基于ERAS理念的混合式教学模式在外科学中的改革创新探索

A reform and innovative exploration of blended teaching mode in surgery based on ERAS concept

目的为回应“健康中国”战略对医学教育提出的新要求、新挑战,解决当前外科教学中存在的重讲授轻启发、重教师轻学生、重理论轻实践、重技能轻人文的问题,切实推进外科医学教育创新改革,为其他医学学科教学改革创新提供参考。方法本研究基于加速康复外科(en-hanced recovery after surgery,ERAS)理念,以培养具备临床岗位胜任力的应用型人才为核心,提升医学生“运用知识”和“实践创新”两种能力,推进专业知识吸收和医学实践操作相结合、医学素养与人文素质培养相结合、线上线下教学与床旁模拟教学三个相结合;采用LBL+PBL+CBL+TBL四维多元化教学方式,有机整合“外科+护理+麻醉+心理+人文思政”五大知识版块,通过“期末理论考核+OSCE(客观结构化临床考试)+数字化题库多阶段Quiz+临床沟通能力量表+学习成效评价量表+网络互评”进行六阶以能力为导向的综合评价改革,探索构建基于ERAS理念的外科教学改革模式。结果基于ERAS理念的混合式教学模式在外科学本科教学中的应用,凸显了以培养临床岗位胜任力应用型人才的核心,贴合临床实际,提升了医学生临床与多学科知识理解与整合的能力,巩固了学生对知识的掌握、运用和实践创新的能力。结论本研究构建的基于ERAS理念的混合式教学模式在外科学教学的应用,能够促进学生综合掌握临床知识、灵活运用知识解决实际问题,提升其自主学习能力、创新能力、团队合作能力、医学人文素养以及综合应用能力。

Objective To respond to the new requirements and challenges posed by the“Healthy China”initiative for medical education,solve the problems of emphasizing lectures over inspiration,emphasizing teachers over students,emphasizing theory over practice,and emphasizing skills over humanities in current surgical teaching,effectively promote innovative reform of surgical medical education,and provide reference for teaching reform and innovation in other medical disciplines.Methods Based on the concept of enhanced recovery after surgery(ERAS),this study focuses on cultivating applied talents with clinical post competence,enhancing the abilities of medical students in“applying knowledge”and“practical innovation”,promoting the integration of professional knowledge absorption and medical practice operation,the combination of medical literacy and humanistic quality cultivation,and the combination of online and offline teaching and bedside simulation teaching.A four-dimensional diversified teaching method of LBL+PBL+CBL+TBL was adopted,the five knowledge blocks of“surgery+nursing+anesthesia+psychology+humanistic ideological and political education”was organically integrated,and the six stages of comprehensive evaluation reform oriented by abilities,which contains“final theoretical assessment+OSCE(objective structured clinical examination)+digital question bank multi-stage quiz+clinical communication ability scale+learning effectiveness evaluation scale+network mutual evaluation”,was applied to construct surgical teaching reform mode based on ERAS concept.Results The application of blended teaching mode based on ERAS concept in undergraduate teaching of surgery highlights the core of cultivating applied talents with clinical post competence,fits clinical practice,enhances the understanding and integration of clinical and multidisciplinary knowledge among medical students,and consolidates their ability to master,apply and innovate in practice.Conclusion The application of blended teaching mode based on ERAS concept in the teaching of surgery can achieve the teaching objectives including promoting students’comprehensive mastery of clinical knowledge and flexible application of knowledge to solve practical problems,and enhancing self-learning ability,innovative ability,teamwork ability,medical humanities literacy,and comprehensive application ability.