目的 探讨在呼吸内科学见习教学中,在教学实施不同阶段教师角色依据不同教学方法主动转换的教学效果。方法 采用实验对照方法。选择中山大学2013级五年制预防医学专业86名学生和2013级五年制临床医学专业60名学生为研究对象。在呼吸内科学见习教学中,将同一专业同一批次学生随机分为教师角色主动转换组(实验组)和教师角色主导组(对照组)。对实验组实施基于案例的学习(case-based learning, CBL)教学和基于授课的学习(lecture-based learning, LBL)教学相结合的教学方法,教师在教学实施不同阶段依据不同教学方法主动转换角色;对照组实施单纯以教师为主导的LBL教学方法。教学结束后,分别比较两个专业两组学生的考核成绩及通过问卷调查了解教学效果。结果 在肺炎和慢性阻塞性肺病的基本知识考核中,两个专业的实验组学生成绩和对照组学生成绩差异均无统计学意义(均P＞0.05);但是在拓宽知识的考核中,预防医学专业实验组学生成绩优于对照组(Z=3.33,P＜0.01),临床医学专业实验组学生成绩优于对照组(Z=3.24,P＜0.01);在偏重理解与应用能力的出科考核中,预防医学专业的实验组学生成绩优于对照组(Z=2.11,P＜0.05),临床医学专业实验组学生成绩优于对照组(Z=2.22,P＜0.05)。问卷调查结果显示,比较同一专业的两组学生对教师教学的多个项目的评分指标,差异具有统计学意义(均P＜0.05)。结论 教师角色依不同教学方法主动转换在两个不同专业呼吸内科学见习教学中具有优势,能够在有限的时间内提高见习质量和见习效果。
Objective To investigate the teaching effects of teachers' role active conversion according different teaching methods: case-based learning (CBL) combined with lecture-based learning (LBL) in respiratory medicine pre-clinical practice of different specialties.Methods CBL combined with LBL was applied to respiratory medicine pre-clinical practice teaching from department of preventive medicine and department of clinical medicine, and the teaching effects was compared with that of LBL.Results Although no significant differences were noted in basic knowledge of pneumonia and COPD (both P＞0.05), the expanding theoretical achievements of CBL combined with LBL, as well as students' performances of after-department phase examination emphasizing on clinical practice abilities, were significantly better than that of LBL. In the expanding theoretical achievements, the experimental group of preventive medical students was better than the control group(Z=3.33, P<0.01), the experimental group of clinical medicine students was better than the control group(Z=3.24, P<0.01). In the clinical practice abilities, the experimental group of preventive medical students was better than the control group(Z=2.11, P<0.05), the experimental group of clinical medicine students was better than the control group(Z=2.22, P<0.05). Some parameters including the enthusiasm, initiative and collaboration of students in a questionnaire survey can be improved by using teaching methods of CBL combined with LBL.Conclusions Teachers' role active conversion according different teaching methods such as CBL combined with LBL has an obvious advantage in the different specialties pre-clinical practice teaching of respiratory medicine and may improve the teaching quality.
[1] 崔瑷.基于问题的案例教学在呼吸内科临床见习中的应用[J].中国病案,2012,13(8):53-54. DOI:10.3969/j.issn.1672-2566.2012.08.030.
Cui A. Adoption of problem-based case learning in pre-clinical education of respiratory medicine[J]. Chinese Medical Record,2012,13(8):53-54. DOI:10.3969/j.issn.1672-2566.2012.08.030.
[2] 郭闻渊,罗逸潜,张凤琴,等. CBL与LBL结合在普外科教学中的应用[J]. 西北医学教育,2010,18(3):610-613.DOI: 10.3969/j.issn.1006-2769.2010.03.071.
Guo WY, Luo YQ, Zhang FQ, et al. Combination of CBL with LBL and their application in general surgery teaching[J]. Northwest Medical Education, 2010,18(3):610-613.DOI: 10.3969/j.issn.1006-2769.2010.03.071.
[3] 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.1673-677X.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.
[4] 佘巍巍,王昌明,莫碧文,等.改良式PBL教学法在呼吸内科见习中的应用[J].中国高等医学教育,2012(1):118-119. DOI: 10.3969/j.issn.1002-1701.2012.01.058.
She WW, Wang CM, Mo BW, et al. Adoption of modified PBL learning in pre-clinical education of respiratory medicine[J]. China Higher Medical Education, 2012(1):118-119. DOI: 10.3969/j.issn.1002-1701.2012.01.058.
[5] 龚邦东,汤建平,房星星,等.两种组合教学方法在内科学见习教学中实施效果的比较[J].中华医学教育杂志,2015,35(1):84-86,114.DOI:10.3760/cma.j.issn.1673-677X.2015.01.027.
Gong BD, Tang JP, Fang XX, et al. To compare the implementary effects of two kinds of teaching methods on internal medicine clinical practice[J]. Chin J Med Edu,2015,35(1):84-86,114. DOI:10.3760/cma.j.issn.1673-677X.2015.01.027.
[6] 彭公永. PBL结合案例教学法在呼吸内科临床见习教学中的应用[J].继续医学教育,2014,28(8):58-60. DOI:10.3969/J.ISSN.1004-6763.2014.08.032.
Peng GY. Application of PBL combined with case-based learning in pre-clinical education of respiratory medicine[J]. Continuing Medical Education, 2014,28(8):58-60. DOI:10.3969/J.ISSN.1004-6763.2014.08.032.
[7] 梁冬梅,李春海,彭林辉. 两种教学方法在外科学见习教学中的联合应用[J]. 中华医学教育杂志,2015,35(1):89-91. DOI:10.3760/cma.j.issn.1673-677X.2015.01.029.
Liang DM, Li CH, Peng LH. The use of lecture-based learning and team-based learning methods in surgical clerkship teaching[J]. Chin J Med Edu, 2015,35(1):89-91. DOI:10.3760/cma.j.issn.1673-677X.2015.01.029.
[8] 蔡朝阳,金士剑,郑刚.案例教学方法在耳鼻咽喉科学见习教学中的应用研究[J]. 中华医学教育杂志,2014,34(3):418-420. DOI:10.3760/cma.j.issn.1673-677X.2014.03.028.
Cai ZY, Jin SJ, Zheng G. Application of case based learning in otolaryngology for medical undergraduate students[J]. Chin J Med Edu, 2014,34(3):418-420. DOI:10.3760/cma.j.issn.1673-677X.2014.03.028.
[9] Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults[J]. Clin Infect Dis,2007,44(Suppl2):S27-S72. DOI: 10.1086/511159.
