Page 111 - 《中国药房》2025年11期

基于分层学习实践模式的咳喘药师能力培训评价指标体系研究
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李 远 ，杨 贤，严思敏，李 俐（南京大学医学院附属鼓楼医院药学部，南京 210008）
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中图分类号 R95 文献标志码 A 文章编号 1001-0408（2025）11-1389-05
DOI 10.6039/j.issn.1001-0408.2025.11.18

摘 要 目的 构建在分层学习实践模式（LLPM）下的医院咳喘药学服务门诊（CWPC）药师培训质量评价标准指标体系，并应用
于临床实践。方法 本教学团队根据本院实际情况，建立LLPM培训咳喘药师。采用定性访谈法形成相关评价指标，文献研究法
编制专家问卷，专家函询法对国内呼吸科专业相关领域10名专家进行两轮咨询以构建咳喘药师教学质量评价指标体系。计算专
家的积极系数、权威系数、肯德尔和谐系数和意见集中程度，并采用层次分析法确定指标体系的各指标权重。教学团队于2023年
6 月－2024 年 6 月期间共纳入 21 名药师进行教学培训，教学团队根据评价指标体系中的药师受益和患者受益指标对试验组
（LLPM）和对照组（传统教学模式）学员进行考核评分和比较。结果 本研究探索建立了LLPM下的咳喘药师培训体系，并运用德
尔菲法初步建立了评价指标体系。两轮德尔菲法问卷的回收率为100％，权威系数＞0.8，肯德尔和谐系数在0.235～0.459之间，P
值均小于0.05。最终确定了4个一级指标（学员反馈、学习收获、行为改进、培训成绩）、12个二级指标和33个三级指标。在实践应
用评价中试验组药师获益明显，且患者接受皮质类固醇治疗的慢性阻塞性肺病或哮喘服务患者的每月比例（80.5％）、咳喘团队服
务门诊患者平均每月增加人数（较去年同期）14.8人次、满意度指标（4.9）均显著高于对照组（P＜0.05）。结论 LLPM应用于咳喘
药师的能力培训存在诸多益处，具有指导意义，并且构建的该模式下的培训质量评价指标体系是科学可靠的。
关键词 咳喘药师；临床药学；分层学习实践模式；评价指标体系

Study on the evaluation index system for cough and wheeze pharmacist competency training based on the
layered learning practice model
LI Yuan，YANG Xian，YAN Simin，LI Li（Dept. of Pharmacy， Nanjing Drum Tower Hospital， the Affiliated
Hospital of Nanjing University Medical School， Nanjing 210008， China）

ABSTRACT OBJECTIVE To develop the quality evaluation standard indicator system for hospital cough and wheeze
pharmaceutical care clinic （CWPC） pharmacist training within the layered learning practice model （LLPM）， and apply it in clinical
practice. METHODS Our teaching team established an LLPM model to train cough and wheeze pharmacists， according to the
actual conditions of our college. Using qualitative interview methods， expert questionnaires were compiled with literature research；
the expert correspondence methods were employed to conduct two rounds of consultation with 10 domestic respiratory medicine
experts， thus constructing an evaluation index system for the teaching quality of cough and wheeze pharmacists. The experts’
positive coefficient， authority coefficient， Kendall’s harmony coefficient， and the degree of concentration of opinions were
calculated. The analytic hierarchy process （AHP） was used to determine the weight of each indicator within the index system. From
June 2023 to June 2024， the teaching team enrolled 21 pharmacists in the training program. The teaching team assessed and scored
the trial group （LLPM） and control group （traditional teaching model） based on the benefit indicators for pharmacists and patients
in the evaluation index system， and compared the results. RESULTS This study explored the establishment of a training system for
cough and wheeze pharmacists under the LLPM model， and initially established an evaluation index system using the Delphi
method. In two rounds of Delphi method questionnaires， the recovery rate was 100%， with an authority coefficient exceeding 0.8，
Kendall’s harmony coefficient ranging from 0.235 to 0.459， and all P-values being less than 0.05. Four primary （comprising trainee
feedback， learning gains， behavioral improvements， and training performance）， 12 secondary and 33 tertiary indicators were
finalized. In the empirical evaluation， the results of the two groups showed a significant benefit to the pharmacists in the trial group.
Specifically， the percentage of patients receiving corticosteroids for COPD or wheeze service patients per month （80.5%）， an
average increase in the number of cough and wheeze team service outpatient visits per month （compared to the same period of the
previous year） of 14.8 visits per month， and the patient satisfaction score （4.9） were all significantly higher than those in the
control group （P＜0.05）. CONCLUSIONS The application of the LLPM in competency training for pharmacists specializing in
cough and wheeze care yields multiple benefits and holds
significant guiding value. The constructed training quality
Δ 基金项目 南京大学中国医院改革发展研究院医院管理类课题
evaluation index system under this model is scientific and
（No.NDYGN2023088）
＊第一作者 主管药师，硕士。研究方向：临床药学。E-mail： reliable.
913601852@qq.com KEYWORDS cough and wheeze pharmacist； clinical
# 通信作者 副主任中药师，硕士。研究方向：临床药学。Email： pharmacy； layered learning practice model； evaluation index
njgllily@163.com system

中国药房 2025年第36卷第11期 China Pharmacy 2025 Vol. 36 No. 11 · 1389 ·