案例分析教学法联合教师标准化病人在卒中后神经源性膀胱临床沟通教学中的应用

doi:10.3969/j.issn.1673-5765.2024.06.013

中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (6): 725-728.DOI: 10.3969/j.issn.1673-5765.2024.06.013

案例分析教学法联合教师标准化病人在卒中后神经源性膀胱临床沟通教学中的应用

郝强¹，王首洋¹，柳竹²，张勇¹

1 北京 100070 首都医科大学附属北京天坛医院泌尿外科
2 首都医科大学附属北京天坛医院神经病学中心

收稿日期:2023-12-19 出版日期:2024-06-20 发布日期:2024-06-20
通讯作者: 张勇 zhangyongttyy@126.com
基金资助:
首都卫生发展科研专项（2022-2-2044）
首都医科大学2023年教育教学改革研究课题（2023JYY240）

Application of Case-Based Learning Combined with Teacher-Standardized Patient in Clinical Communication Teaching for Post-Stroke Neurogenic Bladder

HAO Qiang¹, WANG Shouyang¹, LIU Zhu², ZHANG Yong¹

1 Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
2 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2023-12-19 Online:2024-06-20 Published:2024-06-20
Contact: ZHANG Yong, E-mail: zhangyongttyy@126.com

摘要/Abstract

摘要： 目的探讨案例分析教学法（case-based learning，CBL）联合教师标准化病人（teacher-standardized patient，TSP）在卒中后神经源性膀胱医患沟通教学中的应用效果。
方法纳入首都医科大学附属北京天坛医院接受规范化培训的60名住院医师，随机分为对照组和试验组。对照组采用传统以授课为导向的教学法，试验组采用CBL联合TSP的教学方法。教学内容为卒中后神经源性膀胱的医患沟通，共计12学时。教学结束后使用TSP和医患沟通技能评价量表（set the stage，elicit information，give information，understand the patient’s perspective，and end the encounter；SEGUE）评估住院医师的医患沟通能力。
结果对照组和试验组在年龄、性别、入组前理论考试分数及操作考试分数方面差异无统计学意义。教学结束后，试验组在SEGUE的问诊准备[（4.6±0.6）分 vs.（3.7±0.8）分，P＜0.0001]、信息采集[（8.6±1.1）分 vs.（7.3±0.9）分，P＜0.0001]、信息提供[（3.7±0.5）分 vs.（3.3±0.6）分，P=0.0099]、患者理解[（3.5±0.4）分 vs.（2.4±0.7）分，P＜0.0001]及总分[（22.1±1.5）分 vs.（18.5±2.0）分，P＜0.0001]方面均显著高于对照组，在问诊结束[（1.7±0.6）分 vs.（1.7±0.5）分，P=0.6305]方面与对照组差异无统计学意义。
结论采用CBL联合TSP的教学方法能够显著提高住院医师在卒中后神经源性膀胱医患沟通方面的能力。这一教学策略有望成为医学教育中提高医患沟通技能的有效手段，从而提高医疗服务质量。

关键词: 案例分析教学法; 教师标准化病人; 医患沟通; 医学教育

Abstract: Objective To explore the effect of case-based learning (CBL) combined with teacher-standardized patient (TSP) in the teaching of doctor-patient communication for post-stroke neurogenic bladder.
Methods Sixty residents undergoing standardized training at Beijing Tiantan Hospital, Capital Medical University, were included and randomly divided into a control group and an experimental group. The control group received traditional lecture-based learning, while the experimental group received the CBL combined with the TSP approach. The teaching content was a course on doctor-patient communication regarding post-stroke neurogenic bladder, with a total of 12 class hours. After the teaching sessions, residents’ doctor-patient communication skills were assessed using TSP and the set elicit give understand end scale (set the stage, elicit information, give information, understand the patient’s perspective, and end the encounter; SEGUE).
Results There were no significant differences between the control group and the experimental group in terms of age, gender, theoretical exam scores, and operational exam scores at baseline. Following the teaching sessions, residents in the experimental group scored significantly higher than the control group on the SEGUE in the areas of setting the stage [(4.6±0.6) points vs. (3.7±0.8) points, P＜0.0001], eliciting information [(8.6±1.1) points vs. (7.3±0.9) points, P＜0.0001], giving information [(3.7±0.5) points vs. (3.3±0.6) points, P=0.0099], understanding the patient’s perspective [(3.5±0.4) points vs. (2.4±0.7) points, P＜0.0001], and total score [(22.1±1.5) points vs. (18.5±2.0) points, P＜0.0001]. There was no significant difference between the experimental group and the control group in ending the encounter [(1.7±0.6) points vs. (1.7±0.5) points, P=0.6305].
Conclusions The teaching method of CBL combined with TSP can significantly improve the doctor-patient communication skills of residents in dealing with post-stroke neurogenic bladder. This teaching strategy holds promise as an effective means to enhance doctor-patient communication skills in medical education and improve the quality of medical service.

Key words: Case-based learning; Teacher-standardized patient; Doctor-patient communication; Medical education

中图分类号:

郝强, 王首洋, 柳竹, 张勇. 案例分析教学法联合教师标准化病人在卒中后神经源性膀胱临床沟通教学中的应用[J]. 中国卒中杂志, 2024, 19(6): 725-728.

HAO Qiang, WANG Shouyang, LIU Zhu, ZHANG Yong. Application of Case-Based Learning Combined with Teacher-Standardized Patient in Clinical Communication Teaching for Post-Stroke Neurogenic Bladder[J]. Chinese Journal of Stroke, 2024, 19(6): 725-728.

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案例分析教学法联合教师标准化病人在卒中后神经源性膀胱临床沟通教学中的应用

Application of Case-Based Learning Combined with Teacher-Standardized Patient in Clinical Communication Teaching for Post-Stroke Neurogenic Bladder

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