摘要目的:探讨Miller金字塔理论结合巴林特小组活动在烧伤外科住院医师规范化培训中的应用研究。方法:将在浙江大学医学院附属第二医院烧伤外科规培的74名住院医师纳入研究，按照不同的教学方法分为对照组和观察组。对照组37名学员予以传统教学，观察组37名学员予以Miller金字塔理论结合巴林特小组活动进行培训。评估两组学员对教学效果的评价及医患沟通技能。采用SPSS 22.0进行卡方检验和 t检验。 结果:观察组学员对教学效果的评价优于对照组（ t=3.01、3.47、3.49、3.32、2.54； P=0.004、0.001、0.001、0.001、0.013）。与培训前比较，培训后两组学员的医患沟通技能评价量表（Set Elicit Give Understand End，SEGUE）评分升高，且观察组高于对照组（ t=3.23、2.99、2.07、3.62、3.00、7.89； P=0.002、0.004、0.042、0.001、0.004、<0.001）。 结论:Miller金字塔理论结合巴林特小组活动应用在烧伤外科住院医师规范化培训中，可提高学员对教学效果的评价，改善其医患沟通技能。

abstractsObjective:To explore the application of Miller's pyramid theory combined with Bahrain's team activities in the standardized residency training (SRT) of burn surgeons.Methods:Seventy-four residents who were on the SRT program in the Department of Burns & Wound Care in The Second Affiliated Hospital of Zhejiang University were enrolled in the study. The students were divided into control group and observation group according to the teaching methods. Thirty-seven students in the control group were provided with conventional teaching, and 37 students in the observation group were provided with training based on Miller' pyramid theory combined with Bahrain's team activities. The two groups were evaluated for teaching effectiveness and doctor-patient communication skills. SPSS22.0 was used for the chi-square test and t test. Results:The evaluation outcome of teaching effectiveness in the observation group was better than that in the control group ( t=3.01, 3.47, 3.49, 3.32, and 2.54; P=0.004, 0.001, 0.001, 0.001, and 0.013). After the training, the scores of Set Elicit Give Understand End scale in the two groups increased, with significantly higher scores achieved in the observation group than in the control group ( t=3.23, 2.99, 2.07, 3.62, 3.00, and 7.89; P=0.002, 0.004, 0.042, 0.001, 0.004, and <0.001). Conclusion:The application of Miller's pyramid theory and Bahrain's team activities in the SRT of burn surgeons can improve students' evaluation of teaching effectiveness and improve their doctor-patient communication skills.