目的 探讨计划-执行-检查-处理(plan-do-check-act,PDCA)循环结合体验式学习在内分泌临床实习教学中的应用效果。方法 采用试验对照方法,选择2018年1月至2019年12月在中山大学孙逸仙纪念医院进行内分泌实习的2013级和2014级五年制临床医学专业111名学生为研究对象,采用随机数字表将其分为试验组(57人)和对照组(54人)。试验组学生采用PDCA循环结合体验式学习教学方式,对照组学生采用传统教学方式。采用t检验、Mann-Whitney U 非参数检验比较两组学生的考核成绩以及满意度问卷调查结果。结果 试验组学生比对照组学生在临床实践能力考核成绩[(55.18±3.61)分比(45.37±2.95)分]和总成绩[(89.30±4.99)分比(79.48±4.17)分]评分高,其差异均具有统计学意义(均P<0.001);两组学生在理论考核成绩[(34.12±2.20)分比(34.11±2.47)分]评分无统计学差异(P=0.972)。试验组学生的总体满意度优于对照组学生[(93.86±3.76)分比(86.47±3.07)分],试验组学生比对照组学生在教学计划设计[21.74(2.71)比15.22(6.52)]、临床思维能力提高[4.35(1.09)比2.17(1.09)]和学习兴趣增加[4.35(1.09)比3.26(1.09)]的评分高,其差异均具有统计学意义(均P<0.001)。结论 PDCA循环结合体验式学习有助于提高内分泌实习效果和学生满意度,这种教学方式有助于改进教学计划设计、提高学生的临床思维能力和学习兴趣。
Objective To explore the application effect of plan-do-check-act (PDCA) cycle combining with experiential learning in clinical practice teaching of endocrinology. Methods Test control method was used. The study subjects were 111 students enrolled in 2013～2014 of five-year program of clinical medicine and was training as interns in the Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2018 to December 2019. There were 57 students divided into the experimental group and 54 into control group using a randomized digital table. Students in the experimental group received PDCA cycle combining with experiential learning teaching, while those in the control group received classic teacher-centered teaching. T test, Mann-Whitney U test were performed to compare the scores between the two groups, and a satisfaction survey was also conducted. Results The experimental group scored higher than the control group in clinical capacity assessment [(55.18±3.61) vs. (45.37±2.95)] and the total results [(89.30±4.99) vs. (79.48±4.17)](all P<0.001). But there was no difference in the theoretical assessment between the two groups [(34.12±2.20) vs. (34.11±2.47), P=0.972]. Meanwhile, the experimental group scored higher in satisfaction survey [(93.86±3.76) vs. (86.47±3.07)] than the control group, including teaching planning design [21.74(2.71) vs. 15.22(6.52)], improvement of clinical practice [4.35(1.09) vs. 2.17(1.09)] and learning interest [4.35(1.09) vs. 3.26(1.09)](all P<0.001). Conclusions PDCA cycle combined with experiential learning improves practice effect and students' satisfaction, which may improve the training outcomes on teaching planning design, clinical practice capacity and learning interest.
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