基于循证医学PICOS模式的TBL在神经病学临床教学中的应用研究

Application research of TBL based on evidence-based medicine PICOS model in practice teaching of Neurology

目的探讨基于循证医学PICOS模式的以团队为基础的学习（team—basedlearning，TBL）在神经病学临床教学中的应用效果。方法将2016年3至4月参加神经内科课间实习的47名学生作为教学对象，随机分为实验组24人、对照组23人。实验组采用基于PICOS模式的TBL教学，对照组仅采用TBL教学。在本学期3次课间实习结束后，从相关疾病的发病机制、临床表现、辅助检查、诊断及治疗等方面对学生进行考核；同时应用问卷，调查学生对教学方法的满意程度。采用SPSS17．0对两组学生考评结果行t检验或卡方检验。结果在专业理论知识考核方面，实验组平均成绩优于对照组[（89．08±3．60）VS（79．09±7．75），t=5．707，P=0．03]。调查显示，实验组认为教学方法“有助于理解神经病学诊疗思路”和“有利于理论联系实际”的学生人数明显高于对照组，差异均有统计学意义（P〈0．05）。结论在神经病学临床教学中．基于循证医学PICOS模式的TBL应用效果明显优于单纯TBL教学。

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [（89.08±3.60） vs. （79.09 ±7.75）, t=5.707, P= 0.03 ]. Survey showed that in the experimental group, the number of students in the trial group who thought teaching method ＂could help understand clinical thinking of neurology＂ and ＂could help integrate the theory into clinical practice＂ was significantly higher than that in the control group （P〈0.05）. Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.