住培学员标准化病人结合基于问题学习教学方法在骨科学实习教学中的应用

Application of resident standardized patients combined with PBL teaching method in orthopedic practice teaching

目的探讨住院医师规范化培训(简称住培)学员标准化病人结合基于问题学习(problem-based learning,PBL)教学方法在骨科学实习教学中的应用效果。方法选拔嘉兴学院附属医院骨科招收的住培学员,将其培训成为标准化病人。选取2019年9月至2020年6月在嘉兴学院附属医院骨科实习的2015级五年制临床医学专业100名学生为研究对象,将其随机分为试验组和对照组,每组50名学生。试验组学生采用住培学员标准化病人结合PBL教学方法进行骨科学实习,对照组学生采用传统教学方法进行骨科学实习。实习教学结束后,对两组学生进行理论知识考核、临床技能考核和客观结构化临床考试(objective structured clinical examination,OSCE),以及教学效果评价问卷调查。结果骨科学实习出科时,试验组学生理论知识、临床技能和OSCE成绩均明显高于对照组学生,其差异均具有统计学意义(均P<0.05);试验组学生系统问诊、体格检查、辅助检查判读、病历书写、操作技能、临床思维等各项临床操作考核成绩均明显优于对照组学生,其差异均具有统计学意义(均P<0.05)。问卷调查结果表明,试验组学生在学习兴趣、沟通能力、解决实际问题能力、人文素养、教学满意度等方面的评分均明显高于对照组学生,其差异均具有统计学意义(均P<0.05)。结论住培学员标准化病人结合PBL教学方法有利于实习学生掌握骨科学理论知识和操作技能,提高临床思维和沟通交流能力,调动学习兴趣,促进骨科学实习教学质量提升。

Objective To explore the application of resident standardized patients combined with problem-based learning(PBL)teaching method in orthopedic practice teaching.Methods Selected resident standardized trainees recruited by Department of Orthopedics,Affiliated Hospital of Jiaxing University,and trained them to become resident standardized patients.A total of 100 grade 2015 five-year clinical medical students from September 2019 to June 2020 in the Department of Orthopaedics,Affiliated Hospital of Jiaxing University were selected as the research objects,and randomly divided into the experimental group and the control group,with 50 trainee in each group.The trainee in the experimental group adopted the teaching method of resident standardized patients combined with PBL,while the trainee in the control group adopted the traditional teaching method.After the teaching,the theoretical knowledge,clinical skills and objective structured clinical examination(OSCE)were examined and questionaire survey on teching effectiveness was conducted.Results When trainee left the department,the theoretical knowledge,clinical skills and OSCE scores of students in the experimental group were significantly higher than those in the control group,and the differences were all statistically significant(all P<0.05).The students in the experimental group scored significantly better than those in the control group in the aspects of systematic inquiry,physical examination,auxiliary examination and interpretation,medical record writing,operation skills,clinical thinking,and the differences were all stastically significant(all P<0.05).The results of the questionnaire survey also showed that the students in the experimental group are significantly higher than those in the control group in terms of learning interest,communication ability,ability to solve practical problems,humanistic quality and teaching satisfaction,and the differences were all stastically significant(all P<0.05).Conclusions The application of resident standardized patient combined PBL teaching method is helpful for interns to master orthopedic theory and skills,improve their clinical thinking and communication ability,arouse students’interest in learning,and improve the teaching quality.