CAJ | 학술논문

目的：评价采用不同形式对肺血栓栓塞症(简称肺栓塞)规范化诊断与治疗的继续医学教育效果。方法对19家医院(9家3级医院,10家2级医院)的医务人员进行了四个层次的肺栓塞规范化诊治的培训：通过举办学习班对100名临床一线医生进行培训；采用学习班结合病例专题讨论和专家现场点评方式,培训了60名临床骨干医生；采用学习班结合实际操作和结果判读的形式分别对放射科医生和超声科医生进行培训。结果培训结束后,临床一线医生肺栓塞规范化诊治问卷调查正确率从培训前的55%,提高至78%(P<0.001)；骨干医生培训后模拟肺栓塞诊治正确率从培训前的71%提高至88%(P<0.001)；放射科医生肺栓塞规范化影像学诊断技能考核合格率由培训前的65%提高至85%(P=0.041)；超声科医生规范化超声诊断技能考核合格率由培训前的70%提高至90%(P=0.014)。结论采用学习班的形式对提高肺栓塞规范化诊治意识有显著效果,而采用多种形式如学习班结合病例讨论与专家点评,或结合实际操作及结果判定的形式,对医生实践技能的培训效果较好。
목적：평개채용불동형식대폐혈전전새증(간칭폐전새)규범화진단여치료적계속의학교육효과。방법대19가의원(9가3급의원,10가2급의원)적의무인원진행료사개층차적폐전새규범화진치적배훈：통과거판학습반대100명림상일선의생진행배훈；채용학습반결합병례전제토론화전가현장점평방식,배훈료60명림상골간의생；채용학습반결합실제조작화결과판독적형식분별대방사과의생화초성과의생진행배훈。결과배훈결속후,림상일선의생폐전새규범화진치문권조사정학솔종배훈전적55%,제고지78%(P<0.001)；골간의생배훈후모의폐전새진치정학솔종배훈전적71%제고지88%(P<0.001)；방사과의생폐전새규범화영상학진단기능고핵합격솔유배훈전적65%제고지85%(P=0.041)；초성과의생규범화초성진단기능고핵합격솔유배훈전적70%제고지90%(P=0.014)。결론채용학습반적형식대제고폐전새규범화진치의식유현저효과,이채용다충형식여학습반결합병례토론여전가점평,혹결합실제조작급결과판정적형식,대의생실천기능적배훈효과교호。
Objective To evaluate the continuing medical education (CME) effect on standardized diagnosis and treatment of pulmonary thromboembolism (PTE). Methods From 19 hospitals (level 2 or 3 hospitals) located in Beijing, China. A total of 100 junior physicians received lecture training ,60 senior physicians received multiple education methods, combining lectures with special topics on cases and leader opinion, 20 doctors who engaged in radiology and 20 doctors who engaged in ultrasonics received training of combining lectures with instrumental operation and diagnosis, respectively. Results After training , the junior physicians’correct rate of standardized PTE diagnosis and treatment by questionnaire survey increased from 55%before training to 78%(P<0.001), the senior physicians’correct rate of simulation PTE diagnosis and treatment raised from 71%to 88%(P<0.001), the radiologists’qualification rate increased from 65%to 85%(P=0.041) and the sinologists’qualification rate increased from 70%to 90%(P=0.014). Conclusion For CME on standardized PTE diagnosis and treatment, lectures have great impact on improving physicians’awareness while multiple formats such as lectures combining with case discussion lectures and leader opinion or with instrumental operation are effective on the improvement in performances.