开展以问题为基础学习改善医学生交流恐惧的远期研究

The long-term effect of problem-based learning on communication apprehension of medical students

目的 探讨开展以问题为基础学习（PBL）对医学生交流恐惧的远期影响.方法 以中国医科大学五年制临床医学专业学习全科医学概论课程（四年级）60名学生为研究对象,按照学号将其平均分为实验组和对照组,实验组30人,对照组30人.实验组学生采用PBL教学方法对学生交流恐惧进行干预,对照组学生采用传统教学方法,两组学生由相同的教师授课.全科医学概论授课结束后和大学毕业前分2次采用交流恐惧自陈量表（PRCA-24）评价两组学生的交流恐惧水平.用SPSS 13.0进行数据统计.结果 课后调查结果显示,实验组学生的总分（P＜0.05）、小组分（P＜0.01）和公众分（P＜0.05）显著低于对照组,差异具有统计学意义.毕业前调查结果显示,实验组学生小组分（P＜0.01）显著低于对照组,差异具有统计学意义;而总分和其他分量表得分差异不具有统计学意义（P＞0.05）.实验组在课后调查和毕业前调查的自身比较差异不具有统计学意义（P＞0.05）,对照组在课后调查和毕业前调查的自身比较差异不具有统计学意义（P＞0.05）.结论 PBL教学能够在短期内显著改善医学生交流恐惧心理,但干预效果难以长期保持.长期连续性开展PBL教学可能更有利于学生能力培养.

Objective To discuss the long-term effect of problem-based learning （PBL） on communication apprehension of medical student.Methods A total of 60 students in China Medical University were assigned to the PBL group （n =30） and the control group（n =30） based on the student ID number.The PBL group adopted the PBL teaching method,while the control group adopted the traditional teaching method.All of the two groups shared the same teachers.The Personal Report of Communication Apprehension （PRCA-24） was used to evaluate the situation of communication apprehension for 2 times （after PBL course and before graduation） and SPSS 13.0 software was used for statistical analysis.Results In the questionnaire survey after class,the total score（P 〈0.05）,group discussion score （P 〈0.01） and international score （P 〈 0.05） of PBL group were significantly lower than the control group.In the questionnaire survey before graduation,the group discussion score （P 〈 0.05） was significantly lower than the control group while the difference in total score and other subscales did not show statistically significant.The difference in PBL group in the investigation survey after class and before graduation show statistically significant.The difference in control group in the investigation survey after class and before graduation show statistically significant too.Conclusions Problem-based learning can relieve the communication apprehension of the medical students significantly in short-term.But the intervention effect is difficult to keep for a long time.Long-term continuity PBL teaching may be more conducive to students＇ ability training.