外科住院医师衔接教育课程的构建与初步应用评价

Development and Preliminary Evaluation of a Transition-to-Residency Curriculum for Surgical Residents

  • 摘要: 目的 探索新入院外科住院医师衔接教育课程的系统构建路径,并通过课程实施前后的初步应用评价,为该类课程的设计与推广提供实践参考。方法 采用单中心历史对照设计,以2020年新入院住院医师为课程实施前的传统教学组,以2024年新入院住院医师为课程实施后的教学改革组,两组均于入院3个月后完成自评调查。参照Kern六步课程开发法,基于需求评估结果构建外科住院医师衔接教育课程,涵盖理论授课(18次)与技能操作培训(3次),于入院后3个月内完成。采用自评问卷调查两组住院医师入院3个月后的临床适应度及教学满意度。组间比较采用独立样本t检验,计算效应量Cohen's d,并进行敏感性与把握度分析。结果 教学改革组(n=33)各维度的临床适应度及教学满意度评分均高于传统教学组(n=22),但差异均无统计学意义。总体临床适应度由(6.82±2.13)分升至(7.15±1.37)分(均值差0.33分,95%CI:-0.61~1.28);教学工作满意度由(7.45±1.71)分升至(7.88±1.65)分(均值差0.42分,95%CI:-0.50~1.35);带教师资满意度由(7.95±1.76)分升至(8.61±1.52)分(均值差0.65分,95%CI:-0.24~1.55)。把握度分析显示,当前样本量可检测的教学满意度最小组间差异约为1.32分,实际观察值(0.42分)低于该界值。结论 本研究构建的衔接教育课程为新入院外科住院医师提供了系统化的理论教学与基础技能培训框架,并初步验证了该课程的实施可行性,其有效性尚需通过更大样本、前瞻性研究设计及客观评价指标进一步验证。

     

    Abstract: Objective This study aimed to systematically construct a transitional curriculum for newly recruited surgical residents and to evaluate its preliminary application outcomes through pre and postimplement-ation assessments, so as to provide practical references for the design and dissemination of such curricula. Methods A singlecenter historical controlled design was adopted. Residents admitted in 2020 served as the traditional teaching group (preimplementation), while those admitted in 2024 served as the teaching reform group (postimplementation). Both groups completed selfadministered surveys three months after admission. Fol-lowing Kern's sixstep approach, the transitional curriculum for surgical residents was developed based on needs assessment results, comprising 18 theoretical lectures and 3 practical skill training sessions, all delivered within the first three months after admission. Selfadministered questionnaires were used to assess clinical readiness and teaching satisfaction in both groups at three months postadmission. Betweengroup comparisons were performed using independent samples ttests, with Cohen's d effect sizes calculated, along with sensitivity analyses and power analyses. Results The teaching reform group (n=33) demonstrated higher scores across all dimensions of clinical readiness and teaching satisfaction compared with the traditional teaching group (n=22), although none of the differences reached statistical significance. Overall clinical readiness improved from 6. 82±2. 13 to 7. 15±1. 37 (mean difference 0. 33, 95% CI:-0. 61 to 1. 28); satisfaction with teaching work increased from 7. 45±1. 71 to 7. 88±1. 65 (mean difference 0. 42, 95% CI:-0. 50 to 1. 35); and satisfaction with faculty instruction rose from 7. 95±1. 76 to 8. 61±1. 52 (mean difference 0. 65, 95% CI:-0. 24 to 1. 55). Power analysis indicated that the current sample size could detect a minimum betweengroup difference of approximately 1. 32 points in teaching satisfaction, whereas the observed difference (0. 42) was below this threshold. Conclusions The transitional curriculum developed in this study provides a systematized framework of theoretical instruction and foundational skills training for newly admitted surgical residents, and its feasibility has been preliminarily validated. Its effectiveness, however, warrants further confirmation through largersample, prospec-tive studies with objective outcome measures.

     

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