PBL教学结合标准化病人在肾内科临床教学中的应用

Application of PBL combined with standardized patients in clinical teaching of nephrology

目的评价以问题为导向的学习(PBL)结合标准化病人(SP)方法在肾内科临床教学中的应用效果。方法选取某医学院校五年制临床医学专业在某医院临床见习的2013、2014级四年级医学生共270人作为研究对象,将学生分为三组:PBL教学组、PBL+SP教学组和传统教学组,课程结束后进行问卷调查及考核。结果PBL+SP组100%的学生对课堂评价为满意或十分满意,PBL组98.51%的学生对课堂评价为满意或十分满意,而传统教学组仅有80.74%的学生对课堂评价为满意或十分满意。PBL+SP组和PBL组学生十分满意和满意总和率明显高于传统教学组(P<0.05),PBL+SP组十分满意率明显高于PBL组(P<0.05)。PBL+SP组学生均愿意再次在教学中应用SP。在提高上课学习兴趣、自主学习能力、医患沟通能力、临床思维能力、知识掌握能力、语言表达能力、团队协作能力、批判思维能力及临床实践能力方面,PBL+SP组和PBL组得分明显高于传统教学组(P<0.05),在提高上课学习兴趣、医患沟通能力、临床思维能力、语言表达能力及临床实践能力方面,PBL+SP组得分明显高于PBL组(P<0.05)。PBL+SP组和PBL组病史采集和理论知识成绩明显高于传统教学组(P<0.05),PBL+SP组病史采集成绩明显高于PBL组(P<0.05)。结论在肾内科临床教学中运用PBL结合SP的教学模式,能够提高医学生的学习主动性、创造性,增加学习兴趣,提升医学生的医患沟通、团队协作、批判思维及临床实践等综合能力,值得推广。

Objective To evaluatethe application of PBL combined with standardized patients in clinical teaching of nephrology.Methods Totally 270 fourth grade medical students of five-year clinical medicine specialty in one medical university were divided into three groups:the PBL group,the PBL+SP group and the traditional group.Questionnaires and assessment wereperformed at the end of the course.Results The results ofquestionnaire showed 100%of the students in the PBL+SP group were satisfied or very satisfied with the course,98.51%of the students in the PBL group were satisfied or very satisfied with the course,while only 80.74%of the students in the traditional group were satisfied the course.The satisfaction rate of the PBL+SP group and the PBL group were significantly higher than that of the traditional group(P<0.05)and the percentage of students very satisfied withthemethodin PBL+SP group was significantly higher than that of the PBL group(P<0.05).Students in the PBL+SP group were willing to apply with SP in the future.The assessment showed that the score of PBL+SP group and PBL group were significantly higher than that of the traditional group in learning interest,initiative,creativity,clinical practice ability,comprehensive communication skills with patients,teamwork and critical thinking(P<0.05).And the score of the PBL+SP group was significantly higher than that of thePBL group in learning interest,clinical practice ability,critical thinking,comprehensive communication skills with patients,expressive language skills(P<0.05).The collecting medical history and theoretical knowledge scores of PBL+SP group and PBL group were significantly higher than that of the traditional group students(P<0.05),and the collecting medical history score of PBL+SP group was significantly higher than PBL group(P<0.05).Conclusion The application of PBL combined with SP in clinical teaching of nephrology will enhance students'interest,initiative,creativity and clinical practice ability,develop students'comprehensive communication skills with patients,teamwork and critical thinking,and is worth promoting in clinical teaching.