引用本文:刘婧宇,赵婧雅,黄轩,黄林环,何志明,罗艳敏,陈海天,周祎.情景模拟联合Debriefing-GAS方法在产前遗传咨询教学中的应用[J].中华医学教育探索杂志,2024,23(5):677-682
情景模拟联合Debriefing-GAS方法在产前遗传咨询教学中的应用
Application of situational simulation combined with the debriefing-GAS method in the teaching of prenatal genetic counseling
DOI:10.3760/cma.j.cn116021-20221003-01556
中文关键词:  复盘  遗传咨询  胎儿医学  医学模拟教育  教学改革
英文关键词:Debriefing  Genetic counseling  Fetal medicine  Simulation-based medical education  Teaching reform
基金项目:2021中山大学本科教学质量与教学改革工程项目(31911130-210407);2022年中山大学附属第一医院毕业后医学教育教学改革(B202218);2022年广东省本科高校教学质量与教学改革工程项目(粤教高函〔2023〕4号)
作者单位邮编
刘婧宇 中山大学附属第一医院妇产科广州 510080 510080
赵婧雅 中山大学附属第一医院妇产科广州 510080 510080
黄轩 中山大学附属第一医院妇产科广州 510080 510080
黄林环 中山大学附属第一医院妇产科广州 510080 510080
何志明 中山大学附属第一医院妇产科广州 510080 510080
罗艳敏 中山大学附属第一医院妇产科广州 510080 510080
陈海天 中山大学附属第一医院妇产科广州 510080 510080
周祎* 中山大学附属第一医院妇产科广州 510080 510080
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中文摘要:
      目的 探讨情景模拟联合(Debriefing-GAS)方法在产前遗传咨询能力教学中的应用效果。方法 选取2021年5月至2022年5月在中山大学附属第一医院进行遗传咨询培训的30名2017至2018级五年制和八年制临床医学专业本科生作为研究对象,采用情景模拟联合Debriefing-GAS方法对学生进行胎儿疾病产前遗传咨询教学。通过教师考核比较教学过程中遗传咨询能力的变化,并通过问卷调查学生对于教学的满意度。采用SPSS 26.0统计软件进行数据分析;正态分布计量资料采用(均数±标准差)表示,非正态分布计量资料采用中位数(四分位数)表示,计数资料采用频数及率表示;采用配对样本t检验比较教学前后考核成绩。结果 经过教学后,学生遗传咨询考核成绩与教学前比较有所提高[(74.5±18.6)分vs.(87.2±14.5)分,t=4.10,P<0.001],临床能力[(35.4±9.6)分 vs.(41.1±6.9)分,t=3.72,P=0.001)]、医患沟通能力[(17.5±4.6)分vs.(20.8±3.8),t=4.34,P<0.001]、专业素养[(11.0±2.5)分 vs.(12.5±2.3)分,t=2.89,P=0.007]、团队合作能力[(3.5±1.0)分vs.(4.2±0.8)分,t=3.67,P=0.001),以及组织效能[(7.1±2.0)分vs.(8.3±1.7)分,t=2.94,P=0.006]等综合能力均得到提升,差异有统计学意义。问卷调查结果显示,学生对遗传咨询教学整体实施流程及环节设置合理性[3.0(3.0,4.0)分]、教学质量[3.5(3.0,4.0)分]、教学能否有效增加学生的学习兴趣及主动性[4.0(3.0,4.0)分]、提高理论知识水平[4.0(3.0,4.0)分]、遗传咨询沟通技巧的掌握[3.0(3.0,4.0)分],以及相关技术研究和应用前景了解[3.0(3.0,4.0)分]的满意度评价等级均在满意之上。但有2名(6.7%)学生认为,此种教学方式并不能高效地达到教学目的,因为教学过程稍显冗长复杂。结论 情景模拟联合Debriefing-GAS方法在产前遗传咨询教学中获得了较好的应用效果,可以帮助本科生掌握产前遗传咨询理论知识,提高其临床综合素养,学生满意度较高,可在临床中推广应用。
英文摘要:
      Objective To investigate the application effect of situational simulation combined with the Debriefing-GAS method in the teaching of prenatal genetic counseling.Methods A total of 30 medical students of the five- and eight-year programs in the classes of 2017 and 2018 who received genetic counseling training in The First Affiliated Hospital of Sun Yat-sen University from May 2021 to May 2022 were selected as research subjects, and situational simulation combined with the debriefing-GAS method was used for the teaching of prenatal genetic counseling. Assessment was performed by the teacher to evaluate the change in genetic counseling abilities during the teaching process, and a questionnaire survey was conducted to investigate the degree of satisfaction with teaching among the students. SPSS 26.0 software was used for data analysis; normally distributed continuous data were expressed as mean±standard deviation, non-normally distributed continuous data were expressed as Md(P25,P75), and categorical data were expressed as frequency and rate; the paired samples t-test was used for comparison of assessment scores before and after teaching.Results After teaching, there were significant increases in the assessment scores of genetic counseling [(74.5±18.6) points vs. (87.2±14.5) points, t=4.10, P<0.001] and comprehensive abilities such as clinical ability [(35.4±9.6) points vs. (41.1±6.9) points, t=3.72, P=0.001], doctor-patient communication [(17.5±4.6) points vs. (20.8±3.8) points, t=4.34, P<0.001], professional literacy [(11.0±2.5) points vs. (12.5±2.3) points, t=2.89, P=0.007], teamwork [(3.5±1.0) points vs. (4.2±0.8) points, t=3.67, P=0.001], and organizational effectiveness [(7.1±2.0) points vs. (8.3±1.7) points, t=2.94, P=0.006]. The questionnaire survey showed that the degree of satisfaction among students was rated above satisfaction for the reasonability of the implementation process and links of genetic counseling teaching [3.0 (3.0, 4.0) points], teaching quality [3.5 (3.0, 4.0) points], whether the teaching model could effectively increase the interest and initiative in learning [4.0 (3.0, 4.0) points], the improvement in theoretical knowledge [4.0 (3.0, 4.0) points], communication skills in genetic counseling [3.0 (3.0, 4.0) points], and the understanding of related techniques and application prospect [3.0 (3.0, 4.0) points]. However, two students (6.7%) thought that this teaching model could not efficiently reach teaching objectives, since the teaching process was slightly complicated.Conclusions Situational simulation combined with the debriefing-GAS method has achieved a good effect in the teaching of prenatal genetic counseling and can help undergraduates to master the theoretical knowledge of prenatal genetic counseling and improve their comprehensive clinical abilities, with a relatively high degree of satisfaction, and therefore, it holds promise for clinical application.
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