以问题为基础学习结合模拟标准化病人教学模式在急性心肌梗死诊断教学中的应用

Application of problem-based learning combined with simulated standardized patient teaching model in teaching diagnostics of acute myocardial infarction

目的探讨以问题为基础学习(PBL)模拟标准化病人(SP)教学模式在急性心肌梗死(AMI)诊断教学中的应用。方法2016年3月至2017年3月,选取在济宁医学院附属医院心内科见习的2013级本科临床医学专业3个班级学生(共153例)作为研究对象,由同一名教授进行理论课授课,授课内容均为AMI诊断方法。随机数字表法分为对照组、PBL组及试验组3组,每班即每组各51例。对照组行传统教学模式,PBL组行PBL+理论教学模式,试验组行PBL+SP教学模式。比较3组理论成绩、病历书写、学生满意度及教师对学生表现满意度。结果试验组病历书写(80.56±7.23)分、理论知识(79.84±5.63)分高于PBL组[(76.24±6.45)分、(74.28±5.05)分]、对照组[(70.21±6.13)分、(69.56±4.89)分],差异有统计学意义(F=31.45,49.95;均P<0.01);试验组体格检查(17.38±1.27)分、病史(49.47±1.34)分、主诉(16.82±0.67)分等综合能力考核成绩评分高于PBL组[(14.23±1.06)分、(44.88±1.21)分、(13.26±0.54)分]、对照组[(11.55±0.98)分、(40.52±1.04)分、(10.97±0.61)分],差异有统计学意义(F=352.43,705.92,1195.02;均P<0.01);试验组教师对学生表现满意度82.35%(42/51)高于PBL组60.78%(31/51)、对照组43.14%(22/51),差异有统计学意义(χ……2=16.72,P<0.01)。结论PBL结合SP教学模式应用于AMI诊断教学中,可提高学生理论考试成绩及综合能力,提高学生与教师满意度,改善师生关系,提高教学质量。

Objective To explore the application of problem-based learning(PBL)combined with simulated standardized patient(SP)teaching mode in teaching diagnostics of acute myocardial infarction(AMI).Methods From March 2016 to March 2017,153 students in three classes of undergraduate clinical medicine specialty in grade 2013 were selected as the subjects of study,who were taught by the same professor in the theoretical courses,and the teaching contents were all about the diagnostic methods of AMI.The students were randomly divided into control group,PBL group and experimental group with 51 cases in each group.The control group received traditional teaching mode,the PBL group received PBL and theoretical teaching mode,and the experimental group received PBL and SP teaching mode.The theoretical results,medical record writing,students'satisfaction and teachers'satisfaction with students'performance were compared among the three groups.Results The scores of medical record writing[(80.56±7.23)points]and theoretical knowledge[(79.84±5.63)points]in the experimental group were higher than those in the PBL group[(76.24±6.45)points,(74.28±5.05)points]and control group[(70.21±6.13)points,(69.56±4.89)points].The differences were statistically significant(F 1=31.45,49.95,all P<0.01).The scores of physical examination[(17.38±1.27)points],medical history[(49.47±1.34)points]and chief complaint[(16.82±0.67)points]of the experimental group were higher than those of PBL group[(14.23±1.06)points,(44.88±1.21)points,(13.26±0.54)points]and control group[(11.55±0.98)points,(40.52±1.04)points,(10.97±0.61)points].The differences were statistically significant(F=352.43,705.92,1195.02,all P<0.01).Teachers'satisfaction with students'performance in the experimental group was(42/51,82.35%)higher than that in the PBL group(60.78%,37/51)and the control group(43.14%,22/51)(χ^2=16.72,P<0.01).Conclusion The application of PBL combined with SP teaching mode in teaching diagnostics of AMI can effectively improve students'learning enthusiasm and initiative,improve students'and teachers'satisfaction,improve teacher-student relationship and teaching quality.