医学教育

人工智能驱动的模拟医学培训:技术革新与教育范式转型

Artificial intelligence-driven simulated medical training:Technological innovation and transformation of educational paradigms

:257-263
 
       本文系统探讨了人工智能(AI)技术在模拟医学培训中的应用现状、优势与挑战。AI通过虚拟患者系统、手术模拟评估、医学影像诊断培训及结构化报告优化四大核心场景,显著提升培训的智能化与个性化水平。研究表明,AI驱动的实时反馈机制(如手术技能评估系统)在随机对照试验中表现优于传统专家指导, 并具备大规模推广潜力, 可降低人力成本。然而,技术仍面临算法透明性、数据隐私伦理及临床转化效果验证等挑战。未来需深化跨学科合作, 结合增强现实(AR)等技术创新, 构建全球资源共享的智能认证体系, 推动医学教育范式转型。
       This review summarizes and discusses the application status, advantages,and challenges of artificial intelligence(AI)technology in simulated medical training.AI significantly enhances the intelligence and personalization of training through four core scenarios:virtual patient systems, surgical simulation assessment, medical imaging diagnosis training, and structured reporting optimization.Researches demonstrates that AI-driven real-time feedback mechanisms(e.g., surgical skill assessment systems)outperform traditional expert guidance in randomized controlled trials(P<0.001)and exhibit potential for large-scale implementation to reduce labor costs.However, challenges remain regarding algorithmic transparency, data privacy ethics, and clinical translation validation.Future efforts require deepened interdisciplinary collaboration, integration with innovations like augmented reality, and the establishment of a globally shared intelligent certification system to advance the transformation of medical education paradigms.
医学教育

基于BOPPPS模型的课程设计在基层护理培训中的应用

The application of course design based on BOPPPS model in nursing basic training

:282-287
 
目的 探讨导言-目标-前测-对照-后测-总结(BOPPPS)教学模式在基层护理培训中的应用效果。方法 采用类实验研究方法,将2021年5月—2021年12月参加培训的96名护士设为对照组,使用传统教学模式,将2022年1月—2022年12月参加培训的325名护士设为研究组,使用BOPPPS教学模式。对两组学员的教学效果通过理论、操作考核及问卷调查进行比较。结果 对照组学员理论知识、技能操作以及培训满意度均高于对照组,差异均有统计学意义(均P<0.05)。结论 BOPPPS教学模式在基层护理实训课中具有重要意义,可提高学员理论和技能操作能力,提升学员满意度。
Objective To explore the application effect of BOPPPS teaching mode in nursing primary training. Methods Adopting class experimental research method,96 nurses who participated in the training from May 2021 to December 2021 were the control group,using the traditional teaching method.The 325 nurses who participated in the training from January 2022 to December 2022 were set up as a study group using the BOPPPS teaching model.The teaching effectiveness of the two groups of nurses was compared through theoretical and operative examinations and questionnaires. Results The theoretical knowledge,skill operation and training satisfaction of the trainees in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05). Conclusions BOPPPS teaching mode is of great significance in nursing primary practical training course,which can improve the theory and skill operation ability of trainees and enhance the satisfaction of trainees.
医学教育

