系统结构式同伴互助学习(peer-assisted learning,PAL)是指学生经过系统培训,按照一定规则进行互助学习的行为。本研究选择同济大学附属同济医院第一年住院医师规范化培训(简称住培)学员为研究对象,设计和实施系统结构式PAL自主训练计划。完成训练后,通过问卷了解住培学员满意度,并设置多站式实践技能考核评估训练效果。结果表明,住培学员对训练计划安排、教师示范视频、考核记录册设置和学员指导者设置的满意度评分分别为(4.79±0.58)分、(4.74±0.67)分、(4.78±0.51)分和(4.89±0.40)分,与检测值(4分)相比,其差异均具有统计学意义(均P<0.05);住培学员电子互评评分[(4.11±1.47)分]与检测值(4分)的差异无统计学意义(P=0.523)。多站式实践技能考核通过率[88.0%(73/83)]高于训练前年度实践技能考核通过率[67.5%(56/83)],其差异具有统计学意义(P=0.003)。可见,住培基地实施系统结构式PAL自主训练能够有效提升住培学员临床实践技能,可以为其他住培基地进行较大规模多项目培训提供参考。
Systematic structured peer assisted learning (PAL) is an organized learning behavior that students receive training and implement regulated learning. This study took the first-year residents as the trainees,an autonomous training plan was developed and carried out. After training, the residents' satisfaction was investigated by questionnaire, and a multi-station objective structured clinical examination (OSCE) was carried out to evaluate the training outcomes. The satisfaction investigation showed that the scores of training project organization, demonstration videos, assessment record book and peer leaders as instructors were (4.79±0.58),(4.74±0.67),(4.78±0.51) and (4.89±0.40) respectively, the differences were statistically significant compared with the test value 4 points (all P<0.05).While score of mutual electronic evaluation form was (4.11±1.47),and there was no significant difference compared with the test value 4 points(P=0.523). The passing rate of multi-station OSCE for practical skill was 88.0%(73/83), which was significantly higher than rate of baseline assessment 67.5%(56/83)(P=0.003). The systematic structured PAL-mode autonomous training project is quite feasible and can provide a useful reference for other residency training bases to implement large scale multi-item training program.
[1] 杨森, 赵华新, 石建伟, 等. 上海市全科专业住院医师规范化培训学员对培训效果的评价[J].中华医学教育杂志,2020,40(5):382-386. DOI:10.3760/cma.j.cn115259-20190813-00658.
[2] 陈文娟,王冬,李蓉,等. 临床住院医师规范化培训的思考与方法探索[J].中国继续医学教育,2018,10(30):1-2. DOI:10.3969/j.issn.1674-9308.2018.30.001
[3] 李海潮. 第二代医学教育改革与胜任力导向医学教育的关系分析[J].中华医学教育杂志,2019,39(11):801-806. DOI:10.3760/cma.j.issn.1673-677X.2019.11.001.
[4] Loda T, Erschens R, Loenneker H, et al. Cognitive and social congruence in peer-assisted learning - a scoping review[J]. PLoS One, 2019,14(9):e0222224. DOI:10.1371/journal.pone.0222224.
[5] 温华, 马婧, 朱亚鑫, 等.同伴互助学习在医学教育中的应用 [J].中华医学教育杂志,2018,38 (2): 232-236. DOI:10.3760/cma.j.issn.1673-677X.2018.02.015
[6] Burgess A, McGregor D, Mellis C. Medical students as peer tutors: a systematic review[J]. BMC Med Educ, 2014,14:115-122. DOI:10.1186/1472-6920-14-115.]
[7] Ross MT, Cameron HS. Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30[J]. Med Teach, 2007,29(6):527-545. DOI:10.1080/01421590701665886.
[8] Glynn LG, MacFarlane A, Kelly M, et al. Helping each other to learn--a process evaluation of peer assisted learning[J]. BMC Med Educ, 2006,(6):18-26. DOI:10.1186/1472-6920-6-18.
[9] Balilah M, Babgi M, Alnemari W, et al. A proposed framework to develop, describe and evaluate peer-assisted learning programs[J]. Adv Med Educ Pract, 2020,(11):1005-1013. DOI:10.2147/AMEP.S282582.
[10] 丁雯瑾, 蒋更如, 归曦, 等. 同伴互助学习在消化内科临床操作教学中的应用[J].中华医学教育杂志,2018,38(5):714-717,752. DOI:10.3760/cma.j.issn.1673-677X.2018.05.017.
