案例教学法联合情景模拟教学在骨科实习生中的应用

Effect of Case-based Instruction Combined with Situational Simulation Teaching on case Analysis and Clinical Comprehensive Practice ability of Orthopedic Interns

目的 观察案例教学法联合情景模拟教学在骨科实习生中应用效果,及对病例分析及临床综合实践能力的影响。方法 研究对象为2020年1月至2021年12月于广东医科大学骨科进行临床实习的实习生,将2020年1月至2020年12月于广东医科大学附属医院骨科实习的实习生设为对照组(25人),将2021年1月到2021年12月于本院骨科实习的实习生设为观察组(25人),对照组采用传统教学法,观察组接受案例教学法联合情景模拟教学。比较两组出科时理论考核、实践技能考核成绩、实践技能考核中出现的各类错误及对课程的满意情况。结果 出科时,观察组病史采集、病情分析、诊断及鉴别诊断、治疗方案拟定分值及理论成绩总分均高于对照组,差异有统计学意义(P<0.05),而两组实习生的基础知识成绩比较,差异无统计学意义(t=0.713,P=0.479)。观察组病史采集、查体及阅片分值及总分均高于对照组,且观察组清创不彻底、专科查体不熟练、石膏固定不熟练、对患者及其家属指导不足发生率均低于对照组,差异有统计学意义(χ^(2)=4.153、4.500、4.348、3.947,P<0.05)。观察组对激发学习兴趣、提升思维能力、提升自学能力、提升归纳总结能力、提升表达能力、提升协作能力的满意度均高于对照组,差异有统计学意义(P<0.05)。结论 案例教学法联合情景模拟教学不仅能提高骨科实习生病例分析能力,而且可以提高临床综合实践能力,提高其对课程的满意度。

Objective To observe the application effect of case teaching method combined with scenario simulation teaching in orthopedic interns,and its impact on case analysis and clinical comprehensive practice ability.Methods The study subjects were interns who underwent clinical practice in orthopedics at Guangdong Medical University from January 2020 to December2021.Interns who practiced in the affiliated hospital of Guangdong Medical University from January 2020 to December 2020were set as the control group (25 people),and those who practiced in our hospital from January 2021 to December 2021 were set as the observation group (25 people).The control group adopted traditional teaching methods,and the observation group received case teaching method combined with scenario simulation teaching.The theoretical examination scores,practical skills examination scores,various errors occurred in the practical skills examination,and satisfaction with the course at the end of the course were compared between the two groups.Results At the end of the course,the scores of history collection,condition analysis,diagnosis and differential diagnosis,treatment plan formulation,and total theoretical scores of the observation group were higher than those of the control group,with statistically significant differences (P<0.05),while there was no statistically significant difference in the basic knowledge scores of interns in both groups (t=0.713,P=0.479).The scores of history collection,physical examination and film reading,and total scores of the observation group were higher than those of the control group.The incidence rates of incomplete debridement,unskilled specialty physical examination,unskilled plaster fixation,and insufficient guidance for patients and their families in the observation group were lower than those in the control group,with statistically significant differences(χ^(2)=4.153,4.500,4.348,3.947,P<0.05).The satisfaction of the observation group with stimulating learning interest,improving thinking ability,improving self-learning ability,improving induction and summarization ability,improving expression ability,and improving cooperation ability was higher than that of the control group,with statistically significant differences(P<0.05).Conclusion Case teaching method combined with scenario simulation teaching can not only improve the case analysis ability of orthopedic interns but also improve their clinical comprehensive practice ability and increase their satisfaction with the course.