BOPPPS模式下模块化教学结合模拟演练在创伤急救培训中的应用

Application of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model

:422-428
 
目的 探讨BOPPPS[(导引(B),目标(O),课前测试(P),参与式学习(P),课后测试(P),总结(S)]模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法 选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士,随机分为对照组和干预组,每组45名护士。对照组采用传统授课模式进行教学培训;干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果 干预组的综合理论成绩为(80.74±6.87)分、单项技能成绩为(92.13±2.26)分,相较于对照组均提高(P<0.05)。干预组对创伤急救课程的总体满意度:非常同意23例、同意20例,比例均高于对照组(P<0.05)。干预组的创伤急救救护综合能力如病情评估预判能力,优秀26例、良好15例;护理计划分析实施能力,优秀25例、良好13例;团队协作与资源管理能力,优秀27例、良好15例;情景感知与应变能力,优秀30例、良好11例;综合救护能力,优秀36例、良好5例。显著优于对照组(P<0.05)。结论 BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力,且取得了较高的满意度,值得进一步推广应用。
Objective To explore the application effect of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model.Methods A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group(n=45) and intervention group(n=45).The control group was trained by traditional teaching mode.The intervention group was trained by BOPPPS modular teaching combined with simulation exercise.After the training,the comprehensive theory of trauma first aid,individual skills,comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed.Results The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group(P<0.05).The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group(P<0.05).The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group(P<0.05).Conclusions The combination of modular teaching and simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergency department,and has obtained a high degree of satisfaction,which is worthy of further popularization and application.
医学教育

基于Mini-CEX的可视化思维导图联合案例教学在全科住院医师规范化培训中的应用效果

Effect of visual mind mapping combined with case teaching based on Mini-CEX for standardized training of general practitioners

:1153-1157
 
目的 探讨基于迷你临床演练评估(Mini-CEX)的可视化思维导图联合案例教学在全科住院医师规范化培训中的应用效果。方法 选取参加全科住院医师规范化培训的52例学员并分为试验组(n=26)和对照组(n=26)。对照组采取以案例讲授为主的传统教学模式,试验组采取基于Mini-CEX的可视化思维导图联合案例教学模式。对比两组Mini-CEX评分、考核成绩及教学满意度。结果 试验组Mini-CEX测评的问诊技巧、体格检查、临床判断、诊治能力、技能操作及整体表现得分均高于对照组(P<0.05)。试验组理论知识[(86.89±4.75)分 vs (82.96±4.87分)]、专业技能[(84.20±3.46)分 vs (70.18±4.93)分]及病历书写成绩[(80.64±5.26)分 vs (75.58±5.94)分]均高于对照组(t分别为2.678、13.685、2.764,P分别为0.009、<0.001、0.007)。试验组住院医师教学满意度高于对照组(P<0.05)。结论 基于Mini-CEX的可视化思维导图联合案例教学模式用于全科住院医师规范化培训,有助于提高教学效果及教学满意度。
Objective To evaluate the effect of visual mind mapping combined with case teaching based on mini-clinical evaluation exercise(Mini-CEX)for standardized training of general practitioners.Methods A total of 52 students who participated the standardized training of general practitioners were selected and divided into an experimental group(n=26)and a control group(n=26).The control group adopted the traditional teaching mode based on case teaching and the experimental group adopted the visual mind mapping combined with case teaching based on Mini-CEX.The Mini-CEX score,assessment results and teaching satisfaction of two groups were compared.Results The interrogation skills,physical examination,clinical judgment,diagnosis and treatment ability,skill operation and overall performance of Mini-CEX in experimental group were higher than control group(P<0.05).Theoretical knowledge score([86.89±4.75] vs [82.96±4.87]),professional skills score([84.20±3.46] vs [70.18±4.93])and medical record writing score([80.64±5.26] vs [75.58±5.94])of experimental groups were higher than control group(t=2.678,13.685,2.764,P=0.009,<0.001,0.007).The teaching satisfaction of residents in experimental group was higher than control group(P<0.05).Conclusions The visual mind mapping combined with case teaching based on Mini-CEX for standardized training of general practitioners is helpful to improve teaching effect and teaching satisfaction.
医学教育

深圳市助产士培训临床实操技能掌握的现况研究

A study on the mastery of clinical practical skills in midwifery training in Shenzhen

