基于RE-AIM和柯氏模型的反思实践培训方案在本科医学带教中的应用

Application of Rethinking Practical Training Scheme Based on RE-AIM and Kirkpatrick Model in Undergraduate Medical Teaching

目的观察基于可及性、有效性、采用率、实施性与持续性(reach,effectiveness,adoption,implementation,maintenance,RE-AIM)和柯氏模型的反思实践培训方案在本科医学带教中的应用效果。方法选取2022年3月-2023年6月重庆医科大学附属第一医医学临床医学专业学生124名,使用随机数字表法将其分为对照组(n=61)及研究组(n=63)。对照组采用传统教学方案,研究组使用基于RE-AIM和柯氏模型的反思实践培训方案进行教学。观察2组学生的教学效果、考核成绩、自我效能、批判思维评分及学生满意度。结果研究组临床思维能力、医学人文精神、公共卫生服务、社区情怀评分均高于对照组;研究组实践成绩、理论成绩、总分高于对照组;研究组工作职责评分、教育要求评分高于对照组;研究组寻找真相、自信心、求知欲、分析能力、开放思维、认知成熟度、系统化能力7个维度均高于对照组;研究组学习兴趣激发、思维能力提高、自学能力培养、理论知识掌握、语言和表达能力提高5个维度满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论基于RE-AIM和柯氏模型的反思实践培训方案有助于提高本科医学生的教学效果,提高教理论及实践成绩,培养实习生批判思维并提高其对带教工作的满意。

Objective To observe the application effects of a reflective practice training program based on the RE-AIM framework(Reach,effectiveness,Adoption,Implementation,Maintenance)and Kirkpatrick model in undergraduate medical education.Methods A total of 124 undergraduates majoring in clinical medicine in the First Affiliated Hospital of Chongqing Medical University were selected from March 2022 to June 2023,and divided into control group(n=61)and research group(n=63)using random number table method.The control group was taught with traditional teaching scheme,while the study group was taught with reflective practice training scheme based on RE-AIM and Kirchner model.The teaching effect,assessment results,self-efficacy,critical thinking rating and student satisfaction were observed.Results The scores of clinical thinking ability,medical humanistic spirit,public health service and community sentiment of the study group were higher than those of the control group.The practical scores,theoretical scores and total scores of the study group were higher than those of the control group.The scores of job responsibilities and educational requirements of the study group were higher than those of the control group.The study group was significantly higher than the control group in 7 dimensions:truth seeking,self-confidence,intellectual curiosity,analytical ability,open mind,cognitive maturity and systemization ability.The satisfaction scores of the study group were significantly higher than those of the control group in 5 dimensions:stimulation of learning interest,improvement of thinking ability,cultivation of self-learning ability,mastery of theoretical knowledge,and improvement of language and expression ability,the differences were statistically significant(P<0.05).Conclusion The reflective practice training program based on RE-AIM and Kirchhoff model is helpful to improve the teaching effect of undergraduate medical students,improve their catechism and practice results,train interns'critical thinking and improve their satisfaction with teaching work.