培养合格的眼科医师对于防盲治盲工作、为人民提供优质眼健康服务是十分重要的,不同地区的住院医师规范化培训各有特点。文章从各个方面比较了内地与香港眼科住院医师规范化培训体系的异同,包括培训对象、培训师资、轮转阶段和要求、考核机制。香港的培训体系时间为6年,大致上相当于住院医师规范化培训和专科医师规范化培训结合在一起。通过比较两者的差异,有助于我们结合自己的实际情况,改进内地的眼科学住院医师教育培养体系,也为下一步开展眼科专科医师规范化培训提供参考。
The training of qualified ophthalmologists holds paramount significance in preventing blindness, treating eye diseases, and delivering optimal eye health services to the people. Given the unique nature of standardized residency training across geographical regions, this study delves into the comparative analysis of ophthalmology residency standardized training systems in the Mainland and Hong Kong. Specifically, we examine the the similarities and disparities in multiple facets, encompassing trainees' profiles, faculty expertise, rotation phases and prerequisites, as well as assessment methodologies. Notably, the training system in Hong Kong has a duration of 6 years, approximating the combined length of standardized residency training and standardized specialist training. By comparing the differences, we aim to facilitate the refinement of ophthalmology residency education and training in Mainland China, tailored to our specific context, while also serving as a reference for advancing standardized ophthalmology specialist training initiatives.
目的:了解医学专业学位硕士(专硕)研究生培养并轨住院医师规范化培训制度下的眼科专硕科研能 力现状,并提出提升科研能力的对策。方法:对哈尔滨医科大学三所附属医院眼科学76名不同年级 专硕研究生的科研能力现状、阻碍科研学习的因素、科研训练意愿等进行问卷调查。结果:在目前 的培养模式下,专硕科研和临床知识基础相对薄弱及临床学习任务繁重是科研学习的主要障碍。 结论:提出教学基地可以因需施教、提供多模式科研训练;强化临床诊疗培训为科研思维培养助 力;导师可以结合新时代发展背景优化科研选题策略、拓宽学生科研视野等措施。
Objective: To understand the current situation of scientific research ability of postgraduates with professional degrees in ophthalmology and put forward improvement measures. Methods: A questionnaire survey was conducted on the current situation of scientific research ability, scientific research obstacles and scientific research training willingness, 76 postgraduate students of different grades majoring in ophthalmology of three affiliated hospitals of Harbin Medical University were involved. Results: Under the merging residency training system, the foundation of scientific research and clinical knowledge of postgraduates is relatively weak, and the heavy clinical learning task were the main obstacles to scientific research of postgraduates. Conclusion: It is proposed that the teaching bases could provide multi-mode scientific research training to cater to students' individual needs. Not only clinical diagnosis and treatment training could be strengthened to cultivate students’ scientific research thinking, but scientific research topic selection strategy could be optimized by to meet the demand for development of times and broaden students’ scientific research vision.
目的:探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法:通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间,安排老师和学员出诊;在教学门诊开展4个月后,通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。 结果:共有16名老师和8名学员参加了督导式教学门诊,调查问卷结果显示100%的带教老师和学员认可该教学模式,参加过教学门诊的学员临床技能考核得分显著高于对照组(t =3.631, P<0.05)。结论:督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性,并可以提高学员的临床技能水平。
Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents.
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:比较单一EYESi虚拟手术模拟器(Dry-lab)、Wet-lab以及两种方式联合教学在超声乳化白内障吸除显微手术培训中的效果及差异,以期探索更科学高效的教学方式。方法:选取中山大学中山眼科中心接受住院医师规范化培训的1年级住院医师18名,随机分为Dry-lab组、Wet-lab组和联合组,每组各6人,分别接受8次有效Dry-lab训练、8次Wet-lab训练、4次有效Dry-lab训练联合4次Wet-lab训练。培训前后问卷调查评估三种教学方式的模拟效果与学员满意度,并在猪眼模型上考核超声乳化白内障吸除手术的三个主要步骤,以评估学员的培训效果。结果:Dry-lab与Wet-lab训练均能有效帮助学员学习使用显微器械,操作手感较好。但在立体感(P=0.007)、与人眼操作相比近似度(P<0.001)以及对掌握技术的帮助度(P=0.003)上,Wet-lab优于Dry-lab训练;而在缩短培训用时(P<0.001)上,Dry-lab培训更具优势。联合培训模式培训效果优于单一Wet-lab训练(P=0.014)和模拟器培训(P=0.012),整体满意度高于Wet-lab训练(P=0.042)和Dry-lab培训(P=0.042)。结论:Dry-lab与Wet-lab训练在超声乳化白内障吸除显微手术培训中各有优势,而两者相结合的教学模式更为高效,培训效果更佳,整体满意度高。
Objective: To compare the effects and distinctions among three methods of phacoemulsification training: EYESi simulator (Dry-lab), Wet-lab, and a combined approach, in order to find out more scientific and efficient teaching method. Methods: 18 first-year residents undergoing residency training at Zhongshan Ophthalmic Center, Sun Yatsen University were randomly assigned to three groups: Dry-lab, Wet-lab, and Combined. Each group, consisting of 6 individuals, underwent a specific training regimen—8 sessions of effective simulator training for the Dry-lab group, 8 Wet-lab sessions for the Wet-lab group, and a combination of 4 effective simulator sessions with 4 Wet-lab sessions for the Combined group. The questionnaires were