基于MDT的小班授课在普通外科住培带教中的应用研究

目的 本研究旨在评估多学科协作诊疗（multi-disciplinary treatment，MDT）模式结合小班授课对普通外科住培医师获取专业知识、掌握临床技能以及整体学习体验的影响。方法 选取2023年1至8月在普通外科轮转的2021级住培医师共60名，分为MDT教学组（n=30）和传统教学组（n=30）。所有住培医师在入科前进行一次理论测试及Mini-CEX技能考核，并比较两组入科前的理论测试成绩及Mini-CEX技能考核成绩。随后进行分组教学，其中MDT教学组针对胃肠道肿瘤采用MDT模式进行小班授课；传统教学组即以传统的“一带一”方式进行日常教学。住培轮转结束时，比较两组住培医师的理论考试成绩、技能操作考核情况以及对教学满意度的评价。采用SPSS 26.0进行统计学分析。结果 两组住培医师在入科前的理论考核成绩及Mini-CEX技能考核成绩差异均无统计学意义（P>0.05）。带教后，MDT教学组理论考试成绩（88.15±3.45）相对于传统教学组（72.25±4.36）更高，差异具有统计学意义（P<0.05）。MDT教学组Mini-CEX技能考核成绩（86.35±2.24）相对于传统教学组（76.28±3.92）更高，差异具有统计学意义（P<0.05）。问卷调查结果显示，MDT教学组住培医师对MDT小班授课教学满意度更高，对教学效果的评价也更好。结论 基于MDT模式的小班授课有利于提高普通外科住培医师胃肠道肿瘤的规范化培训质量，且住培医师的接受度更高，是住培教学有益的尝试。

Application of multidisciplinary small-class teaching in general surgery residency training

Objective To investigate the effects of multidisciplinary small-class teaching on expertise and skill acquisition and learning experience in standardized residency training in general surgery.Methods Sixty residents of grade 2021 rotating in general surgery from January to August 2023 were divided into multidisciplinary teaching group (n=30) and traditional teaching group (n=30, to receive tradition one-on-one teaching). All the residents underwent a theoretical examination and Mini-Clinical Evaluation Exercise (Mini-CEX) skill assessment before admission, and the scores were compared between the two groups. At the end of training, the two groups were compared in terms of theoretical and Mini-CEX skill assessment scores and the degree of satisfaction with teaching. Statistical analysis was conducted using SPSS 26.0.Results There were no significant differences in the theoretical assessment and Mini-CEX skill assessment scores before admission between the two groups (P>0.05). At the end of training, the multidisciplinary teaching group had a significantly higher theoretical examination score [(88.15±3.45) vs. (72.25±4.36), P<0.05] and a significantly higher Mini-CEX score [(86.35±2.24) vs. (76.28±3.92), P<0.05] compared with the traditional teaching group. According to the survey, the residents in the multidisciplinary teaching group were more satisfied with teaching and more likely to recognize the teaching effects.Conclusions Multidisciplinary small-class teaching can help improve the quality of standardized general surgery residency training on gastrointestinal tumor treatment, which is a highly accepted and effective attempt at standardized residency training.