肺血栓栓塞症的继续医学教育效果评价

目的评价采用不同形式对肺血栓栓塞症（简称肺栓塞）规范化诊断与治疗的继续医学教育效果。方法对19家医院（9家3级医院，10家2级医院）的医务人员进行了四个层次的肺栓塞规范化诊治的培训：通过举办学习班对100名临床一线医生进行培训；采用学习班结合病例专题讨论和专家现场点评方式，培训了60名临床骨干医生；采用学习班结合实际操作和结果判读的形式分别对放射科医生和超声科医生进行培训。结果培训结束后，临床一线医生肺栓塞规范化诊治问卷调查正确率从培训前的55％，提高至78％（P〈0．001）；骨干医生培训后模拟肺栓塞诊治正确率从培训前的71％提高至88％（P〈0．001）；放射科医生肺栓塞规范化影像学诊断技能考核合格率由培训前的65％提高至85％（P=0．041）；超声科医生规范化超声诊断技能考核合格率由培训前的70％提高至90％（P=0．014）。结论采用学习班的形式对提高肺栓塞规范化诊治意识有显著效果，而采用多种形式如学习班结合病例讨论与专家点评，或结合实际操作及结果判定的形式，对医生实践技能的培训效果较好。

Continuing medical education effect on standardized diagnosis and treatment of pulmonary thromboembolism

Objective To evaluate the continuing medical education （CME） effect on standardized diagnosis and treatment of pulmonary thromboembolism （PTE）. Methods From 19 hospitals （level 2 or 3 hospitals） located in Beijing, China. A total of 100 junior physicians received lecture training ,60 senior physicians received multiple education methods, combining lectures with special topics on cases and leader opinion, 20 doctors who engaged in radiology and 20 doctors who engaged in ultrasonics received training of combining lectures with instrumental operation and diagnosis, respectively. Results After training, the junior physicians＇ correct rate of standardized PTE diagnosis and treatment by questionnaire survey increased from 55% before training to 78% （P〈O.001）, the senior physicians＇ correct rate of simulation PTE diagnosis and treatment raised from 71% to 88% （P〈0.001）, the radiologists＇ qualification rate increased from 65% to 85% （P=0.041） and the sinologists＇ qualification rate increased from 70% to 90% （P=0.014）. Conclusion For CME on standardized PTE diagnosis and treatment, lectures have great impact on improving physicians＇ awareness while multiple formats such as lectures combining with case discussion lectures and leader opinion or with instrumental operation are effective on the improvement in performances.