基于成果导向教育理念的急诊科住院医师规范化培训气管插管教学实践

doi:10.16138/j.1673-6087.2025.06.08

摘要/Abstract

摘要：

目的：探讨基于成果导向教育（outcome-based education，OBE）理念的教学方法在急诊科住院医师规范化培训（住培）气管插管实训教学中的应用效果。方法：选取2023年8月—2024年7月于上海交通大学医学院附属瑞金医院急诊科住培医师48名为研究对象，随机分为OBE教学组和传统实训组，对2组学生采取相对应的教学方法，比较2组学生的考核成绩、考试通过率，并在课后进行对教学方法的满意度以及操作成功自信心的问卷调查。结果：OBE教学组理论考核和操作考核成绩优于传统实训组（均P<0.05)。OBE教学组操作考核时气管插管一次性通过率高于传统实训组（79.2%比20.8%，P<0.001），气管插管时间短于传统实训组[（63.2±20.7）s 比（97.3±12.8） s，P<0.001]。OBE教学组对教学的满意度以及操作成功的信心高于传统实训组（均P<0.001)。结论：基于OBE理念的教学方法可以有效提高急诊科住培医师气管插管技能，为气管插管实训课程提供新的教学模式。

关键词: 成果导向教育, 气管插管, 急诊医学教学, 住院医师, 规范化培训

Abstract:

Objective To evaluate the effect of outcome-based education (OBE) approach on endotracheal intubation training for emergency department residents during the standardized residency training. Methods From August 2023 to July 2024, 48 emergency department residents undergoing standardized training at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were enrolled and randomly assigned to an OBE teaching group or a traditional training group. Each group received the corresponding teaching method, and the examination scores as well as pass rates were compared between the two groups. After the training, a questionnaire was administered to assess satisfaction with the teaching method and confidence in performing successful endotracheal intubation. Results The OBE teaching group achieved significantly higher theoretical and practical examination scores than the traditional training group (P < 0.05). The OBE group has a higher first-attempt success rate of endotracheal intubation during the practical examination than the traditional group (79.2% vs 20.8%, P < 0.001), and a significantly shorter intubation duration [(63.2 ± 20.7) s vs (97.3 ± 12.8) s, P < 0.001]. The OBE group also reported higher satisfaction with the teaching method and greater confidence in performing the procedure successfully (P < 0.001). Conclusions The OBE-based teaching method can effectively improve endotracheal intubation skills of emergency department residents, and offers a new instructional model for practical endotracheal intubation courses.

Key words: Outcome-based education, Endotracheal intubation, Emergency medicine education, Resident, Standardized training

中图分类号:

R459.7

陈敏, 盛慧球, 杨之涛, 周伟君, 毛恩强. 基于成果导向教育理念的急诊科住院医师规范化培训气管插管教学实践[J]. 内科理论与实践, 2025, 20(06): 477-481.

CHEN Min, SHENG Huiqiu, YANG Zhitao, ZHOU Weijun, MAO Enqiang. Teaching practice of endotracheal intubation in emergency department standardized residency training guided by the outcome-based education concept[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(06): 477-481.

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组别	年龄（岁）	男性[n（%）]	本科学历[n（%）]
传统实训组	26.7 ± 3.3	13（54.2）	8（33.3）
OBE教学组	25.6 ± 1.9	12（50.0）	8（33.3）
t/χ²	0.882	0.083	0.000
P	0.391	0.773	1.000

组别	理论考核成绩	操作考核成绩
传统实训组	81.6 ± 8.6	85.8 ± 3.4
OBE教学组	88.8 ± 3.6	92.1 ± 4.1
t	−2.330	−3.540
P	0.033	0.003

组别	气管插管一次性通过率[n（%）]	气管插管时间（s）
传统实训组	5（20.8）	97.3 ± 12.8
OBE教学组	19（79.2）	63.2 ± 20.7
t/χ²	16.333	4.205
P	< 0.001	< 0.001

组别	教学的满意度				操作成功的信心
组别	4分	3分	2分	1分	4分	3分	2分	1分
传统实训组	3（12.5）	8（33.3）	13（54.2）	0（0.0）	0（0.0）	0（0.0）	5（20.8）	19（79.2）
OBE教学组	19（79.2）	5（20.8）	0（0.0）	0（0.0）	19（79.2）	3（12.5）	2（8.3）	0（0.0）
Z	− 4.979				− 6.245
P	< 0.001				< 0.001