目的：结合眼科住院医师规范化培训(住培)的特点，建立基于钉钉平台的全面质量管理模式(total quality management, TQM)，探索一种高效的顺应时代特征的眼科教学管理模式。方法：研究团队依托中山大学中山眼科中心，选取82名眼科四证合一的住培一年级的学生作为研究对象，并将其随机分为两组，试验组41人采用基于钉钉平台的TQM模式进行全过程教学管理，采用全员参与、全程跟踪、全面评价的管理模式以保障教学质量。对照组41人接受传统的教学管理模式。观察指标为两组间教学前后测试分数、教学后满意度调查的问卷得分等。结果：通过对两组学生进行课前课后的测试，TQM模式组相较于传统模式组在学习成绩有所提升，课前课后分数的差值分别为40(30,40)分和30(20,50)分，比较差异有统计学意义(P =0.031)。问卷调查结果显示，两组满意度总分比较差异无统计学意义[10(10,10) 分 vs. 10(9,10)分，P =0.207]，但在满意度分项内容掌握性上，TQM模式组分值高于传统模式组[5(5,5)分 vs. 5(4,5)分，P =0.046]。结论：基于钉钉平台的TQM模式在眼科教学中能够有效提高住培的教学质量与学生满意度，相比传统教学管理模式具有更大的教学优势，可为眼科住培提供了一种创新且实用的教学管理模式，对于培养适应时代需求的高水平眼科医师具有重要意义。
Objective: To combine the characteristics of standardized training for ophthalmic resident physicians, establishes a Total Quality Management (TQM) model based on the DingTalk platform, and explored an efficient ophthalmic teaching management model that adapts to the characteristics of the times. Methods: The research team, based at Zhongshan Ophthalmic Center, selected 82 first-year postgraduate students undergoing the national standardized training for resident doctors (STRD) as participants, randomly allocating them into two groups. The experimental group consisting of 41 trainees received TQM-modeled online learning via the DingTalk platform, adopting a management model of full participation, full process tracking, and comprehensive evaluation to ensure teaching quality. While the control group, also comprising 41 trainees, underwent traditional offline instruction. The TQM group engaged in live streaming lectures on the DingTalk platform, whereas the conventional group continued with face-to-face teaching in classroom. Data including pre- and post-teaching scores, as well as scores from satisfaction surveys are analyzed. Results: Comparing pre- and post-teaching scores, significant statistical differences were found between the TQM and traditional groups, with mean score improvements of 40(30,40) points and 30(20,50) points, respectively, indicating statistical significance (P =0.013). Furthermore, the questionnaire survey revealed that the TQM group scored higher than the traditional group in aspects such as course design, clinical relevance, content mastery, and instructor satisfaction. In addition, the questionnaire survey showed that there was no statistically significant difference in the total satisfaction score between the two groups (10(10,10) points vs. 10(9,10)points P =0.207), but in terms of mastery of satisfaction sub items, the TQM model group scored higher than the traditional model group (5(5,5) points vs. 5(4,5) points, P =0.046). Conclusions: The application of a TQM-based model on the DingTalk platform significantly enhances the teaching quality and student satisfaction in the residency training of ophthalmologists, demonstrating greater pedagogical advantages over traditional methods. This efficient ophthalmic teaching management model thus provides a promising solution for standardized residency training in ophthalmology, and holds considerable importance for nurturing highly competent ophthalmologists who can meet the demands of the current era.
目的：以提升进行住院医师规范化培训(住培)的眼科医生临床诊疗思维能力为导向，建立LRC渐进协作教学体系(LRC Stepwise Collaborative Learning Model)。方法：2023年7月—2023年12月，以26名进行眼科住培的医生为试验组的研究对象，采用小讲课(Lecture)、教学查房(Rounds)及病例讨论(Case discussion)的LRC渐进协作教学体系，通过定量分析方法评估教学效果。结果：实施LRC渐进协作教学模式后，住培医生平均成绩由培训前的50.00 (40, 50)分提高至培训后的90.00 (80, 100)分，差异具有统计学意义(P＜0.001)。问卷调查满分5分，小讲课、教学查房和病例讨论三种教学形式的满意度满分比例分别为92.3%(24/26)，84.6%(22/26)、76.9%(20/26)，三种教学形式的满意评分分别为5.00 (5.00, 5.00)、5.00 (5.00, 5.00)、5.00 (4.75, 5.00)分。结论：LRC渐进协作教学体系作为住培教学新体系，得到眼科住培医生的认可，促进临床诊疗思维的整体提升，有助于岗位胜任力的培养，为未来教学模式的设计与实施提供了重要参考。
Objective: To introduce the LRC Stepwise Collaborative Learning Model, a novel teaching approach designed to improve clinical thinking skills in ophthalmology training. Methods: From July 2023 to December 2024, 26 ophthalmology residents were included in the experimental group, underwent training using LRC Stepwise Collaborative Learning Model of Lectures, Rounds and Case Discussions. Their educational outcomes were quantitatively analyzed. Results: The LRC Stepwise Collaborative Learning Model improved average resident scores from pre-training [50(40, 50) points] to post-training [90(80,100) points], with a statistical significance (P < 0.001). The questionnaire survey had a maximum score of 5 points, and the rates of full marks for the three teaching forms of lectures, rounds, and case discussions were 92.3% (24/26), 84.6% (22/26), and 76.9% (20/26), respectively. The satisfaction scores for the three teaching forms were 5.00 (5.00, 5.00), 5.00 (5.00, 5.00), and 5.00 (4.75, 5.00) points, respectively. Conclusions: The LRC Stepwise Collaborative Learning Model, as a new training system for residency education, has been recognized by ophthalmology residents. It facilitates the overall improvement of clinical thinking, contributes to competency development, and provides valuable insights for future teaching model designs.
