目的 探讨同伴互助学习(peer-assisted learning,PAL)在消化内科临床操作教学中的应用效果及实践评价。方法 选取2015年~2017年在上海交通大学医学院附属新华医院内科实习的87名学生为研究对象,进行腹腔穿刺及胃管留置的教学,其中43名学生为对照组,采用传统教学方式,44名学生为实验组,接受PAL教学。教学结束后,比较两组学生操作考试及理论考试成绩;采用评判性思维能力测量表比较两组7个维度的评判性思维能力;通过问卷调查分析学生对其教学效果的评价。结果 实验组学生腹腔穿刺和胃管操作考试成绩分别为(84.86±4.54)分和(83.76±4.14)分,高于对照组学生的(80.09±4.64)分和(79.79±5.05)分,差异均具有统计学意义(均P＜0.05);两组学生操作考试及理论考试总分的差异有统计学意义[(83.75±2.35)vs (80.92±3.63),P＜0.05]。实验组学生评判性思维能力总分 (217.62±31.76)分,优于对照组学生的(80.92±3.63)分,差异具有统计学意义(P＜0.05),在“寻找真相”、“系统化能力”和“自信心”方面优势明显,差异均具有统计学意义(均P<0.05)。结论 PAL教学有助于操作实践技能的学习和评判性思维能力的提高,促进学生间沟通、交流和协作,具有一定的可行性。
Objective To explore and evaluate the application of peer-assisted learning(PAL) teaching in the clinical skills of gastroenterology department. Methods The teaching and practice of abdominal puncture and gastric tube retention were carried out in 87 medical interns of Xinhua Hospital in 2015-2017, of which 43 were along to the control group, and 44 were along to the test group. The traditional teaching method was used in control group while the PAL teaching was received in test one. The practice test and theoretical examination results were compared in the two groups. The assessment about the ability of the critical thinking ability on the 7 dimensions was used. Besides, the effect of teaching was evaluated through a questionnaire survey. Results The scores of abdominal puncture and gastric tube operation in test group were (84.86 ±4.54) and (83.76±4.14), respectively, higher than those of the control group (80.09±4.64) and (79.79±5.05), with statistical significance (all P<0.05). The difference between two groups in the total scores of practice test and theoretical examination was statistically significant [(83.75 ±2.35) vs (80.92±3.63), P< 0.05]. The total score of critical thinking ability in test group (217.62 + 31.76) was superior to that of the control group (80.92 + 3.63) (P<0.05). It had obvious advantages in “finding the truth”, “systematized ability” and “self-confidence” (all P<0.05). Conclusions PAL teaching could improve the practical skills and critical thinking ability. More communication and collaboration among students occurred during the PAL teaching. Therefore, it had certain feasibility.
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