基于问题学习教学方法在胸外科住院医师规范化培训中的应用

doi:10.3760/cma.j.issn.1673-677X.2017.05.031

摘要/Abstract

摘要： 目的探讨基于问题学习教学方法在胸外科住院医师规范化培训中的应用。方法选择在郑州大学第二附属医院胸外科进行规范化培训的92名学员作为研究对象,将其随机平均分为实验组和对照组,实验组采用基于问题学习教学方法,对照组采用传统教学方法。通过考核成绩和问卷调查结果比较两组学员的教学效果。结果实验组学员的案例分析题和操作技能成绩高于对照组学员,两者差异均具有统计学意义(均P<0.05),而在单项选择题、简答题成绩上,两组学员差异均无统计学意义(均P>0.05)。所用教学方法在激发学习兴趣、提高临床思维能力和临床技能掌握上,实验组学员的评价高于对照组学员,两者差异均具有统计学意义(均P<0.05),而在提高学习效率、赞成所用教学方法方面,两组学员的评价差异均无统计学意义(均P>0.05)。结论基于问题学习教学方法在胸外科住院医师规范化培训中取得了良好的效果,该种教学方法能够促进教学互动、提高教学质量。

关键词: 以问题为基础学习, 教学方法, 住院医师规范化培训, 胸外科

Abstract: Objective To investigate the applying effects of problem-based learning (PBL) in standardized training of residents of thoracic surgery.Methods A total of 92 students, who were trained by standardized training of residents of thoracic surgery in the Second Affiliated Hospital of Zhengzhou University, were selected as subjects. The students were randomly divided into experimental group and control group. The experimental group was treated with PBL and the traditional teaching method was adopted in the control group. The results of the two groups were compared by the results of the examination and the questionnaire.Results The scores of the students in the experimental group were higher than those in the control group, and the differences were all statistically significant (all P<0.05). But in the single choice question examination and simple question examination, the differences in the two groups of student were not statistically significant(all P>0.05). In terms of stimulating interest in learning, improving clinical thinking ability and mastering of clinical skills, the evaluation of the experimental group was higher than that of the control group, the differences were all statistically significant (all P<0.05).But there was no statistically significant difference between the two groups in terms of improving learning efficiency and the satisfaction of the teaching method (all P>0.05).Conclusions PBL in the standardized training of residents of thoracic surgery has achieved good results, this method can promote teaching interaction, improve teaching quality.

Key words: Problem-based learning, Teaching method, Standardized training of residents, Thoracic surgery

张进, 杨鲲鹏, 侯向生, 葛晓晴, 乔孟晗, 侯露. 基于问题学习教学方法在胸外科住院医师规范化培训中的应用[J]. 中华医学教育杂志, 2017, 37(5): 779-782.

Zhang Jin, Yang Kunpeng, Hou Xiangsheng, Ge Xiaoqing, Qiao Menghan, Hou Lu. The applying of problem-based learning in standardized training of residents of thoracic surgery[J]. Chinese Journal of Medical Education, 2017, 37(5): 779-782.

