伤寒论》中英文课堂有效教学的研究与比较
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摘要
随着中医高等教育制度在国内外的不断发展,中医教育者需要用明确的证据来探讨有效的教学行为,从而提高教学效果,保证教育质量,促进中医人才的有效培养。有效教学研究与提高教育质量乃至临床医疗水平密切相关,而课堂教学仍然是中医院校教学的主要教学场景和教学方法,《伤寒论》作为中医经典著作,与中医教育质量临床实践水平密切相关,其课堂有效教学尚未被研究。
     研究目的本课题以两个特定的中医高等教育机构为案例(中国北京中医药大学和澳洲墨尔本皇家理工大学),通过设计并论证《伤寒论》课堂有效教学测量工具,比较跨文化背景下《伤寒论》有效教学的异同,从而研究《伤寒论》课堂有效教学维度,探索《伤寒论》课程特异性教学行为。本课题研究问题1:两校本科生《伤寒论》教学内容各是什么?有何异同?研究问题2:《伤寒论》课堂有效教学行为是什么?两校有何异同?研究问题3:两校师生如何看待《伤寒论》课堂有效教学?有何异同?
     研究方法本课题采用文献分析法比较两校《伤寒论》课程的教学内容,量表设计法测量课堂教学行为和学生对课堂教学有效性的量化评价,设计《伤寒论》认知水平测试卷获得学生认知水平学习成绩,运用SPSS统计软件分析与《伤寒论》认知水平测试成绩及学生对于教学有效性的评价相关度,来探讨《伤寒论》有效课堂教学行为。本课题也采用参与观察法进行数据的三角求证以及访谈法获得师生对于《伤寒论》有效教学的质性看法。
     研究结果本课题的研究结果总结如下:
     1)两校的《伤寒论》教学内容、有效教学行为、以及两校师生对于《伤寒论》有效教学的看法均有差异;
     2)清晰度、组织性、教师热情、师生关系、教学策略、教学互动、合作式教学、教师性格、课程特异性教学行为均是与学生评价教学有效性密切相关的有效教学行为;其中清晰度和组织性与学生高层次认知水平测试成绩显著相关;
     3)《伤寒论》课程特异性有效教学维度包括如下课堂教学行为:深入解释条文;用日常生活经验作为例证;用个人经验作为例证(包括本人和/或其他名医的个人经验如病案);用临床研究报道为例证;引用四大中医经典(神农本草,内经,温病,金匮);介绍不同学派的观点;
     4)《伤寒论》有效教学维度可归为三个因子:教学能力(清晰度、组织性、热情、教师性格)、以学生为中心(师生关系、教学策略、教学互动、合作式教学)和课程特异性教学行为;
     5)一般有效教学维度与本课题设计的《伤寒论》认知水平测试成绩密切相关,其中清晰度和组织性与高层次认知水平测试成绩显著正相关;而《伤寒论》课堂中大多数常见的课程特异性教学行为与本课题设计的《伤寒论》认知水平测试成绩的相关性尚未确定;
     6)不同语言文化背景下,共性有效教学维度具体的低推论教学行为描述很可能不同(如组织性和清晰度),但也有相同之处(如讲课时微笑)。
     讨论本课题在综合运用定性和定量学研究方法的基础上,研究并比较了跨文化背景下的《伤寒论》有效教学概念范畴,初步结论如下:
     1)多学科共性的一般有效教学维度(清晰度、组织性、教师热情、师生关系、教学策略、教学互动、合作式教学、教师性格)也是适用于《伤寒论》的课堂有效教学维度。
     2)《伤寒论》学科具有特有的课程特异性有效教学维度:
     3)《伤寒论》课堂有效教学可归因为三个维度:教师教学能力;以学生为中心的教学行为和课程特异性教学行为;
     4)《伤寒论》课程特异性有效教学行为的学习成果测量方法有待进一步研究:
     5)跨文化背景下,《伤寒论》课堂有效教学的具体行为描述及意义存在差异:
     6)跨文化背景下,影响《伤寒论》课堂教学有效性因素可能包括:教学内容差异,教师课堂教学行为差异;学生因素(年龄,学习方法等)差异和其他因素差异等。
     本研究从方法学和研究结果两方面均为开创性的研究,证实了《伤寒论》课堂有效教学的复杂多维性,提示未来《伤寒论》有效教学研究应该从多种角度多种方法共同来研究,而中医教学工作者需要不断的继续深入研究,并科学报告,来积累中医有效教学的科学证据,用证据指导实际的教学行为,从而提高教学质量,间接改善中医临床服务水平,可持续性的发展中医事业。
With the development of Traditional Chinese Medicine(TCM) higher education in China and abroad,TCM educators need to improve teaching effectiveness with evidence-based intervention to ensure educational quality and production of talents.Researches on teaching effectiveness are crucial to the improvement of educational quality and clinical care as well. Classromm is the major teaching settting for TCM higher education.However,how to teach effectively in the classroom has not been studied before.
