基于PBL教学法以Morning Report为主要形式探索中医内科临床教学研究

Exploration of Clinical Teaching Research on Chinese Internal Medicine Based on Problem-Based Learning Method with Morning Report as the Main Form

目的:研究基于PBL教学法以Morning Report为主要形式的教学方式(简称PBL-Morning Report)在临床教学实践中的效果。方法:调查对象为在首都医科大学附属北京中医医院心血管科临床轮转的研究生规培医师、本科实习医师、社会规培医师和进修医师。将2021年1—12月在常规临床教学基础上接受PBL-Morning Report的学生设为观察组,回顾性选择2020年后半年因疫情原因仅接受常规临床教学的学生并设为对照组。观察组学生在结束转科的最后1周通过微信“问卷星”接受独立的数据调研,对照组在2021年1月通过微信“问卷星”接受回顾性调研。调研内容:基础理论掌握情况,病历书写能力,病例理解/病历汇报能力,中医思维在临床实践的应用能力,自主学习与研究能力。每项问题根据所赋值分数(0、3、6、9分)进行定量评分。结果:共发放问卷221份,回收问卷221份,其中观察组166份,对照组55份。调查内容各项评分观察组均高于对照组,差异均有统计学意义(P<0.05)。亚组分析显示,研究生规培医师除在自主学习与研究能力方面的评分观察组相较于对照组,差异无统计学意义(P>0.05),其余调查内容各项评分观察组均高于对照组,差异有统计学意义(P<0.05)。本科实习医师调查内容所有项目评分观察组均略高于对照组,但差异均无统计学意义(P>0.05)。结论:PBL-Morning Report有助于提高学生中医内科综合临床实践能力。

Objective:To study the effect of Morning Report as the main teaching method on clinical teaching practice based on the PBL method.Methods:The survey was conducted among postgraduate physicians during standardized training,undergraduate interns,social physicians during standardized training and advanced physicians who practiced clinical department-rounding in the Cardiovascular Department of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University.Students who received PBL-Morning Report based on routine clinical teaching from January to December 2021 were set as the observation group,and students who received only routine clinical teaching in the second half of 2020 due to the epidemic were retrospectively selected and set as the control group. The observation groupwas given independent data survey via “WJX.CN” on WeChat in the last week of department-rounding,and the control group received retrospective survey via “WJX.CN” on WeChat in January 2021. Surveycontent includes mastery of basic theory,and abilities to write medical records,understand cases/reportmedical records,apply Chinese medicine thinking in clinical practice,and independent learning and study.Each question is scored quantitatively according to the assigned score (0,3,6,and 9 points). Results:Atotal of 221 questionnaires were distributed and returned,including 166 in the observation group and 55 inthe control group. The scores of each item in survey content in the observation group were higher thanthose in the control group,differences being significant (P<0.05). The analysis of subgroup showed thatthere was no significant difference being found in the comparisons of scores of independent learning andstudy ability of postgraduate physicians during standardized training between the two groups (P>0.05),andthe scores of remaining items in survey content in the observation group were higher than those in thecontrol group, the difference being significant (P<0.05). The scores of all items in survey content ofundergraduate interns in the observation group were slightly higher than those in the control group, butthere was no significance in the differences (P>0.05). Conclusion:PBL-Morning Report can help improvethe comprehensive practical clinical competency for Chinese internal medicine of students.