参考文献

[1] 任琼珍,钱志红,张霞英.“一天一问题”的以问题为基础学习教学方法在临床实习中的应用[J].中华医学教育杂志,2013,33(1):85-88.DOI:10.3760/cma.j.issn.1673-677X. 2013.01.030.
Ren QZ, Qian ZH, Zhang XY. Process of problem-based learning teaching model “one day with one problem”in clinical practice[J]. Chin J Med Edu,2013,33(1):85-88.DOI:10.3760/cma.j.issn.1673-677X.2013.01.030.
[2] 谈梦伟,龚德军,徐志云.CBL、PBL联合Paper Review教学模式在住院医师规范化培训胸心外科临床教学中的应用体会[J].世界最新医学信息文摘,2015,15(36):190-191.DOI: 10.3969/j.issn.1671-3141.2015.36.166.
[3] 买尔旦·赛力木,阿里旦·艾尔肯,杨颖.CBL和PBL双轨式教学在胃肠外科住院医师规范化培训中的应用[J].医药前沿,2015,5(18):331-332.
[4] 陈勇兵,施立,朱蓉英,等.CBL联合PBL教学方法在胸外科临床教学中的应用效果分析[J].齐齐哈尔医学院学报,2014,35(21):3222-3224.
Chen YB, Shi L, Zhu RY, et al. An analysis of application effect of CBL combined with PBL teaching method in the clinical teaching of thoracic surgery[J].Journal of Qiqihar University of Medicine,2014,35(21):3222-3224.
[5] 陈海生,林秋伟.PBL教学方法在心胸外科学临床教学中的应用[J].医药前沿,2012(25): 371-371.
[6] 车春莉,郭庆峰,张一梅,等.PBL教学模式在中国高等医学教育中应用的思考[J].中国高等医学教育,2010(1):126-127.
[7] 曾静波,庄晓明,孙懿.PBL结合CBL教学方法提高住院医师临床能力[J].中国高等医学教育,2014(4):101-102,131.DOI:10.3969/j.issn.1002-1701.2014.04.054.
Zeng JB, Zhuang XM, Sun Y. Application of PBL combined with CBL to increase clinical ability of resident physician[J].China Higher Medical Education, 2014(4):101-102,131.DOI:10.3969/j.issn.1002-1701.2014.04.054.
[8] 郭晓静,邹德荣.PBL结合CBL教学在口腔住院医师规范化培训中的应用与思考[J].中华医学教育探索杂志,2016,15(1):96-99.DOI:10.3760/cma.j.issn.2095-1485.2016.01.024.
Guo XJ, Zou DR. Application and thinking of PBL combined with CBL teaching modes in resident standardization training of dentists[J]. Chin J Med Edu Res, 2016,15(1):96-99.DOI:10.3760/cma.j.issn.2095-1485.2016.01.024.
[9] 安永,吴春,潘征夏,等.PBL与LBL相结合在小儿心胸外科临床实习教学中的效果评价[J].中华医学教育探索杂志,2016,15(2):193-196.DOI:10.3760/cma.j.issn.2095-1485. 2016.02.021.
An Y, Wu C, Pan ZX, et al. The effect of problem-based learning combined with lecture-based learning in clinical practice teaching of pediatric cardiothoracic surgery[J]. Chin J Med Edu Res,2016,15(2):193-196.DOI:10.3760/ cma.j.issn.2095-1485.2016.02.021.
[10] 香钰婷,姜矞恒,王颢,等.北京大学医学部教师对以问题为基础学习教学中案例的评价[J].中华医学教育杂志,2014,34(6):935-938.DOI:10.3760/cma.j.issn.1673-677X. 2014.06.040.
Xiang YT, Jiang YH, Wang H, et al. Teachers' evaluation of PBL cases in Peking University Health Science Center[J].Chin J Med Edu,2014,34(6):935-938.DOI:10.3760/cma.j.issn.1673-677X.2014.06.040.
[11] 窦春江,兰咏梅,马薇,等.病案式以问题为基础学习教学方法在内科学教学中的应用研究[J].中华医学教育杂志,2015,35(3):379-382.DOI:10.3760/cma.j.issn.1673-677 X.2015.03.020.
Dou CJ, Lan YM, Ma W, et al. The applying of problem-based learning in internal medicine education through case studies[J]. Chin J Med Edu,2015,35(3):379-382.DOI:10.3760/cma.j.issn.1673-677X.2015.03.020.
[12] 胡电,贾艳爽,古航,等.导师责任制结合PBL教学模式在妇产科住院医师规范化培训中的初步探索[J].中国高等医学教育,2015(5):3-4.DOI:10.3969/j.issn.1002-1701.2015.05.002.
Hu D, Jia YS, Gu H, et al. Using tutorial system combined with PBL for resident standardization of obstetrics and gynecology[J].China Higher Medical Education,2015(5):3-4.DOI:10.3969/j.issn.1002-1701.2015.05.002.
[13] 解立怡,曹罡,赵耀.PBL联合CBL教学模式在住院医师规范化培训中的应用[J].中国病案,2015,16(10):74-76.
Xie LY, Cao G, Zhao Y. Teaching method combined PBL with CBL in standardized training of residents[J]. Chinese Medical Record, 2015,16(10):74-76.
[14] 卢强,李小飞,黄立军,等.批判性思维与PBL教学方法在胸外科临床教学中的应用[J]. 浙江临床医学,2013,15(1):105-106.
[15] 刘芳,曾辉.八年制基础医学专业学生普通外科学全程以问题为基础学习教学的调查与分析[J].中华医学教育杂志,2012,32(2):216-218.DOI:10.3760/cma.j.issn.1673- 677X.2012.02.020.
Liu F, Zeng H. The investigation and analysis to eight-year students of basic medicine who used problem-based learning teaching model during the whole teaching proceeding[J].Chin J Med Edu,2012,32(2):216-218.DOI:10.3760/cma.j.issn. 1673-677X.2012.02.020.
[16] Schmidt H G, Rotgans J I, Yew E H. The process of problem-based learning: what works and why[J].Med Educ,2011,45(8):792-806.
[17] Azer S A, Peterson R, Guerrero A P, et al. Twelve tips for constructing problem-based learning cases[J].Med Teach,2012,34(5):361-367.