目的：探讨眼底外科医护一体组团合作模式在管理眼底病日间手术患者实践效果。方法：选取2022年1—6月进行日间手术的582例眼底病患者为对照组，2023年1—6月进行日间手术的633例眼底病患者为研究组，对照组实施责任制整体护理，研究组采取实施医护一体组团合作管理模式进行全流程患者管理。使用χ2检验和t检验比较两组患者围术期护理知识健康教育知晓度、满意度、出院24 h内眼科急症就诊率、出院24 h内随访率、护士职业获益感的差异。结果：研究组患者健康教育知晓度高于对照组，组间比较差异具有统计学意义(t=–18.47，P＜0.05)；研究组患者满意度高于对照组，组间比较差异具有统计学意义(t=–4.005，P＜0.05)；研究组患者出院24 h内随访率为100%，对照组为98.1%，两组比较差异有统计学意义(χ2=12.073，P＜0.05)；研究组患者出院24 h内眼科急症就诊率0.94%，对照组为1.89%，组间比较差异无统计学意义(χ2=1.951，P=0.222)；实施后护士职业获益感分值高于实施前，组间比较差异具有统计学意义(t=–6.637，P＜0.001)。结论：医护一体组团合作管理模式进行眼底外科日间手术患者围术期的全流程管理，改善患者就医感受，提升患者就医体验，提高眼底外专科日间手术患者的依从性，保障患者的安全，提高护士职业获益感。
Objective: To investigate the practical effect of the integrated group cooperation model in managing patients with fundus diseases in day surgery. Methods: 582 patients with fundus disease who underwent day surgery from January to June in 2022 were included as the control group, and 633 patients with fundus disease who underwent day surgery from January to June in 2023 were selected as the study group. The control group implemented the overall responsibility nursing system, while the study group carried out the collaborative management model, integrating medical and nursing for the entire process of patient management. Chi-square test and T-test were used to compare the differences of perioperative nursing knowledge, health education awareness, satisfaction, emergency ophthalmological consultation rate within 24 hours of discharge, follow-up rate within 24 hours of discharge, and nurses' sense of professional benefit between the two groups. Results: The awareness of health education in the study group was higher than that in the control group, and there was significant statistically difference between two groups (t=–18.47, P<0.05). The satisfaction of patients in the study group was higher than that in the control group, and there was significant statistically difference between two groups (t=–4.005, P ＜ 0.05). The follow-up rate within 24 hours after discharge was 100% in the study group and 98.1% in the control group, and the difference was statistically significant (χ2=12.073, P<0.05). The incidence of ophthalmic emergencies within 24 hours of discharge in the study group was 0.94%, while in the control group it was 1.89%. There was no statistically significant difference between the two groups (χ2= 1.951, P=0.222). The perceived benefit score of nurses after implementation was higher than that before implementation, and there was statistically significant between two groups (t=–6.637, P<0.05). Conclusions: The medical and nursing integrated group cooperation management model is used to manage the entire perioperative process of patients undergoing day surgery in fundus surgery. This model can improve patients' medical experience, enhance their compliance with ophthalmic surgery, ensure their safety. At the same time, it can enhance the senses of professional benefits for nurses.
