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放射学标准化住院医师培训中的“3 + X D”结构化报告:它能实现高水平教学目标吗?

"3 + X D" structured report in radiology standardized resident training: Can it meet high-level teaching objectives?

作者信息

Yang Qingling, Peng Rui, Ma Lina, Han Ye, Yuan Lei, Yin Danqing, Li Aceng, Wang Yang, Zheng Minwen, Huang Yayu, Ren Jing

机构信息

Department of Radiology, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), 127 Chang Le West Road, Xi'an, Shaanxi Province, China; Department of Interventional Surgery Center, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), 127 Chang Le West Road, Xi'an, Shaanxi Province, China.

Department of Radiology, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), 127 Chang Le West Road, Xi'an, Shaanxi Province, China.

出版信息

Eur J Radiol. 2024 Dec;181:111780. doi: 10.1016/j.ejrad.2024.111780. Epub 2024 Oct 11.

DOI:10.1016/j.ejrad.2024.111780
PMID:39423779
Abstract

PURPOSE

To evaluate the impact of the innovative "3 + X D" structured report (SR) designed based on Bloom's taxonomy on the learning outcomes of radiology residents during standardized training.

METHODS

This is a prospective study that recruited 120 radiology residents from our hospital between 2020 and 2022. Randomly selected 60 residents from the 2020 grade to constituted the control group, and randomly selected 60 residents from the 2021 grade to formed the experimental group. The former group was trained utilizing the Free-text Reports (FTR) template, while the latter group received training with the "3 + X D" structured reports (SR) template. The learning outcomes of both groups was evaluated utilizing both objective and subjective measures. Objective assessments encompassed examinations of theoretical knowledge, diagnostic skills, and total scores, aligning with the cognitive domains of remembering, understanding, applying, and analyzing as outlined by Bloom's Taxonomy. Subjective assessments, on the other hand, comprised survey questionnaires administered to residents and feedback from clinical instructors, which correlated with the higher-order cognitive level of analyzing, evaluating, and creating within Bloom's Taxonomy.

RESULTS

On 60 residents (mean age, 24.15 years ± 2.11[SD]; 25 male) from control group, and 60 residents (mean age, 24.58 years ± 1.88 [SD]; 27 male) from experimental group. Following the training, significant improvements were observed in the theoretical knowledge, diagnostic skills, and total scores for both groups (p < 0.001). Furthermore, the experimental group demonstrated significantly higher diagnostic skills and total scores compared to the control group (p < 0.001). However, no significant difference was observed in the theoretical knowledge exam between the two groups (p = 0.236). The questionnaire used for subjective assessments had good reliability (Cronbach α was 0.826) and acceptable validity (The KMO was 0.692). Additionally, the survey questionnaires indicated that the experimental group rated higher than the control group in terms of cultivating imaging thinking ability, diagnostic confidence, diagnostic speed, and the convenience of the templates (p < 0.001). Clinicians' feedback scores for the experimental group markedly surpassed those for the control group (p < 0.05).

CONCLUSIONS

Utilizing the "3 + X D" SR template grounded in Bloom's taxonomy for training, the professional competency of radiology residents, particularly their diagnostic skills, saw a marked enhancement, successfully meeting the higher-level educational objectives. Consequently, the "3 + X D" SR template is highly recommended for the standardized training of radiology residents.

摘要

目的

评估基于布鲁姆分类法设计的创新性“3 + X D”结构化报告(SR)对放射科住院医师规范化培训学习成果的影响。

方法

这是一项前瞻性研究,于2020年至2022年从我院招募了120名放射科住院医师。从2020级中随机选取60名住院医师组成对照组,从2021级中随机选取60名住院医师组成实验组。前一组采用自由文本报告(FTR)模板进行培训,而后一组接受“3 + X D”结构化报告(SR)模板的培训。两组的学习成果通过客观和主观两种方式进行评估。客观评估包括理论知识、诊断技能和总成绩的考试,与布鲁姆分类法所概述的记忆、理解、应用和分析的认知领域相一致。另一方面,主观评估包括向住院医师发放的调查问卷以及临床带教老师的反馈,这与布鲁姆分类法中分析、评估和创造的高阶认知水平相关。

结果

对照组有60名住院医师(平均年龄,24.15岁±2.11[标准差];男性25名),实验组有60名住院医师(平均年龄,24.58岁±1.88[标准差];男性27名)。培训后,两组的理论知识、诊断技能和总成绩均有显著提高(p < 0.001)。此外,实验组的诊断技能和总成绩显著高于对照组(p < 0.001)。然而,两组在理论知识考试方面未观察到显著差异(p = 0.236)。用于主观评估的问卷具有良好的信度(Cronbach α为0.826)和可接受的效度(KMO为0.692)。此外,调查问卷显示,实验组在培养影像思维能力、诊断信心、诊断速度和模板便利性方面的评分高于对照组(p < 0.001)。实验组的临床医生反馈得分明显高于对照组(p < 0.05)。

结论

采用基于布鲁姆分类法的“3 + X D”SR模板进行培训,放射科住院医师的专业能力,尤其是诊断技能有显著提高,成功达到了更高层次的教育目标。因此,强烈推荐将“3 + X D”SR模板用于放射科住院医师的规范化培训。

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