国内康复专业课程教学中PBL应用效果的Meta分析

Effects of problem-based learning versus lecture-based learning in teaching of rehabilitation medicine in China： a Meta-analysis

目的评价以问题为基础的学习（problem-based learning，PBL）在康复专业课程中的应用效果，并比较PBL与传统的以授课为基础的学习（lecture-based learning，LBL）的效果差异。方法计算机检索CNKI、CBMdisc、中文科技期刊全文数据库、维普中文科技期刊数据库、万方数据以及Google学术搜索中有关康复专业课程PBL与LBL教学效果比较的对照性研究；检索时间截至2017年10月。选择教学对象为康复治疗专业学生或实习生，实验组采用PBL、对照组采用LBL的对照研究文献；提取文献基本信息、教学方法、课程内容、评估指标等有效数据，采用Cochrance质量评价标准评价文献质量，采用卡方检验并结合I2判断进行异质性分析，采用RevMan 5.3进行Meta分析。结果共纳入研究文献18篇，研究对象1 943人，其中PBL组964人、LBL组979人。Meta分析结果显示，针对康复治疗专业学生，在专业理论成绩（MD=9.26，95%CI=5.24-13.29）、实践技能成绩（MD=12.11，95%CI=5.17-19.06）、综合成绩优秀率（RR=3.90，95%CI=2.10-7.26）、学生主观满意率（RR=8.98，95%CI=4.23-19.07）以及问卷调查结果方面，PBL教学效果评估结果均优于LBL，且差异有统计学意义（P〈0.01）。结论PBL在康复专业课程教学中的应用效果优于LBL，有助于提高学生的学习主动性和满意度。实践中可将PBL与其他教学方法相结合，以充分发挥PBL优势。

Objective To compare problem-based learning （PBL） versus lecture-based learning （LBL） in the teaching of rehabilitation medicine in China.Methods All Chinese articles on PBL and LBL in teaching of rehabilitation medicine courses indexed in CBMdisc, Wanfang database, CNKI database, and Google academic search published prior to October 2017 were included. The methodological quality of the selected studies was assessed with ＇Cochrane Quality Evaluation Standard’. Meta analyses were performed using RevMan 5.3.Results After exclusion of non-eligible citations, a total of 18 documents involving 1943 subjects were satisfied the criteria and were included in this review. Meta-analyses revealed that PBL had a significant improvements on theoretical knowledge examination scores （MD=9.26, 95%CI=5.24 to 13.29）, practical skills examination scores （MD=12.11, 95%CI=5.17 to 19.06）, performance excellent rate （RR=3.90, 95%CI=2.10 to 7.26）, and patient satisfaction rate （RR=8.98, 95%CI=4.23 to 19.07） （P〈0.05） among students compared with LBL in teaching of rehabilitation.Conclusion In this meta analysis, PBL is superior to LBL and worthy popularizing in teaching of rehabilitation.