案例综合教学(CCT)联合情景模拟在麻醉科住培中的应用效果

The Application Effect of Complex Case Teaching (CCT) Combined with Scenario Simulation in Anesthesiology Resident Training

摘要: 目的：探讨案例综合教学(complex case teaching, CCT)联合情景模拟教学模式对麻醉科住院医师规范化培训(以下简称“住培”)的应用效果，探索麻醉科住培新型教学模式。方法：选取2024年9月⁓2025年3月于南阳市第二人民医院轮转麻醉科住培医师40名作为研究对象，随机分配至传统教学对照组(n = 20)和CCT联合情景模拟教学实验组(n = 20)。通过理论考核、技能操作考核、操作技能直接观察量表(Direct Observation of Procedural Skills, DOPS)和迷你临床演练评估量表(Mini-Clinical Evaluation Exercise, Mini-CEX)等多维度评价体系进行效果验证。结果：(1) 实验组理论总成绩和技能总成绩均显著优于对照组(P < 0.01)；(2) 在DOPS评估的11项指标中，有10项指标实验组均高于对照组(P < 0.01)，仅知情同意这一项无显著差异(P = 0.169)；(3) Mini-CEX评估的10项指标中，有9项指标实验组均高于对照组(P < 0.05)，仅体格检查能力这一项(因方差不齐)未呈现显著改善；(4) 教学满意度调查表明，实验组在临床思维能力、团队合作等项目的积极评价比例达80%以上(效应量0.6~0.63)，显著高于对照组(P < 0.01)。结论：CCT联合情景模拟教学能有效提升麻醉科住培医师的理论知识水平、临床操作技能和岗位胜任力，且教学满意度更高。

Abstract: Objective: To explore the effect of complex case teaching (CCT) combined with scenario simulation teaching mode on the standardized training of anesthesiologists in residential training (hereinafter referred to as “residency training”), and to explore a new teaching mode for anesthesia residency training. Method: Forty 2022 resident training physicians who rotated in the Anesthesiology Department of Nanyang Second People’s Hospital from September 2024 to March 2025 were selected as the research subjects and randomly assigned to the traditional teaching control group (n = 20) and the CCT combined scenario simulation teaching experimental group (n = 20). The effectiveness was validated through multidimensional evaluation systems such as theoretical assessment, skill operation assessment, Direct Observation of Procedural Skills (DOPS), and Mini Clinical Evaluation Exercise (Mini CEX). Result: (1) After teaching, the experimental group had significantly better theoretical and skill scores than the control group (P < 0.01); (2) Among the 11 indicators evaluated by DOPS, 10 indicators were higher in the experimental group than in the control group (P < 0.01), and only informed consent showed no significant difference (P = 0.169); (3) Among the 10 indicators evaluated by Mini CEX, 9 indicators in the experimental group were higher than those in the control group (P < 0.05), and only the physical examination ability (due to uneven variance) did not show significant improvement; (4) The satisfaction survey of teaching shows that the experimental group has a positive evaluation rate of over 80% in clinical thinking ability, teamwork and other projects (effect size 0.6-0.63), which is significantly higher than the control group (P < 0.01). Conclusion: CCT combined with scenario simulation teaching can effectively improve the theoretical knowledge level, clinical operation skills, and job competence of anesthesiologists undergoing residency training, and the teaching satisfaction is higher.