目的 探讨计划-实施-研究-处理(plan-do-study-act,PDSA)循环结合线上线下教学方式在内科学见习中的应用。方法 本研究采用试验对照方法。以2020年9月至2021年6月在南京医科大学第一附属医院进行内科学见习的学生作为研究对象,按照所在班级将其随机分为试验组和对照组。试验组31名学生采用PDSA循环结合线上线下教学方式,对照组33名学生采用传统教学方式。教学结束后,比较两组学生的考试成绩、见习情况问卷调查总分以及问卷中沟通交流能力、批判性思维能力、科研能力和自主学习能力各维度的评分,采用χ²检验和t检验比较两组学生考试成绩和评分之间差异。结果 试验组学生的考试成绩为(73.65±12.60)分,高于对照组学生的(67.27±11.52)分,差异具有统计学意义(t=-2.11,P=0.039);试验组学生见习情况问卷调查总分为(85.71±19.27)分,高于对照组学生的(72.52±24.38)分,试验组学生的沟通交流能力、批判性思维能力、科研能力、自主学习能力各项评分分别为(20.45±4.68)分、(28.90±6.26)分、(16.29±3.63)分和(20.06±4.83)分,均高于对照组学生的(17.64±5.61)分、(24.52±8.01)分、(13.58±4.77)分和(16.79±6.07)分,其差异均具有统计学意义(均P<0.05)。结论 在内科学临床见习中应用PDSA循环结合线上线下教学方式,能够有效提高医学生的见习教学效果,具有良好的推广和应用价值。

Objective To explore the application of PDSA cycle combined with online and offline teaching methods in internal medicine clerkship rotation. Methods Experimental control method was used in this study. Students enrolled in internal medicine department of the First Affiliated Hospital of Nanjing Medical University from September 2020 to June 2021 were selected as research subjects, and randomly divided into experimental group (n=31) and control group (n=33) according to their classes. The experimental group adopted PDSA cycle combined with online and offline teaching methods, while the control group adopted traditional teaching method. After teaching, the two groups were compared for the examination results, as well as the total score of clerkship rotation questionnaire and the scores of each dimension of communication ability, critical thinking, scientific research ability and autonomous learning ability, for which χ2 test and t test were used to compare the differences between the two groups of students' test scores and grades. Results The score of test group was (73.65±12.60), which was higher than that of control group (67.27±11.52), the difference was statistically significant (t=-2.11,P=0.039); total score of clerkship rotation questionnaire of the experimental group (85.71±19.27) was higher than that of the control group (72.52±24.38); communication ability, critical thinking, scientific research ability and self-directed learning ability of the experimental group were (20.45±4.68)，(28.90±6.26)，(16.29±3.63) and (20.06±4.83) respectively, which were also higher than the control group of (17.64±5.61)，(24.52±8.01)，(13.58±4.77) and (16.79±6.07). The differences were all statistically significant (all P<0.05). Conclusions The application of PDSA cycle combined with online and offline teaching methods in clinical clerkship rotation of internal medicine can effectively improve learning effectiveness of medical students, and has good promotion and application value.