综合临床路径与情景模拟教学对结核病实习医生心理压力及焦虑的影响:一项回顾性队列研究
Effect of combined clinical pathway and scenario simulation teaching on psychological stress and anxiety among tuberculosis interns: A retrospective cohort study.
作者信息
Chen Zhi, Guo Donglin, Shi Qian, Zeng Zhong
机构信息
Department of Tuberculosis, Tuberculosis Medical Center, The Eighth Medical Center of PLA General Hospital, Beijing, China.
Department of Tuberculosis, Ganzhou No. 5 People's Hospital, Jiangxi, China.
出版信息
Medicine (Baltimore). 2025 Jun 27;104(26):e42779. doi: 10.1097/MD.0000000000042779.
In the realm of medical education, clinical internship represents a pivotal phase where theoretical knowledge must be practically applied amidst real-world patient care, often leading to heightened stress and anxiety among interns. This transitional challenge is particularly acute for tuberculosis (TB) clinical interns, requiring innovative teaching methodologies. Therefore, we aim to evaluate the efficacy of integrating clinical pathway instruction with scenario-based simulation teaching in alleviating psychological stress and anxiety among TB clinical trainees. Data extraction from electronic health and educational evaluation records spanned September 2020 to September 2022, focusing on TB clinical interns. The investigation centered on 2 principal teaching methodologies used during training: the combination of clinical pathway and scenario simulation approaches. Standardized instruments quantified psychological stress and anxiety at 3 intervals - pre-teaching, post-teaching, and a 6-month follow-up. The study encompassed 70 TB clinical interns, allocating 34 to a combined teaching approach integrating clinical pathways and scenario simulations, while 36 underwent conventional teaching methodologies. Post-intervention assessments revealed significant reduction in psychological stress levels among those subjected to the combined methods (t = 2.522, P = .014). This difference was further magnified at the 6-month follow-up, with the combined teaching method group demonstrating markedly lower psychological stress levels (t = 3.54, P < .001). Also, immediately following the intervention, the combined method group experienced significantly lesser anxiety (t = 2.278, P = .026), and the beneficial effect endured through the 6-month mark (t = 2.41, P = .019). Combining clinical pathway teaching method and scenario simulation teaching method are associated with reduced psychological stress and anxiety levels among TB clinical interns.
在医学教育领域,临床实习是一个关键阶段,在此期间,理论知识必须在实际的患者护理中得到应用,这往往会导致实习生压力和焦虑加剧。对于结核病临床实习生来说,这种过渡性挑战尤为严峻,需要创新的教学方法。因此,我们旨在评估将临床路径指导与情景模拟教学相结合在减轻结核病临床实习生心理压力和焦虑方面的效果。从2020年9月至2022年9月的电子健康和教育评估记录中提取数据,重点关注结核病临床实习生。调查集中在培训期间使用的两种主要教学方法:临床路径与情景模拟方法的结合。标准化工具在三个时间点——教学前、教学后和6个月随访时对心理压力和焦虑进行量化。该研究包括70名结核病临床实习生,34名采用临床路径与情景模拟相结合的综合教学方法,36名采用传统教学方法。干预后评估显示,采用综合方法的实习生心理压力水平显著降低(t = 2.522,P = 0.014)。在6个月随访时,这种差异进一步扩大,综合教学方法组的心理压力水平明显更低(t = 3.54,P < 0.001)。此外,干预后立即进行评估,综合方法组的焦虑明显减轻(t = 2.278,P = 0.026),并且这种有益效果持续到6个月时(t = 2.41,P = 0.019)。临床路径教学方法与情景模拟教学方法相结合与降低结核病临床实习生的心理压力和焦虑水平相关。
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