CBL联合情景模拟强化教学法在“4+4”八年制儿科教学中的应用

Application of CBL combined with intensive situational simulation teaching method to “4 + 4” eight-year pediatric medical education

目的 研究以案例为基础的学习(case-based learning, CBL)联合情景模拟强化教学法在“4+4”八年制学生儿科学教学中的效果。方法 以2012级至2019级在上海交通大学医学院附属新华医院儿内科学习的147名“4+4”八年制学生为研究对象。其中2012级至2015级的59名学生为对照组,接受CBL教学联合情景模拟常规教学法;2016级至2019级的88名学生为观察组,接受CBL教学联合情景模拟强化教学法;两组均采用理论考试、CBL病例分析评分和情景模拟考核方式评估教学效果。在课程结束后进行教学满意度调查。结果 观察组学生的儿科学理论课平均成绩明显高于对照组(P<0.05);CBL病例分析中,观察组学生的理论知识掌握程度、病例分析的逻辑推理能力、临床诊断思路的缜密性、鉴别诊断的规范性和语言表达能力、团队协作、学习兴趣评分均显著高于对照组(P<0.05);情景模拟考核中,观察组学生的团队协作、医患沟通能力、临床与理论相结合及处理突发事件能力评分明显高于对照组(P<0.05)。问卷调查显示,观察组学生对教学的满意度明显高于对照组(P<0.05)。结论 与常规教学法相比,强化教学法更能提高学生的基本理论、基本知识、基本技能水平与临床逻辑思维能力,激发学习兴趣,增强医患沟通与团队协作能力,能全面提升教学质量,值得推广应用。

Objective To study the effect of case-based learning(CBL) combined with situational simulation teaching method to “4+4” eight-year pediatric medical education. Methods A total of 147 students of “4+4” eight-year medical education from 2012 to 2019, in the Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, were selected. The students of 2012 to 2015 were selected as control group(n=59) and students of 2016 to 2019 were selected as observation group(n=88). The students in the control group were taught by CBL combined with traditional situational simulation teaching method, and the students in the observation group were taught by CBL combined with intensive situational simulation teaching method, respectively. The two groups were assessed by theoretical examination, CBL case analysis scoring, and situational simulation assessment. The teaching satisfaction survey was conducted after the course. Results Theoretical score in the observation group was significantly higher than that of the control group(P<0.05). Theoretical knowledge, logical ability of case analysis, clinical diagnosis, standardization of differential diagnosis, language expression ability, teamwork, and learning interest in the observation group were significantly higher than those of the control group(P<0.05). The scores of teamwork, ability of doctor-patient communication, combination of clinic and theory, and first aid ability in the situational simulation assessment of the observation group were significantly higher than those of the control group(P<0.05). Questionnaire showed that the overall course satisfaction of the observation group was obviously higher than that of the control group(P<0.05). Conclusion Compared to traditional method, CBL combined with intensive situational simulation teaching method improves pediatric basic and clinical ability, stimulates learning interest, and enhances doctor-patient communication and teamwork ability, which is worthy of application.