teaching is superior to traditional teaching in terms of improving the teaching effectiveness，and GPs' skills in diagnosing and treating obstetrical and gynecological conditions.