混合式教学模式在留学生神经内科临床实习中的应用研究

Study on the Application of Mixed Teaching Mode in Clinical Practice of Neurology for International Students

目的 探究讲授式教学法(lecture based learning,LBL)、以问题为基础的教学方法(problem-based learning,PBL)、慕课(massive open online course,MOOC)联合翻转课堂对于临床医学专业留学生临床实习效果的影响。方法选取2018年6月-2019年6月在哈尔滨医科大学附属第一医院6年制临床医学毕业实习阶段留学生共80名作为研究对象,随机分成4组,每组20人,分别采用4种不同教学模式进行神经内科实习教学:1组采用LBL教学法;2组采用PBL教学法;3组采用LBL联合PBL教学法;4组采用LBL+PBL+慕课联合翻转课堂。课后向每名同学发放调查问卷以此了解学生的满意情况,实习结束以后对4组学生进行理论和临床技能综合考试。以评估留学生的临床知识掌握能力、临床技能操作能力、临床病例分析能力。结果 第4组学生临床知识掌握能力、临床技能操作能力、临床病例分析能力均高于其他3组留学生,差异有统计学意义(P <0.05);第4组学生在专业知识涵盖满意度、临床思维培养满意度、教学体验满意度3个方面评分高于其他3组学生,差异有统计学意义(P <0.05)。结论 在留学生临床实习教学中采用LBL+PBL+MOOC联合翻转课堂教学模式效果显著,能有效激发学生的主观能动性,培养学生自主学习和分析问题的能力,提高学生的学习成绩及临床知识掌握能力、临床技能操作能力、临床病例分析能力,提升整体教学效果和教学满意率。

Objective To explore the effect of LBL,PBL,MOOC combined with flipped classroom teaching mode on clinical practice effect of international students majoring in clinical medicine.Methods From June 2018 to June 2019,a total of 80 international students in the 6-year clinical medicine graduation practice stage in the First Affiliated Hospital of Harbin Medical University were randomly divided into 4 groups,with 20 students in each group,and four different teaching modes were used for neurology practice teaching:group 1 adopted LBL mode;group 2 adopted PBL mode;group 3 adopted LBL+PBL mode;group 4 adopted LBL+PBL+MOOC combined with flip classroom.After each class,the students'feedback on the teaching mode was investigated by questionnaire,and four groups of students were given a comprehensive examination of theoretical and clinical skills after practice.In this way,the students'clinical knowledge mastery ability,clinical skill operation ability and clinical case analysis ability were evaluated.Results Group 4 have significantly higher clinical knowledge mastery,clinical skills operation and clinical case analysis ability than the other three groups of international students(P<0.05).Group 4 students scored higher than the other three groups in terms of satisfaction with professional knowledge coverage,clinical thinking cultivation,and teaching experience,and the difference was statistically significant(P<0.05).Conclusion The combination of LBL+PBL+MOOC in clinical practice teaching for international students has a remarkable effect,which can effectively stimulate students'subjective initiative,cultivate students'autonomous learning ability and analyze problems,obviously improve interns'academic performance and clinical ability,improve the overall teaching effect and teaching satisfaction rate.