孙欣　彭子洋　卜刚　周睿　任宏　付军科

摘  要：目的：胸外科的學科专科性强，属于外科学系统专业化小分支，注重临床操作和手术实践，但学员规培时间较短（1-3月），限于观摩手术的机会有限，由于手术室进入人员数量限制，很多胸外科专业规培学员直至科室规培结束，尚无参加手术甚至观摩手术的机会，使规培质量不能保证，因此探寻规培医师培养的优化模式，才能保证教学改革的不断深化，提高临床教学的质量水平。方法：学科系为改善临床技能及手术操作培训的短板，以雨课堂联合思源学堂教学平台的线上联合模式培养胸外科硕士规培生及规培学员，线上教学辅助线下理论教学，术前进行病例分享并讨论，术中进行直播讲解，术后开展总结及专题讲座，既能在繁重的临床工作中确保教学学时，又能高效调动学生的学习积极性，使每位规培生均可充分学习胸外科相关专科知识，更好地适应新时代的医学人才培养需求。结论：此研究中我们总结了雨课堂及思源学堂平台应用的模式及相关经验，并探讨了此种模式在临床教学及手术直播示范中的实际应用效果，以期改善胸外科的规培教学质量。

关键词：住院医师规范化培训;胸外科;手术直播;线上辅导教学;教学改革

中图分类号：G642       文献标志码：A         文章编号：2096-000X（2021）13-0080-04

Abstract： Objective： The discipline of thoracic surgery is highly specialized， which belongs to the small branch of surgery system specialization， with its focus on clinical operation and surgical practice. But the time for training trainees is short （1-3 months）， the opportunity to observe the operation is limited， and the number of persons entering the operating room is limited. Besides， many trainees who receive thoracic surgery professional training， by the end of the regular training in the department， have no chance to get involved in the operation， or even to observe the operation， so the quality of regular training cannot be guaranteed. Therefore， to explore the optimization mode of training physicians can ensure the continuous deepening of teaching reform and improve the quality of clinical teaching. Methods： In order to improve the shortcomings of clinical skills and surgical operation training， the online joint mode of Rain Classroom and Siyuan Classroom（syxt.xjtu.edu.cn） was used for training both postgraduate students of thoracic surgery major and regular trainees， and online teaching assisted offline theory teaching， by adopting the methods of preoperative case sharing and discussion， intraoperative on-site explanation， and postoperative summary and special lectures， which is intended to ensure the teaching hours spared on heavy clinical work. It can also effectively mobilize students' enthusiasm for the learning， so that each regular trainees can fully learn the relevant specialized knowledge of thoracic surgery， so as to better meet the needs of medical personnel training in the new era. Conclusion： This study summarizes the application model and related experience of Rain Classroom and Siyuan Classroom platforms， and discusses the application effect of this model in clinical teaching and on-site demonstration of surgery， in order to improve the teaching quality of thoracic surgery.

Keywords： standardized training for resident physicians; thoracic surgery; live Surgery; online tutoring lessons; educational reform

住院医师规范化培训（规培）在2014年全面普及、落地实施[1]，是研究生教育阶段及医学专业本科生毕业后教育的重要阶段，对提高我国各个级别医院的住院医师医疗水平和同质性起到了不可忽视的作用[2]。……