CBL联合PBL教学在全科医学住院医师规范化培训中的教学效果

Teaching effect of CBL combined with PBL in the standardized training of general practice residents

目的探讨CBL联合PBL教学在全科医学住院医师规范化培训中的教学效果。方法选取2018年1月~2020年12月在我院进行全科医学住院医师规范化培训生48名,按随机数字表法分为CP组和L组,每组24名。CP组采用CBL联合PBL教学,L组采用LBL传统教学法。连续完成3个月教学后,比较两组学生入科与出科时的考核得分,包括理论、病史采集、病历书写、病例分析、体格检查、结果判定、技能操作及总分;自拟调查问卷反馈,比较两组在临床实践操作、临床思维、语言表达和沟通、分析问题、团队协作、PPT制作、文献查阅、基础知识掌握能力提高等方面认同度,比较两组在促进创新思维和创新能力培养、对知识的理解程度提高、自学主动性提高、激发学习兴趣、学习帮助、临床工作帮助等方面认同度,以及对本组教学认同度和满意度。结果(1)CP组的出科理论、病史采集、病历书写、病例分析、体格检查得分及总分均优于同项入科时得分,差异均有统计学意义(均P<0.05);CP组出科考核中结果判定与技能操作得分与同项入科时得分比较,差异均无统计学意义(均P>0.05)。(2)L组的出科病历书写、病例分析、体格检查得分及总得分均优于同项入科时得分,差异均有统计学意义(均P<0.05);L组出科理论、病史采集、结果判定、技能操作得分与同项入科时得分比较,差异均无统计学意义(均P>0.05)。(3)两组学生入科理论考核、病史采集、病历书写、病例分析、结果判定、体格检查、技能操作及总分比较,差异均无统计学意义(均P>0.05);CP组的出科理论、病史采集、病历书写、病例分析及总分方面与L组出科同项比较,差异均有统计学意义(均P<0.05);CP组出科考核中结果判定、体格检查、技能操作得分与L组出科同项比较,差异均无统计学意义(均P>0.05)。(4)CP组在临床实践操作能力提高、促进创新思维和创新能力培养、分析问题能力提高、基础知识掌握能力提高、对知识的理解程度提高等方面认同度与L组比较,差异均无统计学意义(均P>0.05);CP组在临床思维能力提高、语言表达和沟通能力提高、自学主动性提高、团队协作能力提高、PPT制作能力提高、文献查阅能力提高、激发学习兴趣、学习帮助、临床工作帮助等方面认同度均优于L组,差异均有统计学意义(均P<0.05);CP组学生对本组教学认同度和满意度均优于L组,差异均有统计学意义(均P<0.05)。结论CBL联合PBL教学有利于提高全科住培生学习的主动性和积极性,加深对理论知识的理解,培养自主学习和解决问题能力,提升全科住培生规范化培训质量,取得满意的教学效果。

Objective To explore the teaching effect of CBL combined with PBL in the standardized training of general practice residents.Methods From January 2018 to December 2020,48 general practice resident students in our hospital were selected for a period of three months training and were randomly divided into CP group and L group according to the random number table method,with 24 students in each group.Students in the CP group were taught by CBL combined with PBL method,while the other students in the L group were traditionally taught by LBL method.The scores of entry and exit were compared between the two groups,and the assessment items include:theoretical examination,medical history collection,medical record writing,case analysis,result determination,physical examination,skill operation and total score.The self-designed questionnaire feedback was used to compare the recognized degree of the two groups about the ability improvement in aspects of clinical practice operation,clinical thinking,language expression and communication,as well as problem analysis,team cooperation,PPT production,literature review and basic knowledge.The two groups were also compared the recognized degree in the promotion of innovative thinking and innovative ability,improvement of the understanding level of knowledge and self-study initiative,stimulating interest in learning,learning assistance,clinical work help,and so on.Meanwhile,recognition and satisfaction of the methods theses students were given is included in the compare.Results(1)The exit scores of students in group CP in theory,medical history collection,medical record writing,case analysis,physical examination and total score were all better than their entry scores,and the differences were statistically significant(P<0.05).There were no significant differences in the scores of the exit results and operation skills in group CP compared with the entry scores in the same project(P>0.05).(2)The exit scores of students in group L in medical record writing,case analysis,physical examination and total score of group L were better than same entry score,and the differences were statistically significant(P<0.05);there were no significant differences in the exit scores of theory,medical history collection,outcome determination and operation skills in group L compared with the entry scores in the same project(P>0.05).(3)There were no significant differences between both groups in theoretical examination,medical history collection,medical record writing,case analysis,result determination,physical examination,skill operation and total score(P>0.05);there were statistically significant differences between CP group and L group in terms of theory,medical history collection,medical record writing,case analysis and total score(P<0.05).There was no significant difference in the scores of result determination,physical examination and skill operation between CP group and L group(P>0.05).(4)Compared with L group,there were no significant differences in the recognized degree of CP group about the improvement of clinical practice operation ability,promotion of innovative thinking and innovation ability,as well as improvement of problem analysis ability,improvement of basic knowledge mastery ability,and improvement of knowledge understanding(P>0.05).The recognized degree of CP group was better than the L group in the improvement of clinical thinking ability,language expression and communication ability,self-study initiative,team cooperation ability,PPT making ability,literature review ability,stimulating interest in learning,learning assistance,clinical work help and other aspects,and the differences were statistically significant(P<0.05).The recognition and satisfaction levels of CP group were superior to L group,and the differences were statistically significant(P<0.05).Conclusion CBL combined with PBL teaching was conducive to improve the initiative and enthusiasm of general practice resident training students,deepened the understanding of theoretical knowledge,cultivated their self-learning and problem-solving ability,improved the quality of standardized training of general practice resident,and achieve a satisfactory teaching effect.