真实病例现场带教联合混合分层小组教学在肠道超声培训中的效果分析

Exploring the Effectiveness of A Mixed-Level Group Teaching Model in On-site Intestinal Ultrasound Training

  • 摘要:
    目的 探讨真实病例现场实操带教结合混合分层小组教学模式在肠道超声培训中的应用效果,为构建高效、实用的肠道超声培训体系提供参考。
    方法 以2025年3月在北京协和医院超声医学科参加培训的初、中级职称超声医师作为研究对象。采用混合分层小组教学模式,在教学门诊真实病例情景下进行现场实操带教,内容涵盖病历分析、明确检查目的、实时图像判读及报告规范撰写。通过培训前后的理论测试(基础知识、图像识别、疾病知识)、检查自信心自评及教学满意度反馈评估教学效果。
    结果 共纳入12名学员,平均年龄为(35.2±3.8)岁;主治医师10名(83.3%)、住院医师2名(16.7%)。学员培训后的理论测试成绩较培训前显著提高(89.2±9.0)比(76.7±13.7),P=0.009。分模块分析显示,图像识别模块得分显著提升(51.7±5.8)比(45.0±5.2),P=0.001,得分率由(81.8±9.5)%提高至(93.9±10.5)%;基础知识模块得分(20.0±7.4)比(16.7±8.9),P=0.120与疾病知识模块得分(17.5±3.4)比(15.0±5.6),P=0.139均呈上升趋势,但差异均无统计学意义。学员对独立完成检查的自信心中位数由培训前的1.0(1.0,1.3)分提升至培训后的2.5(2.0,3.3)分(P=0.002)。亚组分析显示,无培训经历学员的总分提升幅度20.0(15.0,40.0)比7.5(1.3,10.0)分,P=0.016、图像识别模块提升幅度10.0(10.0,13.8)比5.0(1.3,8.8),P=0.020显著高于有培训经历学员。教学满意度评价显示,各维度选择“较大帮助”与“非常有帮助”的学员累计占比为83.3%~91.7%。
    结论 基于真实病例的现场带教结合混合分层小组教学模式能显著提升学员的肠道超声图像判读能力与临床胜任力,能够满足不同基础水平学员的学习需求,为探索肠道超声临床实践技能的有效培训途径提供参考。

     

    Abstract:
    Objective To investigate the effectiveness of a teaching model combining real-case bedside instruction with mixed-level group teaching in intestinal ultrasound training, and to provide reference forestablishing an efficient and practical training system for intestinal ultrasound.
    Methods Ultrasound physicians with junior- and intermediate professional titles who attended training at the Department of Ultrasound, Peking Union Medical College Hospital in March 2025 were enrolled. A mixed-level group teaching model was implemented under real clinical scenarios in teaching clinics, with on-site practical instruction covering case analysis, clarification of examination purposes, real-time image interpretation, and standardized report writing. Teaching effectiveness was evaluated through pre- and post-training theoretical tests (covering basic knowledge, image recognition, and disease-related knowledge), self-assessment of confidence in performing examinations, and feedback on teaching satisfaction.
    Results A total of 12 trainees were enrolled, with a mean age of (35.2±3.8) years; 10 trainees (83.3%) were attending physicians and 2 (16.7%) were residents. The trainees' overall theoretical test scores improved significantly after training (89.2±9.0) vs. (76.7±13.7), P=0.009. Module-based analysis showed that the image recognition module score increased significantly (51.7±5.8) vs. (45.0±5.2), P=0.001, with the score rate rising from (81.8±9.5)% to (93.9±10.5)%; scores in the basic knowledge module (20.0±7.4) vs. (16.7±8.9), P=0.120 and disease-related knowledge module (17.5±3.4) vs. (15.0±5.6), P=0.139 both showed upward trends, but the differences were not statistically significant. The median confidence score for independently performing examinations increased from 1.0 (1.0, 1.3) before training to 2.5 (2.0, 3.3) after training (P=0.002). Subgroup analysis revealed that trainees without prior training experience demonstrated significantly greater improvements in total scores 20.0 (15.0, 40.0) vs. 7.5 (1.3, 10.0), P=0.016 and image recognition module scores 10.0 (10.0, 13.8) vs. 5.0 (1.3, 8.8), P=0.020 compared to those with prior experience. Teaching satisfaction surveys indicated that the combined proportion of responses rated as "considerable help" and "extremely helpful" across all dimensions ranged from 83.3% to 91.7%.
    Conclusions The teaching model combining real-case bedside instruction with mixed-level group teaching significantly enhances trainees' image interpretation skills and clinical competence in intestinal ultrasound, effectively addresses the diverse learning needs of trainees at different baseline levels, and provides a reference for developing effective clinical training approaches in intestinal ultrasound practice.

     

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