administered to assess simulation effects and student satisfaction before and after each training sessions. Additionally, the training effects were recorded in the three main steps of phacoemulsification cataract extraction surgery on a pig eye model. Results: Both the EYESi simulator and Wet-lab were proved to be effective in facilitating the learning of microscopic instrument use with commendable operating experience. However, Wet-lab is superior to the virtual simulator in terms of stereoscopic sensation (P=0.007), similarity to the human eye (P<0.001), and assistance in mastering techniques(P=0.003). Simulator training is found to be more advantageous in shortening the overall training time (P<0.001). The training effect of the joint training mode is better than that of single Wet-lab training (P=0.014) and simulator training (P=0.012), and the overall satisfaction is higher than that of Wet-lab training (P=0.042) and simulator training (P=0.042). Conclusion: The EYESi virtual surgery simulator and Wet-lab training have their advantages respectively in training for phacoemulsification cataract extraction microsurgery, and the combined teaching mode is more efficient, with better training effects and overall satisfaction.
目的:探讨眼科临床指南结合团队式学习(team-based learning,TBL)教学课程在眼科住院医师规范化培训中的应用及教学效果。方法:本研究选取2022年1月—2023年6月在广州医科大学附属第一医院眼科进行住院医师规范化培训的15名住院医师作为研究对象,先后交替使用自学讲课、TBL教学这两种教学模式进行眼科临床指南学习,通过填写满意度调查问卷及评估出科考通过率、学业水平测试成绩、结业考通过率,从主观及客观角度探讨临床指南结合TBL学习模式的教学效果。结果:住院医师对增加眼科临床指南学习具有较高评价,且不认为会增加其学习负担。开展指南学习后,住院医师出科考试及格率、学业水平测试通过率、结业考通过率均为100%。在培养团队合作能力、改善学习氛围两方面,TBL讲课的满意度均高于自学讲课(均P<0.001)。93.3%(14/15)的住院医师更喜欢TBL教学模式。结论:眼科临床指南结合TBL教学是一种有效的教学模式,住院医师在主观满意度调查问卷及客观考试成绩的评估中,均达到满意的教学效果。
Objective: To investigate the application and teaching effect of clinical guidelines combined with team based learning(TBL) teaching courses in standardized training for ophthalmic residents. Methods: 15 residents who received standardized training in the ophthalmology department of the First Affiliated Hospital of Guangzhou Medical University were recruited from January 2022 to June 2023. Self-study teaching and TBL teaching were successively applied to teach the clinical guidelines of ophthalmology. The subjective and objective teaching effects were evaluated by satisfaction questionnaire, passing rate of phase examination, achievement of academic proficiency test and passing rate of final examination. Results: The clinical guidelines enjoy the high opinion in the residents, and would not be strengthen their learning burden. After the residents studied clinical guidelines, their passing rate of the phase exam, academic proficiency test and final examination were all 100%. In terms of cultivating teamwork ability and study atmosphere, the satisfaction of TBL lectures was significantly higher than that of self-study lectures (P< 0.001). 93.3% (14/15) of the residents preferred TBL lectures. Conclusions: The combination of ophthalmology clinical guidelines and TBL teaching was proved to be an effective teaching model. The residents achieved excellent teaching results in the subjective satisfaction questionnaire and objective examination scores.
目的:探讨专科护士培训方式以提高斜视病区护士的专业技能以及专科理论水平。方法:每次由护士长安排一名护士进入科主任所在的医疗小组进行为期3~4个月的培训,培训内容主要包括与医生一起出门诊、学习术前斜视专科检查、参加患者术前手术方案的制定和术后的查房,定期参加科室的理论培训。结果:实施斜视专科护士培训方法后,经过培训的护士掌握了斜视专科常用的检查方法,能解读本专科的相关检查报告,护士的专科工作能力、应对咨询能力有提高,医生、患者对护士的满意度均有提高。结论:斜视病区专科护士培训方法对临床护理工作有积极的影响,值得临床科室借鉴。
Objective: To improve the professional skills and theoretical level of the nurses, a new training method was adopted in strabismus ward. Methods: The head nurse arranged a nurse to participate in medical team the director of the department for 3–4 months. The medical works that the nurse had to follow included coperative outpatient medical work with the doctors, clinical examination before strabismus surgery, making individual surgical plans, nursing rounds of wards after surgery, and regular theoretical training of the department. Results: After implementing the training method of strabismus specialist nurses, the trained nurses mastered the common examination methods for strabismus patients, and could analyse the relevant examination reports. The ability of the nurses’ professional work and consultative capacity were improved. Furthermore, the satisfaction of doctors and patients on nursing work was improved. Conclusion: The new training method of specialist nurses in strabismus ward exerts positive effect on clinical nursing work, which is worthy of application in clinical practice.
