Effect of the cycle teaching of planning， execution， check and action on the training of severe ultrasound-guided hemodynamic evaluation for internal medicine residents

doi:10.3877/cma.j.issn.2095-9133.2024.04.007

Abstract

Abstract:

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.

Key words: PDCA cycle, Internal medicine residents, Standardized training, Severe ultrasound, Hemodynamic evaluation

Yibin Lu, Mengdie Li, Ming Xu. Effect of the cycle teaching of planning， execution， check and action on the training of severe ultrasound-guided hemodynamic evaluation for internal medicine residents[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2024, 10(04): 224-228.

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References 16

［1］	曲歌乐，魏占云，张仲迎.住院医师规范化培训中科研能力的培养［J］.中国病案，2023，24（1）：78-79，112.
［2］	陈帆，李函聪，刘春煜，等.关于住院医师规范化培训课程建设的思路对策［J］.中华医学教育探索杂志，2021，20（2）：125-129.
［3］	刘婧，李鸣莉，曾庆奇，等.我国住院医师规范化培训协同培训现状调查［J］.中华医学教育杂志，2022，42（1）：75-79.
［4］	何蕾，苏茂生，马焕先，等.浅谈重症监护医师的规范化培训［J/CD］.中华临床医师杂志（电子版），2013，7（14）：6778-6780.
［5］	屈晶晶，刘容，周华，等.呼吸与危重症医学科住院医师规范化培训的实践与思考［J］.中国继续医学教育，2021，13（26）：75-79.
［6］	郭颖，青永红，任萌，等.PDCA 循环结合体验式学习在内分泌临床实习教学中的应用［J］. 中华医学教育杂志， 2022， 42（3）：258-262.
［7］	国家卫生计生委办公厅关于印发住院医师规范化培训基地认定标准（试行）和住院医师规范化培训内容与标准（试行）的通知［J］. 中华人民共和国国家卫生和计划生育委员会公报， 2014，9：（25-65）.
［8］	床旁超声在急危重症临床应用专家共识组.床旁超声在急危重症临床应用的专家共识［J］.中华急诊医学杂志，2016，25（1）：10-21.
［9］	盛阮妹，王海燕，高彦定，等.老年患者超声引导下锁骨下静脉与腋静脉穿刺的比较［J］. 临床麻醉学杂志， 2020， 36（6）： 540-543.
［10］	Manekar VS， Radke SA. Workplace based assessment （WPBA） in dental education- a review［J］. Journal of Education Technology in Health Sciences，2018，5（2）：80-85.
［11］	Gu S， Zhang A， Huo G， et al. Application of PDCA cycle management for postgraduate medical students during the COVID-19 pandemic［J］.BMC Med Educ，2021，21（1）：308.
［12］	江旭品，冀然，滕苗.PDCA循环在医学生实习教学职业规划引导中的应用［J］.重庆医学，2021，50（6）：1072-1074.
［13］	孙梦雪，吴铁军，田辉.三甲医院重症医学科患者疾病构成及转归分析［J］.中华危重病急救医学，2022，34（2）：183-187.
［14］	于凯江.重症医学：融合与创新［J］.中国急救医学，2019，39（8）：715-716.
［15］	乔志飞，张丽骞，刘春艳，等.床旁超声在感染性休克患者容量反应性评估中的应用［J］.中国医师杂志，2023，25（2）：220-225.
［16］	De Backer D， Aissaoui N， Cecconi M， et al. How can assessing hemodynamics help to assess volume status？［J］. Intensive Care Med，2022，48（10）：1482-1494.

组别	理论考试	CPR	中心静脉穿刺	血气分析判读
A组	89.96±3.07	84.91±5.67	89.98±2.96	86.69±3.15
B组	83.45±3.71	82.96±4.36	89.19±3.44	86.30±3.13
检验值	9.15	1.86	1.17	0.60
P值	＜0.001	＞0.05	＞0.05	＞0.05

组别	理论考试	CPR	中心静脉穿刺	血气分析判读
A组	89.96±3.07	84.91±5.67	89.98±2.96	86.69±3.15
B组	83.45±3.71	82.96±4.36	89.19±3.44	86.30±3.13
检验值	9.15	1.86	1.17	0.60
P值	＜0.001	＞0.05	＞0.05	＞0.05

组别	接诊能力	诊断与鉴别诊断	临床决策	病历质量
A组	89.98±3.81	92.02±4.13	89.56±3.3	93.47±2.46
B组	89.43±4.23	87.32±3.62	84.34±3.5	92.83±2.67
检验值	0.66	5.82	7.34	1.19
P值	＞0.05	＜0.001	＜0.001	＞0.05

组别	接诊能力	诊断与鉴别诊断	临床决策	病历质量
A组	89.98±3.81	92.02±4.13	89.56±3.3	93.47±2.46
B组	89.43±4.23	87.32±3.62	84.34±3.5	92.83±2.67
检验值	0.66	5.82	7.34	1.19
P值	＞0.05	＜0.001	＜0.001	＞0.05

组别	例数	教学方式是否满意	能激发学习兴趣	能提高自学能力	能牢固掌握知识	能增强解决问题的能力	能提高学习积极性	能提高临床思维能力	能增强团队意识
A组	45	39	36	31	33	29	35	34	32
B组	47	25	23	27	19	17	22	20	23
χ ²值		12.17	9.64	1.29	10.13	7.35	9.35	10.33	4.70
P值		＜0.05	＜0.05	＞0.05	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05

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