急危重症患者快速识别与处置课程的设计、实施与多维度评价

Design, Implementation, and Multidimensional Evaluation of the "Rapid Recognition and Response for Critically Ill Patients" Course

  • 摘要: 目的 评价"急危重症患者快速识别与处置"课程的设计与实施效果,为急危重症情境模拟教学改进提供参考。方法 选取2025年6月参加课程培训的全部医护人员为研究对象,课程采用线上理论自学与线下情境模拟相结合的混合式教学。通过理论考核、技能考核及课程与师资满意度调查开展多维度评价。结果 共纳入142名学员,其中临床博士后103名(72.5%)、规范化培训护士24名(16.9%)、规范化培训住院医师15名(10.6%)。理论考核平均分为(93.27±6.95)分,不同类型学员间差异具有统计学意义(η2=0.346,95% CI:0.241~1.000,P<0.001)。技能考核总分为(85.60±9.27)分,其中血流动力学不稳定的心律失常处理(82.67%)和室颤处理(84.03%)得分率相对较低;不同类型学员间技能考核成绩差异无统计学意义(η2=0.000,95% CI:0.000~1.000,P=0.999)。团队层面,团队的理论考核平均分与技能考核总分无显著相关性(r=-0.063,95% CI:-0.455~0.350,P=0.771);个体层面,学员的理论考核与技能考核成绩亦无显著相关性(r=0.056,95% CI:-0.138~0.246,P=0.573);理论考核成绩与课程评价(ρ=-0.001,95% CI:-0.165~0.199,P=0.993)、技能考核成绩与课程评价(ρ=-0.115,95% CI:-0.283~0.070,P=0.246)均无显著相关性。不同授课教师间的评价得分差异具有统计学意义(P=0.043)。结论 "急危重症患者快速识别与处置"课程初步取得良好培训效果,理论考核、技能考核与课程评价三者相互独立,分别反映医护人员的不同能力与体验维度。建议将理论考核与技能考核分别设独立达标线,并针对心律失常识别与室颤处理环节加强专项训练。

     

    Abstract: Objective To evaluate the design and implementation effects of the "Rapid Recognition and Management of Critically Ill Patients" course, and to provide a reference for the improvement of situational simulation teaching in emergency and critical care settings.Methods All medical staff who participated in this course training in June 2025 were enrolled as study subjects.The course adopted a blended teaching method com- bining online theoretical selfstudy with offline situational simulation.Multi-dimensional evaluation was conducted through theoretical assessments, skill assessments, and satisfaction surveys regarding the course and instructors. Results A total of 142 trainees were enrolled, including 103 clinical postdoctoral fellows (72.5%), 24 standardized training nurses (16.9%), and 15 standardized training resident physicians (10.6%).The mean theoretical examination score was 93.27±6.95, with statistically significant differences among different trainee categories (η2=0.346, 95% CI: 0.241-1.000, P<0.001).The total skill assessment score was 85.60± 9.27, with rela- tively lower scoring rates in the management of hemodynamically unstable arrhythmias (82.67%) and ventricular fibrillation (84.03%).No statistically significant difference was observed in skill assessment scores among trainee categories (η2=0.000, 95% CI: 0.000-1.000, P=0.999).At the team level, there was no significant correla- tion between mean theoretical scores and total skill scores (r=-0.063, 95% CI: -0.455 to 0.350, P=0.771); at the individual level, theoretical scores also showed no significant correlation with skill scores (r=0.056, 95% CI: -0.138 to 0.246, P=0.573).Neither theoretical scores nor skill scores were significantly correlated with course evaluation ratings (ρ=-0.001, 95% CI: -0.165 to 0.199, P=0.993; and ρ=-0.115, 95% CI: -0.283 to 0.070, P=0.246, respectively).Differences in evaluation scores among different instructors were statistically significant (P=0.043).Conclusions The course achieved preliminary and favorable training outcomes.Theo- retical examination scores, skill assessment scores, and course evaluation ratings were mutually independent, re- flecting distinct dimensions of competence and learning experience.It is recommended that theoretical and skill assessments be set as independent passing thresholds, and that targeted training be strengthened in the areas of arrhythmia recognition and ventricular fibrillation management.

     

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