目的

探讨PDCA 式［计划（Plan，P）、执行（Do，D）、检查（Check，C）和处理（Action，A）］循环教学方法在内科专业住院医师重症超声引导血流动力学评估培训中的应用价值。

方法

本研究采用前瞻性随机对照研究方法，选取2017年7月至2024年8月期间，信阳市中心医院内科专业在重症医学科（ICU）轮转的90名3年级住院医师并随机划分为A组（试验组）和B组（对照组），每组各45名。两组人员在入科后均常规进行入科教育，其中试验组（A组）应用PDCA循环方法进行重症超声引导血流动力学评估培训；对照组（B组）按照《内科住院医师规范化培训内容与标准》中ICU培养目标与要求实施培训。在培训期结束后分别对两组内科专业住院医师进行问卷调查、理论笔试及临床能力考核，分别对研究结果进行统计分析。

结果

A 组在理论成绩方面优于B 组，差异有统计学意义（P＜0.05）。A 组在疾病的诊断与鉴别诊断、临床决策能力评价效果上优于B 组，差异有统计学意义（P＜0.05）。两组在技能操作、接诊患者及病历书写方面考核评分差异无统计学意义（P＞0.05）。

结论

对内科专业住院医师在ICU轮转中应用PDCA循环方法进行相关培训，能更快更好的掌握重症基本理论及基本技能，更有利于提升内科专业住院医师的临床决策能力。

Objective

To explore the application value of PDCA-style ［plan （P）， execution （Do， D），check （C） and action （A）］ circular teaching method in the training of severe ultrasound-guided hemodynamic evaluation for internal medicine residents.

Methods

In this study， a prospective randomized controlled study method was used.From July 2017 to August 2024，90 third-year residents in Xinyang Central Hospital were selected and randomly divided into group A （experimental group） and group B （control group）， with 45 residents in each group. Both groups received routine education after entering the department， among which the group A was trained in severe ultrasound-guided hemodynamic evaluation by PDCA circulation method；the group B was trained according to the training objectives and requirements of the Department of Critical Care Medicine in the Standardized Training Contents and Standards for Internal Medicine Residents. After the training period， questionnaire survey， written test and clinical ability assessment were conducted for the two groups of internal medicine residents， and the research results were statistically analyzed.

Results

Group A was superior to group B in theoretical achievement， and the difference was statistically significant（P＜0.05）. Group A was superior to group B in the diagnosis and differential diagnosis of diseases and the evaluation of clinical decision-making ability， with statistically significant difference （P＜0.05）. There was no significant difference between the two groups in skill operation， receiving patients and writing medical records（P＞0.05）.

Conclusion

Training residents majoring in internal medicine to apply PDCA cycle method in the rotation of critical medicine department can master the basic theory and skills of critical illness faster and better， which is more conducive to improving the clinical decision-making ability of residents majoring in internal medicine.