近年来，脂质代谢紊乱与眼科疾病关系密切。体外研究和临床前模型显示，高密度脂蛋白(high density lipoprotein，HDL)及其主要蛋白成分载脂蛋白A1(apolipoprotein A1，apoA1)对内皮细胞具有抗氧化、抗炎和抗凋亡作用，对血管具有强大的保护作用。ApoA1模拟肽能够模拟apoA1功能，且分子质量更小，前景非常乐观。而动物实验及人体试验均证实了模拟肽D-4F口服使用的安全性及有效性，因此目前研究最为广泛。目前来说，对于apoA1及其模拟肽在眼科疾病的研究中属于萌芽阶段。本文总结了apoA1及其模拟肽的结构，及其在眼科疾病如视光学、角膜病、玻璃体视网膜疾病中的研究进展，为apoA1及其模拟肽在眼科的进一步研究及开发利用提供参考。
The recent researches indicate that the disorder of lipid metabolism is closely related to ophthalmic diseases.In vitro studies and preclinical studies have shown that high density lipoprotein (HDL) and its main structural protein apolipoprotein A1 (apoA1) have superior efficacy in blood vessel protection, with antioxidant, anti-inflammatory and antiapoptotic effects on endothelial cells. Prospect of the ApoA1 mimetic peptide is very optimistic as it can mimic the function of apoA1, and its molecular weight is smaller. The safety and efficacy of oral use of mimetic peptide D-4F have been confirmed in both animal experiments and clinic trials. Thus, it had been extensively studied. In this paper, we reviewed the structure of apoA1 and its mimetic peptide, as well as their researches related to ophthalmic diseases, such as optometry, corneal diseases and vitreoretinal diseases, so as to provide reference to further researches in apoA1 and its mimetic peptide in the of ophthalmic diseases.
研究生导师的能力和水平是影响研究生教育质量的最关键因素之一。针对眼科学研究生专业基础 知识薄弱、动手实践机会缺乏、创新能力不足，导师队伍教学主动性不强、活力欠佳等问题，中 山眼科中心逐步建立了“行政+专家”的双重教学管理架构，引导激励教师积极主动参与、推动研 究生课程改革、科研创新能力培训、教学信息化建设、教学质控与学生管理等各项教学改革与决 策，通过不断完善教师参与教学改革共同治理的长效机制，打造高素质的教师队伍，实现高质量 的眼科学研究生培养。
The ability and level of postgraduate tutor is one of the key factors affecting the quality of graduate education. In view of the weak basic ophthalmic knowledge, lack of practical opportunities and the inefficiency in innovation ability among ophthalmology graduates, as well as the lack of initiative and vitality in teaching team, Zhongshan Ophthalmic Center, Sun Yat-Sen University has been gradually established the dual management structure of “administration and experts”. By guiding and encouraging the teachers participate in the curriculum reform of graduates, scientific research ability training, management informatization, the teaching quality control, student administration and so on. Through improving the long-term mechanism of teachers’ participation in teaching reform governance, the quality of teachers has been improved, which promote the high-quality development of ophthalmology graduate education.
近年来，脂质代谢紊乱与眼科疾病关系密切。体外研究和临床前模型显示，高密度脂蛋白(high density lipoprotein，HDL)及其主要蛋白成分载脂蛋白A1(apolipoprotein A1，apoA1)对内皮细胞具有抗氧化、抗炎和抗凋亡作用，对血管具有强大的保护作用。ApoA1模拟肽能够模拟apoA1功能，且分子质量更小，前景非常乐观。而动物实验及人体试验均证实了模拟肽D-4F口服使用的安全性及有效性，因此目前研究最为广泛。目前来说，对于apoA1及其模拟肽在眼科疾病的研究中属于萌芽阶段。本文总结了apoA1及其模拟肽的结构，及其在眼科疾病如视光学、角膜病、玻璃体视网膜疾病中的研究进展，为apoA1及其模拟肽在眼科的进一步研究及开发利用提供参考。
The recent researches indicate that the disorder of lipid metabolism is closely related to ophthalmic diseases. In vitro studies and preclinical studies have shown that high density lipoprotein (HDL) and its main structural protein apolipoprotein A1 (apoA1) have superior efficacy in blood vessel protection, with antioxidant, anti-inflammatory and antiapoptotic effects on endothelial cells. Prospect of the ApoA1 mimetic peptide is very optimistic as it can mimic the function of apoA1, and its molecular weight is smaller. The safety and efficacy of oral use of mimetic peptide D-4F have been confirmed in both animal experiments and clinic trials. Thus, it had been extensively studied. In this paper, we reviewed the structure of apoA1 and its mimetic peptide, as well as their researches related to ophthalmic diseases, such as optometry, corneal diseases and vitreoretinal diseases, so as to provide reference to further researches in apoA1 and its mimetic peptide in the field of ophthalmic diseases.
