仿真模拟结合PBL整合式教学在心电图临床技能教学中的应用

Application of simulation combined with PBL integrated teaching in clinical skills teaching of electrocardiogram

目的探讨使用仿真模拟结合以问题为基础的学习(PBL)整合式教学在五年制本科学员中的心电图临床技能教学效果。方法以2023年3月在陆军军医大学第一附属医院参加《临床技能学》心电图章节培训的2019级五年制临床医学专业的138名大四学员为研究对象,按随机抽签的方法分为观察组、仿真组和对照组,每组各46人。观察组采用仿真模拟结合PBL整合式教学,仿真组仅采用仿真教学工具结合传统以讲座为基础的学习(LBL)教学,对照组使用标准化病人(SP)结合传统LBL方法教学。课程结束后,通过心电图技能操作考核、心电图判图、问卷调查形式对3种教学效果进行评价。结果3组间技能操作考核成绩差异无统计学意义,但观察组的心电图判图成绩显著高于仿真组和对照组[(91.54±3.73)分、(87.78±5.41)分、(86.06±5.25)分],差异有统计学意义(F=15.290,P<0.001)。问卷结果显示,观察组学员的主动学习兴趣达标率高于对照组,差异有统计学意义(95.65%vs.78.26%,P<0.05)。学员对教学方法满意率方面,观察组均高于仿真组和对照组,差异有统计学意义(97.83%vs.82.61%,P<0.05;97.83%vs.80.43%,P<0.05)。结论相较于基于SP和仿真模拟工具的传统LPL教学方法,仿真模拟结合PBL整合式教学法提高了心电图临床技能教学质量,同时有助于提升医学生对心电图技能学习的兴趣和教学满意度。

Objective To explore the effect of electrocardiogram(ECG)simulation combined with problem-based learning(PBL)teaching on clinical skills of electrocardiogram on five-year undergraduate students.Methods A total of 138 fourth-year students of 2019 five-year clinical medicine who participated in the training of"Clinical Skills"electrocardiogram section at the First Affiliated Hospital of the Army Medical University in March 2023 were selected as the research subjects.They were divided into an observation group,a simulation group,and a control group by random drawing method,with 46 participants in each group.The observation group used simulation combined with PBL integrated teaching method,the simulation group only used simulation teaching tools combined with traditional lecture-based learning(LBL)teaching method,and the control group used standardized patient(SP)combined with traditional LBL teaching method.At the end of the course,the implementation effects of the three teaching methods were evaluated through the electrocardiogram skill operation,ECG judgment,and questionnaire survey.Results There was no statistical difference in skill operation assessment scores among the three groups.However,the ECG diagnostic scores of the observation group were significantly higher than that of the simulation group and the control group(91.54±3.73 vs.87.78±5.41 vs.86.06±5.25,F=15.290,P<0.001).The questionnaire results showed that the questionnaire results showed that the active learning interest achievement rate of the observation group was higher than that of the control group,and the difference was statistically significant(95.65%vs.78.26%,P<0.05).At the same time,in terms of student evaluation of teaching methods,the observation group had a higher satisfaction rate than the other two groups,and the difference was statistically significant(97.83%vs.82.61%,P<0.05;97.83%vs.80.43%,P<0.05).Conclusion Compared with the LPL teaching method based on SP and simulation tools,the integrated teaching method of simulation and PBL improves the teaching quality of ECG clinical skills,which is helpful to improve medical students'interest in learning electrocardiogram skills and their teaching satisfaction.