研究以问题为基础的教学法与传统教学模式应用于医患沟通中交待病情的效果

Comparative study of the problem-based learning teaching method and traditional teaching model to explainthe disease in the doctor-patient communication

目的探讨以问题为基础（PBL）教学法与传统教学模式应用于医患沟通中交待病情的效果。方法选择首都医科大学临床医学系2007级、2008级学生进行“医患沟通——交待病情”见习课堂的学生99例，其中2007级为传统教学组（52例），2008级为PBL教学组（47例）。传统教学组按照传统的实习方法进行带教，即实习生由教师带领对新收患者进行病情交待，南教师向实习生讲述患者临床特征、诊断、治疗、预后及病情交待要点等。PBL教学组的带教方法为①教师引导学生根据临床案例提出交待病情的技术要点；②学生针对问题查阅教相关临床资料和医学人文相关材料；③教师引导学生对资料进行真实性和临床实用性的评价；④学生分组进行情景演示，教师点评；⑤教师及学生共同对不同情景下交待病情的全过程和沟通效果进行评价和交流。通过满意度问卷调查对比PBL教学法与传统教学模式在医患沟通实践教学中的差异。结果PBL教学组的课堂效果、学习兴趣及知识掌握程度的满意率明显优于传统教学组，组问差异有统计学意义[课堂效果：76．6％（36／47）比50．0％（26／52），学习兴趣：72．3％（34／47）比50．0％（26／52），知识掌握程度：91．5％（43／47）比73．1％（38／52），均P〈0．05]。与传统教学相比，PBL教学组在提高学习主珈性，增强爱伤观念方面满意率也较高，但组问差异无统计学意义（学习主动性：66．0％比55．8％，增强爱伤观念：76．6％比67．3％，均P〉0．05）。传统教学组中51．9％的学生认为需要改进带教方法，在PBL教学组中42．6％的学生建议改进教学方法（P〉0．05）；PBL教学组和传统教学组的教学系统性满意度分别为40．4％和38．5％，差异无统计学意义（P〉0．05）。结论PBL教学法对医学生获得实用的医患沟通技巧、培养良好的医患沟通能力起到积极的作用。

Objective To explore the application effect of the doctor-patient communication on the problem-based learning （PBL） pedagogy and traditional teaching model. Methods Totally 99 students from the Department of Clinical Medicine, Capital Medical University, were enrolled in the study, including a traditional teaching group （52 cases） and teaching group （47 cases）. Traditional teaching group in accordance with traditional practice and PBL teaching group in accordance with （ 1 ） technical points based on the clinical cases ; （2） access to clinical data and medical humanities materials ; （3） evaluation of the authenticity and the clinical usefulness of the information; （4） Scenario demonstrations; （5） evaluation and communication, compared PBL teaching and traditional teaching model through the satisfaction survey Results PBL group＇s interest in learning and knowledge level of satisfaction was significantly better than traditional teaching group＇ s （ interest in learning： 72. 3% vs 50. 0% , the degree of knowledge ： 91.5% vs 73.1% , P 〈 0. 05 ）. Compared with the traditional teaching, the PBL could improve the learning initiative, but no significant difference between the groups was observed. 51.9% of the traditional teaching group needed some improvement, meanwhile, in PBL group this proportion was 42. 6% （P 〉 0. 05 ） ; systematic satisfaction in PBL and traditional teaching group was 40. 4% and 38. 5% , respectively and the difference was not statistically significant （ P 〉 0.05 ）. Conclusion PBL teaching plays an active role in the practical physician-patient communication skills of medical students.