目的 探讨线上线下混合教练式培训联合学生自评在医学生临床操作技能培训中的应用效果。 方法 2020年6月,选取浙江大学2016级五年制临床医学专业24名实习学生作为研究对象,采用随机数字表将其分为试验组和对照组,每组12名学生。在临床操作技能培训中,试验组学生采取线上线下混合教练式培训和学生自评方法,对照组学生采取常规培训方法。实习即将结束时,对两组学生进行客观结构化临床考试(objective structured clinical examination, OSCE)。每周操作结束后当天,试验组学生采用操作技能直接观察评估量表进行自评。 结果 试验组学生的OSCE总成绩为(89.55±6.88)分,高于对照组学生的(83.29±6.80)分,其差异具有统计学意义(P=0.032)。试验组学生自评具有良好的无菌观念从(4.00±0.85)分提高到(4.25±0.75)分,应对及沟通技巧从(4.33±0.78)分提高到(4.50±0.90)分。 结论 线上线下混合教练式培训联合学生自评方式有助于提高学生的临床操作技能水平、无菌观念和应对及沟通技巧。
Objective To explore the effect of blending teaching methods combined with self-evaluation for clinical operation skill training of undergraduates. Methods A total of 24 undergraduates from a five-year program of clinical medicine enrolled in 2016 were selected in June, 2020. The students were randomly divided into experimental group and control group with 12 in each. Blending teaching methods combined with self-evaluation was adopted in experimental group, while traditional teaching method was adopted in control group. Both groups were evaluated by Objective structured clinical examination (OSCE) before the end of the internship. On the day after the weekly operation, the self-assessment of direct observation of procedural skills was conducted in the experimental group. Results The OSCE scores from experimental group(89.55±6.88)and control group(83.29±6.80) were different (P=0.03). Students' self-evaluation of good aseptic concept increased from (4.00±0.85) to (4.25±0.75), and their coping and communication skills increased from (4.33±0.78) to (4.50±0.90) in experimental group. Conclusions The clinical operation skill of medical students can be improved by blending teaching methods combined with self-evaluation. Students' aseptic concept and communication skills are also improved.
[1] Lovell B. What do we know about coaching in medical education?a literature review[J].Med Educ,2018,52(4):376-390.DOI:10.1111/medu.13482.
[2] 秦楠.“互联网+”背景下混合式教学模式建构研究[D].济南:山东师范大学,2017.
[3] 马利伟,张巍方,陈颢,等.混合式教学模式在药学专业生物化学课程教学中的应用[J].中华医学教育杂志,2021,41(6):519-522.DOI:10.3760/cma.j.cn115259-20200921-01373.
[4] 曹燕飞,武翠玲,栗学清,等.混合式教学模式在生物化学与分子生物学教学中的应用[J].中华医学教育杂志,2021,41(8):708-711.DOI:10.3760/cma.j.cn115259-20201130-01650.
[5] 肖袁,罗湘杭,吴静,等.以学生为中心的诊断学在线混合式见习教学实践与思考[J].中华医学教育探索杂志,2020,19(6):701-704.DOI: 10.3760/cma.j.cn116021-20200511-00157.
[6] Chew FS.The case-based radiology teaching conference for residents:beneficial effect of previewing cases and using answer sheets[J].Acad Radiol,2001,8(10):993-997.DOI:10.1016/S1076-6332(03)80644-X.
[7] Yule S, Parker SH, Wilkinson J, et al. Coaching non-technical skills improves surgical residents' performance in a simulated operating room[J]. J Surg Educ,2015,72(6):1124-1130.DOI:10.1016/j.jsurg.2015.06.012.
[8] Cole SJ, Mackenzie H, Ha J, et al. Randomized controlled trial on the effect of coaching in simulated laparoscopic training[J].Surg Endosc,2014,28(3):979-986.DOI:10.1007/s00464-013-3265-0.
[9] Liao WC, Leung JW, Wang HP, et al. Coached practice using ERCP mechanical simulator improves trainees' ERCP performance: a randomized controlled trial[J].Endoscopy,2013,45(10):799-805.DOI:10.1055/s-0033-1344224.
[10] 朱余友,王娟,王黎,等.基于BOPPPS教学模型的微课体系在神经病学实践教学中的应用[J].中华医学教育杂志,2019,39(1):47-51. DOI: 10.3760/cma.j.issn.1673-677X.2019.01.012.
[11] Davis DA, Mazmanian PE, Fordis M, et al. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review[J].JAMA,2006,296(9):1094-1102.DOI:10.1001/jama.296.9.1094.
