以能力为基础的教育理论在心肺复苏教学中的应用

Application of competency based education in teaching of cardiopulmonary resuscitation

目的探讨以能力为基础的教育(competency based education,CBE)理论应用于心肺复苏(CPR)教学的效果。方法将216名南京医科大学2009级临床本科三年级学生随机分为:对照组108名学生,采用传统模式教学CPR;观察组108名学生,采用CBE理论教学CPR。两组教学课时数均为8学时,比较两组学生自学后和课堂教学后的CPR理论考试以及实践课结束后的CPR技能操作成绩,结果进行t检验和χ2检验。并调查学生对CBE教学模式在CPR教学应用中的认可程度。结果与对照组比较,观察组自学后、课堂教学后平均CPR理论考试成绩以及操作考核成绩均明显提高[(69.7±11.3)分比(58.5±13.5)分,(94.2±6.3)比(81.1±8.4)分,(95.7±5.1)分比(79.5±11.1)分,均P<0.05],除观察环境、判断意识与呼吸、启动紧急反应系统、按压与吹气之比、按压中断在10 s之内项目外,观察组摆放体位、按压位置、按压姿势、按压频率、按压深度、胸廓是否回弹、清理呼吸道、开放气道、口对口人工呼吸考核错误率均明显低于对照组(均P<0.05);与对照组比较,观察组教学内容、教学方法、教学效果得分均明显提高[(21.7±2.8)分比(18.6±3.6)分,(38.0±5.2)分比(31.2±8.5)分,(26.1±3.5)分比(21.7±4.8)分,均P<0.05]。结论 CBE教学理论指导下CPR教学过程中以学习者为中心,围绕教学需要学生所具备的知识和能力开展,教学课程灵活,注重调动学生的积极性,侧重于学生的学习能力、实践动手能力和临床思维能力的培养,明显提高了CPR的教学效果,并得到学生的认可。

Objective To explore the effect of competency based education（CBE） in the teaching activity of cardiopulmonary resuscitation（CPR）. Methods 216 medical undergraduates of the 2009 grade in Nanjing Medical University were randomly divided into two groups. The control group（n = 108） was taught CPR by the traditional teaching method and the observation group（n = 108） was taught by the CBE method. Both groups were taught for eight class hours, and examinations for theory assessment after self-study and classroom teaching and for skill assessment after practice class teaching were compared. The results of CPR theory test and skill assessment were compared between the two groups and the data were analyzed with t-test and χ^2 test. The degree of recognition of the CBE teaching method by the students was also investigated. Results The averaged scores of CPR theory after self-study and classroom teaching, and the averaged scores of skill performance in the observation group were statistically higher than those in the control group [（69.7±11.3） scores vs（58.5±13.5） scores,（94.2±6.3） scores vs（81.1±8.4） scores,（95.7±5.1） scores vs（79.5±11.1）scores respectively, all P〈0.05]. In addition to the observation environment, consciousness and respiration, starting the emergency response system, the ratio of pressure and the blowing, the press interrupt program within 10 seconds, the evaluation error rates in the observation group of the putting position, the press location, the press position, the press frequency, the press depth and whether the thoracic springback, clearing the respiratory tract,opening the airway, mouth-to-mouth resuscitation were significantly lower than those in the control group（all P〈0.05）. The scores of teaching content, teaching methods and teaching effects in the observation group were statistically higher than those in the control group [（21.7 ±2.8） scores vs（18.6 ±3.6） scores,（38.0±5.2） scores vs（31.2±8.5） scores,（26.1±3.5） scores vs（21.7±4.8） scores respectively, all P〈0.05]. Conclusion CPR teaching under the guidance of CBE theory is a learner-centered approach and is prepared according to the students＇ knowledge and ability that teaching demanded. This teaching method also emphasizes flexibility in organizing the curriculum,pays attention to arouse the enthusiasm of students, and focuses on fostering students＇ ability of learning, practicing and clinical thinking. All these improve the teaching results of CPR by CBE teaching model and are accepted by the students.