EBM结合PBL教学法在我国临床教学中应用效果的Meta分析

Application of evidence-based medicine combined with problem-based learning method in clinical teaching:a meta-analysis

目的系统评价循证医学(evidence based medicine,EBM)结合以问题为基础的学习(problem-based learning,PBL)在我国临床教学中的应用效果。方法计算机检索WanFang Data、CNKI、VIP、CBM、PubMed和EMbase数据库,搜集EBM结合PBL教学法与传统的以授课为基础的学习法(lecture based learning,LBL)比较在我国临床教学中应用效果的随机对照试验,检索时限均从建库至2020年3月28日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果共纳入33个研究,2855例研究对象。Meta分析结果显示,EBM结合PBL教学组在理论考试[WMD=6.87,95%CI(5.08,8.66),P<0.001]、能力考核[WMD=10.57,95%CI(8.98,12.16),P<0.001]及病例分析[WMD=9.79,95%CI(4.71,14.88),P<0.001]成绩方面均显著高于LBL传统教学组。另外,EBM结合PBL临床教学模式更能提高医学生的自主学习能力、临床思维能力、解决问题能力、文献检索能力、交流表达能力及团队合作能力。结论当前证据显示EBM结合PBL教学模式较传统教学相比,能够提高临床教学质量。

Objectives To systematically review the application of evidence-based medicine(EBM) combined with problem-based learning(PBL) method in clinical teaching. Methods Databases including WanFang Data, CNKI,VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning(LBL) method in clinical teaching from inception to March 28 th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software. Results A total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory(WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination(WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis(WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability,problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.Conclusions Application of EBM combined with PBL method can improve clinical teaching quality.