:686-692
 
目的 了解深圳市助产士培训的现况,为今后进一步加强助产士培训工作提供参考依据。方法 利用方便整群抽样法选取2022年在深圳市助产医疗机构工作的助产士,通过问卷调查及数据分析,了解他们在2009—2020年间参加助产士培训的情况以及对临床实操技能掌握的自评现况。结果 本研究共调查481名助产士,大部分来自三级医院,平均拥有9(5,15)年的助产工作经验,根据其工作年限和经验分别参加初级、中级和(或)高级培训,以参加一次初级或中级培训居多。助产士未参加培训的主要原因为医院人员不足和新入职。临床实操技能掌握自评现况分析显示,助产士初、中级母儿急救实操技能亟待加强,中级培训的助产士带教能力需提升。不同职称助产士的实操技能自评分数比较差异有统计学意义(Z=9.23,P=0.026)。结论 深圳市助产士对于初级培训和中级培训的参与度较高,但对部分临床实操技能的掌握仍存在不足,有必要进一步强化助产士临床实操技能培养,以全面满足孕产妇的健康需求。
Objective To understand the current state of midwifery training in Shenzhen,providing insights for the enhancement of future midwifery training programs.Methods Using a convenience cluster sampling method,midwives working in obstetric medical institutions in Shenzhen in 2022 were selected.Through questionnaire surveys and data analysis,the participation in midwifery training from 2009 to 2020 was examined along with their self-assessment of mastery over clinical practical skills.Results A total of 481 midwives,mostly from tertiary hospitals,with an average of 9(5,15)years of midwifery experience,were surveyed in this study and participated in primary,intermediate and/or advanced training according to their years of experience and years of work,with the majority participating in primary or intermediate training once.The main reasons for midwives not attending training were insufficient hospital staff and new recruits.The analysis of the self-assessment of the mastery of clinical practical skills showed that the practical skills of midwives in maternal and pediatric emergencies at the primary and intermediate levels needed to be strengthened,and the teaching ability of midwives with intermediate training needed to be improved.There was a difference in the self-rating of practical skills among midwives of different titles(Z=9.23,P=0.026).Conclusions Though participation in primary and intermediate midwifery training in Shenzhen City is high,there remains a deficiency in mastering specific clinical practical skills.This research suggests that there’s a pressing need to further enhance the practical clinical skill training for midwives to comprehensively meet the health needs of pregnant and postnatal women.
论著

客观结构化临床考试对护士夜班准入培训效果的影响

Effect of objective structured clinical examination on admission training of night shift nurses

:82-85
 
目的 探究客观结构化临床考试(objective structured clinical examination,OSCE)对夜班护士准入培训效果的影响,并总结经验。方法 选取2017年5月—2018年5月期间首次获得执业注册并接受夜班准入培训的护士62名作为研究对象,采用随机数字法划分为观察组和对照组各31例。夜班准入培训时,对照组采用传统的培训考核模式,观察组采用以客观结构化临床考试为理论框架的培训考核模式,考试内容按教学目标设置,并由临床经验丰富的副高级以上导师围绕专业知识、技能、综合能力等对考点进行设计。培训结束后,两组护士均进行客观结构化临床考试、填写教学满意度量表、分析两组护士护理评估能力、健康教育能力、人文关怀、沟通与协调能力、临床思维能力得分的差异。结果 观察组对培训效果的满意度为83.87%,对照组的满意度为54.84%,差异有统计学意义 (P<0.05);与对照组比较,观察组护士护理评估能力、健康教育能力、人文关怀、沟通与协调能力、临床思维能力及总分上分值明显更高,差异有统计学意义(P<0.05);6个站点得分中,观察组的平均成绩要高于对照组,对实际临床操作、护理诊断和临床判断方面更具优势,差异有统计学意义(P<0.05)。结论 客观结构化临床考试培训模式应用在护士夜班准入培训中,有效提高其临床能力及综合能力,提升了护士对培训课程的满意度。
Objective To explore the effect of objective structured clinical examination (OSCE) on the admission training of night shift nurses and to summarize the experience. Methods A total of 62 nurses who received the practice registration and night shift admission training from May 2017 to May 18, 2017 for the first time were selected as the study subjects. They were randomly divided into observation group and control group. For night shift admission training, the control group adopted the traditional training assessment mode, and the observation group adopted the training assessment mode with objective structured clinical examination as the theoretical framework. The examination content was set according to the teaching objectives, and was designed by clinically experienced supervisors at deputy senior level or above revolving the knowledge points of professional knowledge, skills, comprehensive ability. At the end of the trainings, nurses in the two groups took objective structured clinical examinations and filled out the teaching satisfaction scale. The differences in scores of nursing assessment ability, health education ability, humanistic care, communication and coordination ability, and clinical thinking ability in the two groups were analyzed. Results The satisfaction rate in the observation group was 83.87%, higher than that in the control group, which was 54.84%, and the difference was statistically significant (P<0.05). The scores of nursing assessment ability, health education ability, humanistic care, communication and coordination ability, and clinical thinking ability and the total scores in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). The average score of knowledge points in the observation group was higher than that in the control group, with the former group boasting more advantages in actual clinical operation, nursing diagnosis and clinical judgment, with statistically significant difference between the two groups (P<0.05). Conclusion The application of objective structured clinical examination in nurse's night shift admission training may help improve their clinical ability and comprehensive ability, as well as their satisfaction to training courses.
论著

