教师标准化病人在诊断学实践教学中的应用及效果评价

Application and evaluation of teachers as standardized patient in diagnostics teaching practice

目的探讨教师标准化病人（teacher as standardized patient,TSP）在诊断学实践教学中的应用效果。方法随机选择2011级临床医学五年制本科学生192名，分为TSP组和以课程为基础的教学（lecture-based learning，LBL）组，各96名。TSP组采用教师模拟标准化病人的方式开展教学，LBL组则采用传统教学。实践教学结束后，分别对两组学生进行病史采集、病例分析、职业素质、体格检查及病历书写等方面的临床技能考核．并采用Mann-Whitneyu检验对考核成绩进行对比分析，评价教学效果。结果TSP组在病史采集、病例分析、职业素质及体格检查考核分数分别为（69．66±4．15，17．78±1．39，27．10±1．68，47．83±4．92），均明显优于LBL组得分（53．99±8．39，11．82±1．31，20．09±3．54，39．95±7．38），差异有统计学意义；病历书写的考核分数为（3．09±1．95），与LBL组（2．63±1．53）无统计学差异（P=0．089）。结论TSP应用于诊断学实践教学，既有助于提高教师自身素质和能力，同时能够提升学生临床实践能力及职业素质。

Objective To discuss the effect of the application of teachers as standardized pa- tients （TSP） in the teaching of diagnostics practice. Methods It randomly selected 192 five-year un- dergraduate students of clinic department in 2011 grade, and divided them into experimental group and control group, each having 96 students.The control group used traditional teaching method （lecture- based learning, LBL）, while the experimental group used TSP teaching mode. Both groups were eval- uated by cases collection, cases analysis as well as professional quality, the physical examination, cases descriptions. Then the teaching effect was evaluated through practical skills assessment and perfor- mance in many aspects. In addition, the scores were made to be compared and analyzed with Mann- Whitney u mothed. Results The TSP group got 69.66 ±4.15, 17.78 ± 1.39, 27.10 ±1.68, 47.83 ± 4.92 respectively on the four aspects. It was superior to the LBL group（53.99± 8.39, 11.82 ±1.31, 20.09 ±3.54, 39.95 ± 7.38） （P〈0.01）. In the cases description, the scores were 3.09 ± 1.95, and there was no obvious difference with the LBL （2.63 ±1.53） （P=0.089）. Conclusion The application of TSP in diagnostics teaching practice can improve the teaching quality and competence,as well as train stu- dents＇ ability to analyze problems. And meanwhile, the TSP can develop the students＇ practice compe- tence and perfect the professional quality.