胃肠外科住院医师规范化培训中采用PBL教学模式的效果分析

Application of Problem-based Learning Educational Model in Resident Standardization Training of Gastrointestinal Surgery

目的评估基于问题的学习模式(PBL)在胃肠外科住院医师规范化培训(规培)中的应用效果,以期为提高规培教学质量提供参考。方法纳入2015年1月—2017年1月在我科接受规培的一年级学员80名作为研究对象。采用随机数字表,将所纳入学员随机分为观察组及对照组。观察组采用PBL教学法,对照组采用传统教学方法。共纳入观察组41名,对照组39名。两组学员在胃肠外科规培时间均为2个月,规培结束后,采用百分制量化规培教学效果,包括:(1)带教老师对学员规培效果的客观评估:理论笔试、技能操作、病史采集、病历质量及病例分析的评分;(2)学员对带教老师及规培效果的主观认可度评分,包括:带教能力、带教态度及规培满意程度。结果两组学员在理论笔试成绩上比较,差异不具有统计学意义(t=1.024;P=0.309)。观察组学员在技能操作(t=3.465;P<0.01)、病史采集(t=7.797;P<0.01)、病历质量(t=3.001;P=0.004)及病例分析(t=9.964;P<0.01)考核中取得成绩均高于对照组。观察组学员对带教老师带教能力(t=3.955;P<0.01)、带教态度(t=7.835;P<0.01)及规培满意度(t=6.927;P<0.01)的评分均高于对照组。结论 PBL教学模式可显著提高规培质量并提高学员对规培的认可程度。

Objective Our study was aimed to analyze the application of problem-based learning （PBL） educational model in resident standardization training of gastrointestinal surgery. Methods From January 2015 to January 2017, 80 students from frst grade students in department of gastrointestinal surgery were studied. The participants were randomly divided into the observation group and the control group by the random number table. The PBL teaching method was used in the observation group. The traditional teaching method was used in the control group. A total of 41 students in the observation group and 39 students in the control group were included. The duration of department of gastrointestinal surgery was 2 months in the two groups. After the completion of the regulation, the teaching effect of the system was quantified by the percentile system. It included： （1） the objective assessment of teachers＇ training effect by teaching teachers： theory, written examination, skill operation, medical history collection, medical record quality and case analysis. （2） students＇ subjective acceptance of teachers and training results, including teaching ability, teaching attitude and satisfaction degree of training. Results The difference between the two groups was not statistically significant （t=1.024; P=0.309）. In the observation group, the scores in skill operation （t=3.465, P 〈 0.01）, medical history collection （t=7.797, P 〈 0.01）, medical record quality （t=3.001, P=0.004） and case analysis （t=9.964, P 〈 0.01） were higher than those in the control group. The scores of teaching ability （t=3.955, P 〈 0.01）, teaching attitude （t=7.835, P 〈 0.01） and training satisfaction （t=6.927, P 〈 0.01） in the observation group were all higher than those in the control group. Conclusion PBL teaching shows well effect in standardized training of residents in department of gastrointestinal surgery.