以问题为导向联合线上学习模式在缺血性脑血管病专业进修中的应用分析OA北大核心CSTPCD

Objective To explore the feasibility and effectiveness of problem-based online learning model compared with non-problem-based learning model in terms of training methods and training effects in the ischemic stroke discipline.Methods From January 2017 to January 2023,152 physicians who had received systematic training in Interventional Radiology Center of Xuanwu Hospital,Capital Medical University were interviewed by questionnaire.Due to the different training time,the training mode was non-problem-based from January 2017 to January 2020,and the training model of problem-based online learning model was performed from February 2020 to January 2023.Questionnaires were conducted at the end of the training and 2 months after the training.The questionnaire includes:the gender and age of the trainee doctor,the working years before participating in the training,the purpose of participating in the training,the length of the training,the feelings,suggestions and opinions on the training,whether new procedures were performed after the training and the number of procedures performed after the training(mainly including intracranial and extracranial arterial stenting,carotid endarterectomy,hybrid surgery,arterial bypass surgery,mechanical thrombectomy,or others).Results(1)A total of 152 questionnaires were sent out,136 physicians participated in the questionnaire survey and completed the feedback,among which 4 questionnaires were incomplete or incorrectly filled in.After excluding the invalid questionnaires,a total of 132valid questionnaires remained.The recovery rate and effective response rate of this questionnairewere89.5%and97.1%,respectively.When participating in the training,the age of studying physicians ranged from 25 to 44 years old,and the average age was(34±4)years old.The working years of doctors were 22.7%(30/132)for＞10 years,40.9%(54/132)for＞5-10 years and 36.4%(48/132)for 0-5 years.There was significant difference in the proportion of new operation among different working years(χ2 =2.501,P =0.012).(2)The number of participants in problem-based and non-problem-based learning models was 70 and 62,respectively.In problem-based group,88.6%(62/70)hoped to learn new techniques and improve their surgical ability through training;In the non-problem-based group,the proportion was 87.1%(54/62),and there was no significant difference in the purpose of training among the physicians who participated in different training modes(χ2 =0.067,P = 0.796).The analysis of the training experience showed that 96.2%(127/132)of the practicing physicians believed that the training method was novel and greatly helped to improve their clinical skills,and the proportion of problem-based and non-problem-based models was 97.1%(68/70)and 95.2%(59/62),respectively.There was no significant difference between the two models(χ2 = 0.354,P = 0.552).(3)After training,80.0%(56/70)of new surgeries were performed in problem-based mode compared with66.1%(41/62)in non-problem-based mode,with no significant difference(χ2 =3.247,P =0.072).In terms of the number of operations performed,70.0%(49/70)and 46.8%(29/62)of problem-based and non-problem-based learning models performed≥30 operations,respectively,and the difference was statistically significant(χ2 =7.337,P =0.007).(4)For the studying physicians whose new operations number was≥30,in the non-problem-based learning mode,the number was 13.8%(4/29),82.8%(24/29)and 3.4%(1/29)of studying physicians who studied for 3 months,6 months and 12 months respectively;in the problem-based learning model,the number of studying physicians who studied for 3 months,6 months and 12 months accounted for 4.1%(2/49),57.1%(28/49)and 38.8%(19/49),respectively,and the difference was statistically significant(χ2 = 3.531,P＜0.01).Conclusion The problem-based combined online learning model is helpful for young and middle-aged neurosurgeons to carry out new operations and increase the number of new operations,but the previous work years and training time should be taken as reference.