循证病例报告法在内分泌住院医师规范化培训教学中的应用评价

目的 探讨使用循证病例报告在内分泌住院医师规范化培训教学中的应用效果。方法 选择2015年至2016年内分泌科轮转的住院医师规范化培训医师共51人，随机分成实验组(26人)和对照组(25人)。实验组应用循证病例报告法教学模式，对照组应用传统临床带教模式。比较两组出科考试成绩（包括理论考试和技能考试）及问卷调查了解学生在学习兴趣、临床各方面技能提高及满意度的差异。均为计量资料比较采用t检验。 结果 两组住院医师在理论笔试成绩方面无显著性差异；实验组技能考核总成绩得分（85.13±4.63），高于对照组（76.79±3.11），差异有统计学意义（P=0.000）。问卷调查显示，实验组教学对提高住院医师学习兴趣及主动性、临床思维能力、临床工作能力、文献查阅能力、医学文章写作能力、人文沟通能力及了解最新指南进展等方面有帮助，差异有统计学意义（P=0.000）。实验组对教学方法整体满意度（9.69±0.34）显著高于对照组（8.01±0.39），差异有统计学意义（P=0.000）。结论 内分泌住院医师规范化培训教学中应用循证病例报告开展教学，教学效果明显，值得进一步推广。

Evaluation of the evidence-baced case report method for teaching residents of standardization training in department of endocrinology

Objective To explore the application of the evidence-based case report method in the standardization training of resident physicians at department of endocrinology. Methods Fifty-one residents recruited from the endocrinology department were randomly divided into the experiment group (26 cases) and control group (25 cases). The evidence-baced case report method was conducted in the experimental group, and the traditional clinical teaching mode was applied in the control group. The results of the examination of two groups including the theoretical test and skill test were compared and the questionnaire survey was conducted to find out the differences of students'' interest in learning, clinical skills and satisfaction. All data were compared using t test. Results There was no significant difference in theoretical test between the two groups (P> 0.05). The total score of the skill test in the experimental group was (85.13 ± 4.63) and the control group (76.79 ± 3.11) (P = 0.000). The students in the experimental group showed that the teaching method had more significant effects on improving their learning interest and initiative, clinical thinking ability, clinical work ability, literature review ability and medical article writing ability. Scores of satisfaction with teaching methods (total score was 10) for experimental group were (9.69 ± 0.34), which was also significantly higher than those in the control group (8.01 ± 0.39) (P = 0.000). Conclusion The application of evidence-based case report teaching method in the standardized training of resident physicians in department of endocrinology is worthy of being perfected and further popularized in clinical teaching work.