以问题为基础的案例教学模式在内科护理学中的应用研究

Effect of the combination of problem-based learning(PBL) and case-based learning(CBL) on the critical thinking and comprehensive skills of undergraduate nursing students

目的探讨以问题为基础的学习(problem-based learning,PBL)与以病例为基础的学习(case-based learning,CRL)结合的教学模式对护理本科生评判性思维能力及综合技能的影响。方法在护理本科生的内科护理学课程实践教学中开展PBL与CBL结合的模式教学,将135名护理本科生随机分为两组,试验组65名,采用PBL与CBL结合的教学模式进行教学;对照组70名,采用传统方法进行教学,分别于教学前后对两组学生的评判性思维能力、综合技能的主观评价进行问卷调查。结果试验组学生经过学习后,评判性思维能力总分高于试验课程前(P<0.05),各维度得分均高于试验课程前(P<0.05);对照组学生课程结束后,评判性思维能力总分和各维度得分比较,差异无统计学意义;课程结束后,试验组总体评判性思维能力得分高于对照组(P<0.05),各维度得分除寻求真理、系统化能力外,其余各项得分均高于对照组(P<0.05);两组学生对教学的整体评价尚好,在自主学习能力、综合技能、专业精神方面试验组学生大多持肯定态度,与对照组比较差异有统计学意义(P<0.01)。结论 PBL与CBL结合的教学模式能明显提高学生的评判性思维能力,在自主学习能力、综合技能、专业精神方面的自我评价也有明显提高,而且新的教学模式得到了学生认可。

Objective To evaluate the effect of problem-based learning（PBL） and case-based learning（CBL） on the critical thinking and comprehensive skills of undergraduate nursing students. Methods Totally 135 undergradu- ate nursing students were randomly divided into two groups. The combination of PBL and CBL teaching mode was adopted in the experimental group（n=65） in the course of Medical Nursing,while traditional teaching method was used in the control group（n=70）. The students＇ criticat thinking and comprehensive skills were compared between the two groups before and after the course. Results In the experimental group,the total score and each factor score of critical thinking improved significantly than before（P〈0.05）,while no significant differences were found before and after the course in the control group（P〉0.05）. After the course,the total score and factor scores of critical thinking in the experimental group were significantly higher than those of the control group（P〈0.05）,except the factor scores of truth-seeking and systematicity. The students in the experimental group reported that the innovated teaching model could improve their self-directed learning,comprehensive skills and professional attitudes. Conclusion The combi- nation of PBL and CBL teaching model can significantly improve nursing students＇ critical thinking,as well as their self-evaluation on aspects of self-directed learning,comprehensive skills and professional attitudes. This inno- vated teaching model has been acceptable by undergraduate nursing students.