基于情景模拟的消化内科急危重症教学实践

Scenario-Based Simulation Teaching Practice for Critical Conditions in Gastroenterology

摘要: 目的：探讨情景模拟教学模式在消化内科急危重症教学中的应用成效。方法：选取80名在消化内科进行住院医师规范化培训的学员，采用随机数字表法分为观察组(40名)与对照组(40名)。对照组采用“理论讲授 + 床边带教”的传统培训模式，观察组实施基于情景模拟教学模式，构建“标准化情景–分层演练–多元复盘–质量控制”闭环体系。培训4周后比较两组理论成绩、操作技能、临床思维及满意度。结果：模拟组理论成绩(86.35 ± 4.18分)、操作技能(88.62 ± 3.45分)、临床思维(87.28 ± 3.92分)均高于常规组(78.42 ± 5.63分、80.15 ± 4.78分、79.45 ± 5.17分)，差异有统计学意义(均P < 0.001)；模拟组满意度(95.00%)高于常规组(80.00%)，差异有统计学意义(P < 0.05)。结论：情景模拟教学可在短期内显著提升规培学员急危重症处置能力，值得在临床教学中推广应用。

Abstract: Objective: To explore the effectiveness of scenario-based simulation teaching in training for critical care in gastroenterology. Methods: Eighty residents undergoing standardized training in gastroenterology were randomly divided into an observation group (n = 40) and a control group (n = 40). The control group received traditional training model (“theoretical instruction + bedside teaching”), while the observation group underwent scenario-based simulation training, implementing a closed-loop system of “standardized scenarios, tiered drills, multidimensional debriefing, quality control”. After 4 weeks of training, theoretical scores, operational skills, clinical reasoning, and satisfaction were compared between groups. Results: The simulation group demonstrated significantly higher scores than the conventional group in theoretical knowledge (86.35 ± 4.18 vs. 78.42 ± 5.63), procedural skills (88.62 ± 3.45 vs. 80.15 ± 4.78), and clinical reasoning (87.28 ± 3.92 vs. 79.45 ± 5.17) with statistically significant differences (all P < 0.001). The simulation group also demonstrated higher satisfaction (95.00%) than the conventional group (80.00%), with statistically significant differences (P < 0.05). Conclusion: Scenario-based simulation training can significantly enhance residents’ critical care management capabilities in the short term and warrants broader application in clinical education.