情景模拟在全科医学目标教育中应用效果的META分析

META Analysis of the Application Effect of Scenario Simulation in General Medical Target Education

目的:采用系统评价方法,对比情景模拟教学与传统教学在全科医生培养中的效果。方法:计算机检索Medline、VIP、WanFang Data和CNKI数据库,检索时间均从建库至2018年01月23日。由3位研究者独立筛选文献并根据Cochrane系统评价方法进行纳入文献的质量评价后,使用Excel软件摘录数据,并采用统计软件Stata14.0进行Meta分析。结果:最终纳入6个研究,共710例研究对象。Meta分析结果显示:情景模拟教学组理论考核成绩〔SMD=1.211,95%CI (0.690,1.731),<0.001〕、实践考核成绩〔SMD=1.434,95%CI (0.970,1.898),<0.001〕、自主学习能力〔RR=1.547,95%CI(1.020,2.345),P=0.040〕、专业知识应用能力〔RR=1.421,95%CI(1.113,1.816),P=0.005〕、职业认同感〔RR=1.527,95%CI(1.014,2.299),P=0. 043〕均高于传统教学组,其差异均有统计学意义,而两组在学习兴趣〔RR=1.378,95%CI (0.994,1.912),P=0.054〕、专业知识掌握〔RR=1. 123,95%CI (0.986,1.279),P=0.081〕及教学方法的满意度〔RR=1.057,95%CI(0.865,1.292),P=0.588〕方面比较,差异无统计学意义。结论:情景模拟教学较传统教学有明显优势,值得推荐。受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically evaluate the application effect of scene simulation teaching method verse the traditional teaching in general medical goal-oriented education. Methods The Medline, VIP, Wanfang and CNKI databases were searched up to January 23, 2018. The studies were screened according to the inclusion and exclusion criteria by three researchers independently, extracted the data and assessed the quality according to the method of Cochrane systematic review, and then meta-analysis was performed using Stata 14.0 software. Results A total of 6 studies involving 710 participants were included. The results of meta-analysis showed that the scene simulation teaching group was superior to the traditional teaching group on the score of theoretical test 〔SMD=1.211,95%CI(0.690,1.731), < 0.001〕, practice assessment score〔SMD=1.434,95%CI(0.970,1.898),< 0.001〕, independent learning ability improvement rate〔RR=1.547, 95%CI(1.020,2.345), P=0.040〕, the ability to increase the rate of application expertise〔RR=1.421, 95%CI(1.113, 1.816), P=0.005〕, and the ability to increase the rate of professional identity〔RR=1.527,95%CI(1.014, 2.299),P=0. 043〕with statistical significance.But, the ability to increase the rate of learning interest〔RR=1.378,95%CI(0.994, 1.912),P=0.054〕, the ability to increase the rate of professional knowledge〔RR=1.123,95%CI(0.986,1.279), P=0.081〕, and satisfaction with teaching methods〔RR=1.057,95%CI(0.865, 1.292),P=0.588〕with no statistical significance. Conclusions The scene simulation teaching method has better effects than the traditional teaching method in general medical goal-oriented education,so it is worthy to be recommended. Due to the limited quantity and quality of the included studies, the above conclusion still need to be further verified by more high quality studies.