混合教学在我国医学教育中应用效果的Meta分析

Meta-analysis of the effect of internet-based blended learning in domestic medical education

目的系统分析混合教学在我国医学教育中的应用效果。方法在PubMed, Medline, Embase, Web of Science、万方数据知识服务平台、中国知网、维普数据库中检索我国医学教育中混合教学与传统教学效果比较的文献, 检索期限为2000年1月1日至2023年6月4日, 对纳入文献进行质量评价和荟萃(Meta)分析。结果共纳入77篇文献, 涵盖研究对象13 379名学生。文献质量评价分析表明, 纳入研究的文献质量评价结果均为B级, 存在一定偏倚风险, 且存在发表偏倚。按照课程类型将纳入文献分为基础医学教育阶段课程、临床医学教育阶段课程、临床医学实践课程、临床护理实践课程分别进行分析。Meta分析结果显示, 与传统教学相比, 4类课程采用混合教学的学生理论考试成绩均较高(分别为MD=7.18, 95%CI=2.25~12.11;MD=5.73, 95%CI=3.76~7.71;MD=5.51, 95%CI=3.03~8.00;MD=5.66, 95%CI=1.84~9.49, 均P<0.001);4类课程采用混合教学的学生实践操作成绩较高(分别为MD=3.22, 95%CI=-0.66~7.10, P=0.100;MD=5.45, 95%CI=3.60~7.31;MD=6.14, 95%CI=4.40~7.89;MD=7.62, 95%CI=5.14~10.10, 后3组均P<0.001)。结论混合教学在一定程度上有助于医学生的理论知识掌握和实践操作能力提升。

Objective:This study aimed to analysis the effect of internet-based blended medical education in China.Methods:Electronic searches of PubMed,Medline,Embase,Web of Science,Wanfang,CNKI,and VIP databases were performed.Studies published from January 1,2000 to June 4,2023 on the comparison between internet-based blended medical education and traditional medical education in China were included.Quality evaluation analysis and meta-analysis were conducted.Results:A total of 77 studies consisting of 13379 students met the inclusion and exclusion criteria.The quality evaluation results of the included studies are all grade B,with a certain risk of bias and publication bias.According to the different types of courses,the included studies were divided into four subgroups:medical basic courses,medical specialized courses,clinical medicine practice courses,and clinical nursing practice courses.The average improvements of the knowledge test score of blended learning group in each subgroup were 7.18(95%CI=2.25~12.11,P<0.001),5.73(95%CI=3.76~7.71,P<0.001),5.51(95%CI=3.03~8.00,P<0.001),and 5.66(95%CI=1.84~9.49,P<0.001),respectively.The average improvements of the skill test score of blended learning group in each subgroup were 3.22(95%CI=-0.66~7.10,P=0.100),5.45(95%CI=3.60~7.31,P<0.001),6.14(95%CI=4.40~7.89,P<0.001),and 7.62(95%CI=5.14~10.10,P<0.001),respectively.Conclusions:Internet-based blended learning can significantly improve the knowledge and skill test scores of almost all kinds of medical courses and students.