目的:探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题,以期改进培训方式。方法:以2020年4月在中山大学中山眼科中心培训的154名学员为对象,进行问卷调查,采用SPSS 20.0统计学软件进行数据分析。结果:共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%;住培则显著高于前者,分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断,90.8%的专硕选择了临床诊断(P=0.007),94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001);而住培仅为去除囊壁(P<0.001)。结论:睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高,并根据各类型学员的临床能力和认知差异,进行分级分类培训。
Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.
目的:构建具有较强科学性和实用性的眼科专科护士培训体系,为眼科专科护士的准入、培养、考核提供理论基础。方法:通过查阅文献、焦点小组和专家会议法,拟定眼科专科护士培训体系的课程、带教、评价体系。结果:构建的眼科专科护士培训体系内容包括课程体系、培训过程、临床实践指标、考核评价方法4个部分。其中,课程体系部分包含一级指标5项,二级指标11项,三级指标55项;培训过程包括一级指标4项、二级指标12项;临床实践指标包括一级指标6项、二级指标23项;考核评价方法包括一级指标5项、二级指标10项。结论:眼科专科护士培训体系构建过程科学,内容设置合理,对开展专科护士培训具有较好的指导意义。
Objective: To develop a scientific and practical training system for ophthalmic specialist nurses and provide theoratical basis for the the admission, training and assessment of ophthalmic specialist nurses. Methods: Through extensive review of domestic and foreign literatures, a focus group interview and an expert meeting, the curriculum, teaching and evaluation system of the ophthalmic specialist nurses training system was developed.Results: The training system for ophthalmic specialist nurses consists of four parts: training content, training process, clinical practice, assessment and evaluation. Among them, the training content includes 5 first-level indicators, 11 second-level indicators and 55 third-level indicators. The training process of ophthalmic specialist nurses includes 4 indicators of the first level and 12 indicators of the second level. The clinical practice indexes of ophthalmic specialist nurses include 6 indexes of the first grade and 23 indexes of the second grade. The methods of assessment and evaluation of ophthalmic specialist nurses include 5 indicators of the first level and 10 indicators of the second level. Conclusion: The scientific process and reasonable content of the training system for ophthalmic specialist nurses have a good guiding significance for the training of ophthalmic specialist nurses.
目的:探讨以岗位需求为导向的培训模式在眼科手术室护士上岗前消毒供应专科专项培训中的应用效果。方法:手术室上岗前护士共44名,按随机分配原则,其中23名为实验组,另外21名为对照组。实验组以医院消毒供应中心三大行业标准和医院消毒技术规范为理论依据,以手术室护理岗位需求为目标,制定针对性培训内容,采用多方式培训方法,在消毒供应中心培训3个月考核合格后调入手术室。对照组直接调入手术室工作。采用手术室带教老师对新上岗护士满意度调查作为评价指标。结果:23名学员的理论知识考核、技术操作考核全部合格,小讲课顺利完成。手术室带教老师对实验组的满意度明显高于对照组。结论:建立以岗位需求为导向的眼科手术室护士消毒供应专科培训模式,有助于提高新上岗的手术室护士工作适应性,并提升手术室护士对专科器械的管理能力。
Objective: To explore the application effect of job demand-oriented training model in specialized training of sterile supplying for nurses in the ophthalmic operation room. Methods: A total of 44 nurses who would work in the operating room were randomly divided into the experimental group (n=23) and control group (n=21). Based on the three industrial standards of Central Sterile Supply Department (CSSD) and the technical specifications of disinfection in hospital, and targeting the job requirements of operating room nursing, the experimental group formulates specific training contents and adopts various training methods. The experimental group was transferred to the operating room after being trained in CSSD for 3 months and passing the examination. The control group was transferred directly to the operating room. The degree of satisfaction from the teachers of operating room to new nurses was used as the evaluation index. Results: All the 23 students passed the examination of theoretical knowledge and technical operation, and the small lectures were completed successfully. The degree of satisfaction from teachers in operating room to trainees was obviously higher than that of untrained nurses. Conclusion: The establishment of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room is helpful to improve the work adaptability of the newly-hired nurses in the operation room. It also helps the nurses in the operation room to enhance the management ability on the specialized instruments.