CBL联合分层递进式教学在住院医师规范化培训鼻咽癌教学查房中的应用

The application of CBL joint layered progressive teaching in the teaching rounds of nasopharyngeal carcinoma in resident standardized training

目的探讨在鼻咽癌专科住院医师规范化培训中开展以案例为基础的学习(Case-based learning,CBL)联合分层递进式教学的适用性和有效性。方法在教学查房过程中将住院医师随机分为对照组和实验组各20名,对照组采用传统教学模式,实验组采用CBL联合分层递进式教学模式。轮转结束后,住院医师进行出科考试及住培结业理论模拟考核,并完成教学满意度调查。结果比于对照组,实验组出科考试成绩总分表现更优,优势主要体现在病例分析和医患沟通两方面;实验组住培结业理论模拟考核成绩表现更优,A2型题(病例摘要型最佳选择题)、A3/A4型题(病历组/串型最佳选择题)、案例分析题(不定项选择题)类型的题目得分明显优于对照组,差异均具有统计学意义;实验组的教学满意度调查度总分明显高于对照组,差异主要体现在对带教教师满意度、对教学方法满意度、对教学效果满意度三方面。结论CBL联合分层递进式教学在鼻咽癌教学实践中效果显著,值得推广。

Objective To explore the applicability and effectiveness of Case-based Learning(CBL)combined with layered progressive teaching in the standardized training of resident physicians in the nasopharyngeal carcinoma specialty.Methods During teaching rounds,resident physicians were randomly divided into control and experimental groups,each consisting of 20 participants.The control group received traditional teaching methods,while the experimental group received CBL combined with layered progressive teaching.After the rotation,resident physicians underwent exit exams and theoretical simulation assessments,followed by a satisfaction survey on the teaching.Results Compared to the control group,the experimental group achieved higher overall scores in the exit exams,with particular advantages in case analysis and doctor-patient communication.The experimental group also performed better in the theoretical simulation assessment at the end of residency,especially in questions related to case summary-based multiple-choice questions(A2 type),medical record grouping/serial-based multiple-choice questions(A3/A4 type),and case analysis questions(multiple-choice questions with multiple correct answers).The differences were statistically significant.Moreover,the overall satisfaction score in the teaching satisfaction survey was significantly higher in the experimental group,particularly in satisfaction with teaching instructors,teaching methods,and teaching effectiveness.Conclusion CBL combined with layered progressive teaching demonstrates significant effectiveness in nasopharyngeal carcinoma teaching practices and warrants further promotion.