Shen Junjun, Chen Qin-Chang, Li Jun-Jie
Department of Pediatric Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, People's Republic of China.
Department of Maternal-Fetal Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, People's Republic of China.
Adv Med Educ Pract. 2025 Aug 28;16:1569-1578. doi: 10.2147/AMEP.S539059. eCollection 2025.
Residency training provides systematic, competency-based education for medical graduates. Although specialised knowledge and clinical skills are crucial in pediatric cardiology, training in China is often limited to 2-3 months with lecture-heavy approaches. We explored integrating clinical pathway(CP) and case-based learning (CBL) models to enhance training efficiency.
The study involved 47 second-year pediatric trainees in Guangdong Provincial People's Hospital (2021-2024), randomly divided into a traditional teaching (TT) group and a CP-CBL group. Both groups underwent a 3-month training period, with no significant baseline differences (age: 21.6 ± 1.2 vs 22.1 ± 0.8 years; eight male trainees/group). The TT group received conventional lectures and ward-based learning. In the CP-CBL group, standardized instruction for common diseases was delivered through CP, whereas atypical/complex cases were taught with CBL. Both groups covered identical syllabus and duration. Outcomes were assessed through a theoretical test, case analysis, and an anonymous trainee questionnaire with a 5-point Likert scale. Group means were compared using Welch's t-tests (α = 0.05) in R software (significance level: p < 0.05).
Among 47 pediatric trainees, 24 (51.1%) were assigned to the CP-CBL group. No significant differences in age, experience, or prior CP-CBL exposure were observed between groups. All trainees completed the rotation exam. The CP-CBL group outperformed the TT group in comprehensive assessments (case analysis + theory exams), with 37.5% vs 4.3% of trainees scoring >90 points respectively. Trainees in the CP-CBL group reported higher satisfaction with learning interest (p < 0.01) and perceived skill improvement (p < 0.01), but no significant differences in course organisation (p = 0.49) or instructor performance (p = 0.79).
In pediatric cardiology training, CP-CBL outperformed TT in both knowledge acquisition and learner engagement.
住院医师培训为医学毕业生提供基于能力的系统教育。尽管专业知识和临床技能在儿科心脏病学中至关重要，但在中国的培训通常限于2至3个月，且教学方法以讲座为主。我们探索了整合临床路径（CP）和基于案例的学习（CBL）模式以提高培训效率。
该研究纳入了广东省人民医院47名二年级儿科住院医师（2021 - 2024年），随机分为传统教学（TT）组和CP - CBL组。两组均接受为期3个月的培训，基线无显著差异（年龄：21.6 ± 1.2岁对22.1 ± 0.8岁；每组8名男学员）。TT组接受传统讲座和病房学习。在CP - CBL组中，通过CP对常见疾病进行标准化教学，而异型/复杂病例采用CBL教学。两组涵盖相同的教学大纲和时长。通过理论测试、病例分析以及一份采用5级李克特量表的匿名学员问卷评估结果。在R软件中使用韦尔奇t检验（α = 0.05）比较组均值（显著性水平：p < 0.05）。
在47名儿科住院医师中，24名（51.1%）被分配至CP - CBL组。两组在年龄、经验或之前是否接触过CP - CBL方面未观察到显著差异。所有学员均完成了轮转考试。CP - CBL组在综合评估（病例分析 + 理论考试）中表现优于TT组，分别有37.5%和4.3%的学员得分>90分。CP - CBL组的学员对学习兴趣（p < 0.01）和感知到的技能提升（p < 0.01）满意度更高，但在课程组织（p = 0.49）或教师表现（p = 0.79）方面无显著差异。
在儿科心脏病学培训中，CP - CBL在知识获取和学员参与度方面均优于TT。
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