     Objectives:This case study explored the teaching effectiveness in a TCM course(Shang Han Lun,Treatise on Cold Damage Diseases) in two specific TCM institutions(BUCM and RMIT,Beijing University of Chinese Medicine in China and Royal Melbourne Institute of Technology in Australia).By using a designed and validated measurement tool of Shang Han Lun classroom teaching effectiveness and comparing the similarities and differences between the two institutions,this study was aimed to explore dimensions of teaching effectiveness for Shang Han Lun course while searching answeres for the following three research questions: 1.What are taught in Shang Han Lun classrooms and is there any difference/similarity in the two institutions? 2.What are effective teaching behaviors for Shang Han Lun classroom teaching and is there any difference/similarity in the two institutions? 3.How the teachers and students view teaching effectivness for Shang Han Lun course in the two institutions?
     Methods:Syllabi were examined to compare the teaching contents.Participation observation and survey were designed,validated and used to measure classroom teaching behavior.Achivement tests were composed,validated and used to measure the cognitive achievements of students in the two institutions.Associations between teaching behaviors and student attitude/cognitive achievements were explored using correlational statistics. Participant observation was used to triangulate the data while interviews were conducted to collect faculty and students' opinions of teaching effectiveness for the course.
     Results:Findings from the multiple approaches are summarized as follows:
     1) Differences were present in the two institutions including teaching contents,classromg teaching behaviorsm,and conceptions of teaching effectiveness;
     2) Clarity,organization,enthusiasm,rapport,teaching strategy,interaction,collaborative teaching,personality and couse-specific teaching behaviors were significantly associated with student evaluating teaching effectivenss;
     3) Couse-specific teaching behaviors of Shang Han Lun are:Explains clauses in depth; Mentions everyday life experience as examples;Mentions personal experience as evidence(including his/her own.e.g.case);Mentions clinical studies as evidence; Quotes from four key classics;Introduces different schools of opinions;
     4) Factor analysis identified three effective teaching dimensions:teaching ability(Clarity, organization,enthusiasm,personality),student-centered teaching(rapport,teaching strategy,interaction,collaborative teaching) and course-specific teaching behaviors;
     5) The commonly-seen effective teaching dimensions were established as associating factors
     with students' cognitive achievements,among which clarity and organization were associated with higher level of cognitive achievements.However,correlations were not found between most course-specific teaching behaviors and student tests designed for this study;
     6) Low-inference descriptions of some effective teaching dimensions(e.g.clarity & organization) might not all share among different settings with different cultural and linguistic background though some effective teaching behaviors(e.g.smile while teaching) exceeds cultrual boudary.
     Discussions:These results indicate that:
     1) General effective teaching dimensions(clarity,organization,enthusiasm,rapport,teaching strategy,interaction,collaborative teaching and personality) can be applied to Shang Han Lun classroom as well.
     2) Shang Han Lun has its own course-specific effective teaching dimension;
     3) Shang Han Lun classroom teaching effectiveness could be summarized as three dimensions:teaching ablility,student-centered teaching & learning activity and course-specific teaching.
     4) Further research is necessitated for designing appropriate evaluation and testing of course-specific effective teaching behaviors for Shang Han Lun course;
     5) Low-inference descriptions of effective teaching dimensions might not share among different settings with different cultural and linguistic background.
     6) Factors contributing to Shang Han Lun classroom teaching effectiveness probably include: teaching contents,classroom teaching behaviors,student profile(age,learning styles) and other differences.
     This study is an explorative study in methodology and its findings.Multiple dimensions of teaching effectiveness are established for Shang Han Lun course.It is suggested that future educational studies of Shang Han Lun should be conducted with multiple approachesl.TCM educatiors and researchers needs informed reporting of continuous studies to accumulate evidence for evidence-guideded teaching practice.This is essential for improvement of teaching quliaty,clinical care and sustainable development of TCM.
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