运用PDCA循环提升实习生临床操作能力的研究——以外科换药为例

Using the PDCA cycle to improve clinical medicine interns' operation ability—taking surgical dressing changes as an example

摘要

目的　探讨“计划-执行-检查-处理”（plan-do-check-act，PDCA）循环法在外科实习生外科换药操作提升的有效性，为提高换药掌握率提供参考依据。方法　选取2022年6-11月在国家儿童医学中心复旦大学附属儿科医院外科轮转实习的242名临床医学实习生，根据外科换药诊断性评价的理论与技能得分，了解轮转外科实习生外科换药掌握情况。采用PDCA循环法，建立完整的计划、实施、检查、处理流程，从而获得外科换药终结性评价。理论成绩采用问卷星的形式，操作成绩采用打分形式进行量化。统计并对比分析前后外科换药理论知识得分与操作的掌握率。结果　经过PDCA循环法，实习生外科换药理论知识得分及操作的掌握率均明显高于诊断性评价（P<0.001）。结论　采用PDCA循环法制定针对性的培训方案，形成科学有效的培训模式，注重理论与操作双提高，使全体外科实习生提升外科换药掌握率。

Abstract

Objective　To investigate the effectiveness of the PDCA (plan-do-check-act) cycle method in improving surgical dressing change operations among surgical interns and to provide a reference basis for improving the rate of surgical dressing change mastery among interns.Methods　Two hundred and forty-two clinical medicine interns in our surgical rotation from June to November 2022 were selected to find out their mastery of surgical dressing change based on the theoretical and technical scores of the diagnostic assessment of surgical dressing change. The PDCA cycle method was used to establish a complete planning, implementation, inspection, and treatment process so as to obtain a summative evaluation of surgical dressing changes. Theoretical scores were quantified in the form of questionnaire assessment, and operational scores were quantified in the form of scoring. The mastery rate of the theory and operation of surgical dressing change before and after the analysis was counted and compared.Results　After the PDCA cycle method, the mastery rate of theoretical knowledge and operation of surgical dressing change of interns was significantly higher than the diagnostic evaluation (P<0.001).Conclusion　The PDCA cycle method was used to develop a targeted training program, form a scientific and effective training model, and focus on both theory and operation to improve the mastery rate of surgical dressing changes for all surgical interns.

关键词

PDCA循环法 / 外科换药 / 实习生 / 技能培训

Key words

PDCA cycle method / surgical dressing change / interns / skill training