探讨实习前护理知识技能评价与实习教学目标相结合护理实习培训效果

Effects of nursing practice training combined with the evaluation of nursing knowledge and skills and teaching objectives before practice

:107-110
 
目的 探讨实习前护理知识技能评价与实习教学目标相结合的临床护理实习培训效果。方法 选择2018年在我科实习的护理本科实习生40名为对照组,采取传统的带班实习带教方法进行临床带教;2019年在我科实习的40名护理本科实习生为实验组,对实习生在实习前进行护理知识和护理操作能力评估,根据实习生专业知识与护理技术的评估结果,结合实习教学目标进行针对性的临床带教;实习结束对两组同学掌握的护理理论知识、护理操作技术、服务满意度进行评价。结果 实验组掌握的护理知识、护理操作技术得分均高于对照组,两组结果比较差异有统计学意义(P<0.001);服务满意度评价实验组高于对照组,两组结果比较差异有统计学意义(P<0.05);结论 开展实习前护理专业能力评价与教学目标相结合的护理临床实习培训模式管理,有助于带教老师掌握实习生存在的护理知识缺乏和护理技术薄弱问题,利于带教老师制定合理的实习带教计划和带教重点,提高学生临床实习效果和老师的带教质量。
Objective To explore the effect of clinical nursing practice training combined with the evaluation of nursing knowledge and skills and teaching objectives before practice. Methods 40 nursing undergraduates who practiced in our department in 2018 were selected as the control group, and the traditional method of clinical teaching was adopted; 40 nursing undergraduates who practiced in 2019 were selected as the experimental group to evaluate the nursing knowledge and nursing operation ability of the interns before the practice, according to the evaluation results of professional knowledge and nursing technology of the interns, combined with the practice teaching at the end of the internship. The students in the two groups were evaluated on their theoretical knowledge, nursing operation technology and service satisfaction. Results The scores of nursing knowledge and nursing operation technology in the experimental group were higher than those in the control group, and the results of the two groups were statistically significance (P<0.001); the evaluation of service satisfaction in the experimental group was higher than that in the control group, and the results of the two groups were statistically significance (P<0.05); Conclusion To carry out the management of nursing clinical practice training mode combining the evaluation of nursing professional ability with teaching objectives before practice is helpful for the teachers to find out problems of lack of nursing knowledge and weak nursing technology existing in the interns. It helps the teachers to formulate reasonable practice teaching plan and key points, and improves the effect of students' clinical practice and the quality of teaching.
论著

精神科急救培训用护士作标准化病人的培养与使用

Training and application of nurses as standardized patients for psychiatric first aid

