学生担任SP的CBL教学方法在外科见习中的应用
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摘要
目的探讨学生担任标准化病人(standardized patient,SP)的以病例为引导的教学模式(case based learning,CBL)教学方法在外科见习教学中的应用效果。方法在中山大学附属第三医院2009及2010级临床医学八年制专业学生的外科见习教学中,带教老师准备SP病例并对学生进行培训,由学生担任SP并采取CBL进行教学。通过学生问卷调查、病历分析考试得分率及实习病历考核成绩分析教学效果。结果 100.0%学生接受并认为从该方法获得进步,分别有86.7%、86.7%、70.0%及66.7%学生认为在问诊技巧、临床思维能力、医患沟通能力、主动学习能力方面有进步。进入实习阶段后,学生在问诊能力、病历书写及临床思维满意度方面的得分率分别为83.3%、80.0%及80.0%。与传统教学方法相比,该教学方法学生实习病历考核总分较高[(89.7±2.6)分vs.(87.2±3.3)分],差异具有统计学意义(P <0.01)。结论学生担任SP的CBL教学方法能有效提高外科见习教学质量,培养学生临床思维,提高主动学习能力。
Objective To investigate the application of case based learning with students playing standardized patient roles in surgery noviciate teaching. Methods During surgery noviciate teaching for eight-year clinical medical students of grade 2009 and 2010 in the Third Affiliated Hospital of Sun Yat-sen University, standardized patient cases were prepared and students were trained for role playing. Meanwhile, case based learning teaching method was applied. A self-designed student questionnaire, as well as analysis of scoring rates of case analysis examination and internship medical record, was applied to investigate the teaching effect. Results100.0% of the students accepted and thought that they had made progress from this method. 86.7%, 86.7%, 70.0% and 66.7% of the students thought that they had made progress in inquiry skills, clinical thinking ability,doctor-patient communication ability and active learning ability. After entering the internship stage, the students scored 83.3%, 80.0% and 80.0%respectively in terms of inquiry ability, medical record writing and clinical thinking satisfaction. Compared with the traditional teaching method, this teaching method has a higher score in the examination of students' internship medical records [(89.7±2.6) points vs.(87.2±3.3) points], and the difference is statistically significant(P < 0.01). Conclusion The teaching model of CBL with student-lead SP role play is effective in improving quality of surgery noviciate teaching, as well as training clinical thinking and active study abilities of students. The teaching method is expected to be applied in undergraduate medical education.
Objective To investigate the application of case based learning with students playing standardized patient roles in surgery noviciate teaching. Methods During surgery noviciate teaching for eight-year clinical medical students of grade 2009 and 2010 in the Third Affiliated Hospital of Sun Yat-sen University, standardized patient cases were prepared and students were trained for role playing. Meanwhile, case based learning teaching method was applied. A self-designed student questionnaire, as well as analysis of scoring rates of case analysis examination and internship medical record, was applied to investigate the teaching effect. Results100.0% of the students accepted and thought that they had made progress from this method. 86.7%, 86.7%, 70.0% and 66.7% of the students thought that they had made progress in inquiry skills, clinical thinking ability,doctor-patient communication ability and active learning ability. After entering the internship stage, the students scored 83.3%, 80.0% and 80.0%respectively in terms of inquiry ability, medical record writing and clinical thinking satisfaction. Compared with the traditional teaching method, this teaching method has a higher score in the examination of students' internship medical records [(89.7±2.6) points vs.(87.2±3.3) points], and the difference is statistically significant(P < 0.01). Conclusion The teaching model of CBL with student-lead SP role play is effective in improving quality of surgery noviciate teaching, as well as training clinical thinking and active study abilities of students. The teaching method is expected to be applied in undergraduate medical education.
引文
[1]李祥林,柴勇,王朋朋,等."5+3"模式下五年制临床医学专业见习教学改革实践[J].中华医学教育探索杂志,2017,16(10):986-989.
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[6]季乐乐,赵亚,黄启超.标准化病人在普通外科急腹症见习教学中的应用研究[J].中华神经外科疾病研究杂志,2018,17(3):258-261.
[7]张峰,康艳霞,张贺龙,等.临床肿瘤学PBL教学中标准化病人的应用[J].中华医学教育探索杂志,2018,17(3):277-281.
[8]柏杨,刘国祥,黃继东,等.基于医学本科生能力培养的教学方法改革实践[J].重庆医学,2016,45(28):4020-4022.
[9]郭轶先,苏力. CBL和PBL教学方法在血液学专业见习中的运用效果分析[J].基础医学与临床,2016,36(8):1176-1178.
[10]赵瑞敏,权芳,白艳霞,等. CBL教学法在耳鼻咽喉科学七年制临床见习教学中的应用[J].中国医学教育技术,2017,31(4):479-481.
[11]李蓓. CBL教学应用于临床见习带教的现状及思考[J].中国高等医学教育,2018(5):91-92.
[12]石淑文,张敏,王一红,等.标准化病人在培训和工作中常见问题的探讨[J].中国高等医学教育,2017(12):56-57,102
[2]廖锐,杜成友,李明.临床医学专业学生外科学见习学习倦怠的研究[J].中华医学教育杂志,2018,38(2):222-224,231.
[3]闰萍,张建华,李爱娇,等.医患关系存在问题的严重性研究[J].中国医学伦理学,2018,31(5):597-600.
[4]宋涛,卢冉,官泽宇,等.病例教学法在血管外科教学中的应用分析[J].中国继续医学教育,2016,8(17):10-11.
[5]王贵军.基于标准病例的CBL教学法在普外科见习教学中的效果观察[J].中国继续医学教育,2018,10(12):14-16.
[6]季乐乐,赵亚,黄启超.标准化病人在普通外科急腹症见习教学中的应用研究[J].中华神经外科疾病研究杂志,2018,17(3):258-261.
[7]张峰,康艳霞,张贺龙,等.临床肿瘤学PBL教学中标准化病人的应用[J].中华医学教育探索杂志,2018,17(3):277-281.
[8]柏杨,刘国祥,黃继东,等.基于医学本科生能力培养的教学方法改革实践[J].重庆医学,2016,45(28):4020-4022.
[9]郭轶先,苏力. CBL和PBL教学方法在血液学专业见习中的运用效果分析[J].基础医学与临床,2016,36(8):1176-1178.
[10]赵瑞敏,权芳,白艳霞,等. CBL教学法在耳鼻咽喉科学七年制临床见习教学中的应用[J].中国医学教育技术,2017,31(4):479-481.
[11]李蓓. CBL教学应用于临床见习带教的现状及思考[J].中国高等医学教育,2018(5):91-92.
[12]石淑文,张敏,王一红,等.标准化病人在培训和工作中常见问题的探讨[J].中国高等医学教育,2017(12):56-57,102