目的 评价虚拟病例与标准化病人相结合教学方式在神经病学见习教学中的应用效果。方法 选择大连医科大学第一临床学院2014级临床医学专业127名本科学生为研究对象。将其随机分为实验组和对照组,实验组63名学生,采用虚拟病例与标准化病人相结合教学方式;对照组64名学生,采用传统教学方式。两组学生分别开展相应的神经病学见习教学。采用统一的客观结构化临床考试方式对两组学生进行考核,同时就临床见习效果对两组学生进行问卷调查。结果 实验组学生考核成绩(85.52±3.78)分明显高于对照组学生(80.56±4.52)分,其差异具有统计学意义(t=-6.704,P=0.000)。实验组教学方式在提高学生学习兴趣、自学能力、临床思维、理论知识理解以及未来进入临床实习的自信心方面均优于对照组教学方式,其差异具有统计学意义(P<0.05),获得了较高的满意度。结论 与传统教学方式相比,虚拟病例与标准化病人相结合教学方式在神经病学见习教学中取得了更好的效果,值得推广应用。
Objective To evaluate the effect of combine virtual case with standardized patient in neurological clerkship teaching. Methods 127 undergraduates majoring in clinical medicine of grade 2014 in the First Clinical College of Dalian Medical University were divided into two groups randomly, combining virtual cases with standardized patients group (n=63) and traditional teaching group (n=64), respectively carrying out the neurological clerkship teaching. Test and questionnaireresults are collected and the results are compared. Results Total scores of combining virtual cases with standardized patients group was significantly higher than the traditional teaching group (85.52±3.78 vs 80.56±4.52,t=-6.704,P=0.000). This method acquired great popularity among the students and is helping in increasing the interest of study, self-learning ability, clinical reasoning, basic theories comprehension and the confidence in future clinical work(P<0.05). Conclusions This study has achieved better practical effect by using virtual cases and standardized patients in neurological clerkship, and got higher evaluation by students than the traditional method.
[1] Harless WG, Drennon GG, Marxer JJ, et al. Case: A computer-aided simulation of the clinical encounter[J].J Med Educ,1971,46(5):443-448.
[2] Gaur L, Skochelak S. Evaluating competence in medical students[J].JAMA, 2004,291(17):2143.DOI:10.1001/jama.291.17.2143.
[3] 郑军,曾照芳.医学检验本科教育虚拟实验室构建的研究与实践[J].中华医学教育探索杂志,2011,10(2):233-235.DOI:10.3760/cma.j.issn.2095-1485.2011.02.033.
Zheng J, Zeng ZF. Medical examination of virtual laboratory for undergraduate education[J].Chin J Med Edu Res, 2011,10(2):233-235.DOI:10. 3760/cma.j.issn.2095-1485.2011.02.033.
[4] 梁向艳,张璟,邢金良,等.医学机能虚拟实验教学的现状及发展趋势[J].中华医学教育探索杂志,2016,15(2):185-188.DOI:10.3760/cma.j.issn.2095-1485.2016.02.019.
Liang XY, Zhang J, Xing JL, et al. The current situation and development tendency of medical functional virtual experiments teaching[J].Chin J Med Edu Res,2016,15(2):185-188.DOI:10.3760/cma.j.issn.2095-1485.2016.02.019.
[5] Kleinert R, Heiermann N, Wahba R, et al. Design, realization, and first validation of an immersive web-based virtual patient simulator for training clinical decisions in surgery[J].Journal of Surgical Education,2015,72(6):1131-1138.DOI:10.1016/j.jsurg.2015.05.009.
[6] 常娜,张祎捷,贺维亚.标准化病人在医学生模拟教学中的应用[J].西北医学教育,2014,22(5):1003-1005.
[7] Singleton JA, Carrico RM, Myers JA, et al. Tobacco cessation treatment education for dental students using standardized patients[J].Journal of Dental Education,2014,78(6):895-905.
[8] 梁乃新,杨华夏,黄晓明,等.加强标准化病人培训 提高医学生沟通能力[J].中华医学教育杂志,2012,32(4):570-572.DOI:10.3760/cma.j.issn.1673-677X.2012.04.033.
Liang NX, Yang HX, Huang XM, et al. Strengthen training of standardized patients to improve communication skills of medical students[J].Chin J Med Edu,2012,32(4):570-572.DOI:10.3760/cma.j.issn.1673-677X.2012.04.033.