:89-92
 
目的 探讨精神科急救培训用护士作为标准化病人的培养方法。方法 2013年9月挑选了4名精神科护士参加标准化病人系统培训,考核合格后成为护士标准化病人在2013年10月—11月对30名新护士自缢、噎食急救培训和考核中使用。结果 对急救培训中使用护士标准化病人,30名新护士中认为“新颖,第一次接触”19人(63%)、“满意”的26人(87%);4名作为标准化病人的护士都认为“非常有意义”。结论 精神科急救培训应用护士标准化病人丰富了培训的形式和内涵,得到了绝大部分参与人员的肯定。
Objective To explore the methods of training nurses as standardized patients for psychiatric first aid. Methods 4 nurses were selected to participate in the psychiatric standardized patient training program and all passed the examination. Using these nurse standardized patients to train the 30 new nurses for psychiatric first aid. Results After the first aid training, 19 of the 30 new nurses(63%) felt that it was “novelty and interesting”. 26 nurses(87%) felt “being satisfied”. And those 4 standardized patients felt “very meaningful”. Conclusion Training and application of nurses as standardized patients for psychiatric first aid may enrich the form and content of training program, and gains most of the participants affirmation.
论著

医护合作客观结构化临床考试培训对手术室低年资护士应急能力的影响

Effects of objective structured clinical examination training on emergency ability of the junior nurses in operation room

:54-56
 
目的 探讨医护合作客观结构化临床考试(OSGE)培训对手术室低年资护士应急能力的影响效果。方法 对36名手术室低年资护士进行医护合作OSGE培训,于培训前和培训后3个月对低年资护士进行手术意外事件应对能力、实际参与应对手术意外事件能力以及对手术配合满意度的测评。结果 培训后低年资护士在医护配合、抢救仪器准备、抢救能力、病情评估、应对能力的得分显著提高,在护士抢救到位时间、抢救仪器到位时间、静脉穿刺成功时间明显缩短,医护对手术配合满意度明显提升,与培训前比较差异均有统计学意义(P<0.05)。结论 对手术室低年资护士进行医护合作OSGE培训,可提高其对手术意外事件应对能力和实际参与应对手术意外事件能力,提高医护人员对手术配合的满意度,降低手术风险。
Objective To explore the effect of Objective structured clinical examination (OSGE) training on theemergency ability of nurses in the operation room. Methods Medical cooperation OSGE training was taken for 36 junior nurses in operation room. We evaluated their undergo operation contingency ability, participation contingency ability and operation cooperation in 3 months before and after training. Results After the training, the junior nurses in medical care cooperation, rescue ability, equipment preparation, condition assessment, coping ability were significantly higher. Nurses′s in-place time, equipments in place time, puncture time were shortened. Cooperation satisfaction was improved significantly. Compared with that before training, the differences were statistically significant (P<0.05). Conclusion Medical cooperation OSGE training for junior nurses in operation room may improve undergo operation contingency ability, coping contingency ability and operation cooperation, reduce the risk of surgery.
全科医学

急救培训普及工作的开展与推广方式探讨

Discussion on Promotion Method for Popularization of First-Aid Training and its Development

:91-92
 
目的 调查公众急救培训普及现状及培训需求相关信息,并结合对院前急救工作及急救培训工作等经验的总结与思考,展开对急救培训普及工作的探讨,以指导我国急救培训工作的进一步开展与推广。方法 采用分层随机抽样法,对本市477名市民进行问卷调查。结果 425人(89.1%)认为在18周岁以前就需要掌握基本的急救知识;如无法律保障,原本愿意救援的市民299人中有117人(39.1%)选择放弃施救;最为认同的教学方法是模拟及角色扮演;最希望通过急救培训获得在突发意外灾害事件中正确有效的自救互救能力。结论 普及基本急救知识是城市或区域初级保健的一项重要内容,而目前普及率极低,市民需求迫切,呼吁各级政府及相关的公共服务部门要有计划地多方位、多渠道地组织市民进行内容丰富、形式多样急救培训。
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