目的 探讨元认知结合SOAP评估法在康复治疗学专业学生临床实习中的应用效果。方法 选取2017年至2018年在上海市第十人民医院康复医学科进行实习的康复治疗学专业40名实习生为研究对象,实习生来自于上海健康医学院和上海天华学院。将40名实习生随机分为试验组和对照组,每组20名实习生。试验组采用元认知结合SOAP评估法教学,对照组采用SOAP评估法教学,分别进行3个月的临床带教,采用物理治疗专业临床实践评估(assessment of physiotherapy practice,APP)和病例汇报评价表进行评估。结果 经过3个月的学习,试验组实习生的APP中的专业行为[(15.10±0.71)分比(14.30±1.26)分]、分析和计划[(14.85±0.93)分比(13.95±1.39)分]、干预[(17.95±1.46)分比(16.90±1.61)分],以及SOAP评估法中的客观资料[(4.40±0.75)分比(3.85±0.93)分]、评估[(4.50±0.69)分比(3.90±0.97)分]和计划[(4.40±0.60)分比(3.95±0.68)分]方面均优于对照组实习生,其差异均具有统计学意义(均P＜0.05)。此外,经过3个月的学习,试验组实习生的APP量表总分明显优于对照组实习生[(14.85±0.93)分比(13.95±1.39)分],其差异具有统计学意义(P＜0.01)。结论 元认知结合SOAP评估法可以提高学生临床实践能力、临床推理能力和加强临床康复的规范化,为实习生将来从事康复工作夯实坚定的基础。
Objective To investigate the effect of metacognition (MC) combined with SOAP (subjective, objective, assessment, plan )assessment method in clinical practice of rehabilitation therapy students. Methods Totally 40 rehabilitation therapy students from Shanghai Medical College and Tianhua College in the department of rehabilitation medicine, Shanghai Tenth People's Hospital from 2017 to 2018,were randomly divided into experimental and control groups. The experimental group received MC+SOAP teaching method and the control group received SOAP teaching method.After three months,both groups were evaluated using the APP(assessment of physiotherapy practice,APP)and SOAP. Results After three months,The professional behavior[(15.10±0.71)vs(14.30±1.26)], analysis and planning[(14.85±0.93)vs(13.95±1.39)], intervention [(17.95±1.46)vs(16.90±1.61)]of the APP and the objective data[(4.40±0.75)vs(3.85±0.93)], assessment[(4.50±0.69)vs(3.90±0.97)], and planning [(4.40±0.60)vs(3.95±0.68)]of the SOAP assessment method in the experimental group were higher than those in the control group(all P＜0.05). The total score of the APP scale in the experimental group was improved significantly in the control group[(14.85±0.93)vs(13.95±1.39), P<0.01]. Conclusions Metacognition combined with the SOAP assessment method can improve students' clinical skills, clinical reasoning, and strengthen the standardization of rehabilitation performance.
[1]Flavell JH. Metacognition and cognitive monitoring: a new area of cognitive-developmental[J]. American Psychologist, 1979, 34(10):906-911.DOI:10.1037/0003-066X.34.10.906.
[2]董奇. 论元认知 [J]. 北京师范大学学报: 社会科学版, 1989(1): 68-74.
[3]赖翠. 元认知理论应用于初中数学教学的研究 [J]. 中学教学参考, 2017(11): 5.
[4]Schraw G, Gutierrez AP. Metacognitive strategy instruction that highlights therole of monitoring and control processes [J]. Intelligent Systems Reference Library, 2015, (76):3-16.
[5]黄艳. 基于元认知策略培养学生的英语自主学习能力 [J]. 开封教育学院学报, 2015, 35(1): 78-79.
[6]Reznich CB, Wagner DP, Noel MM. A repurposed tool: the programme evaluation SOAP note [J]. Medical Education, 2010, 44(3): 298-305.
[7]Mowery D, wiebe J, Visweswaran S, et al. Building an automated SOAP classifier for emergency department reports [J]. Journal of biomedical informatics, 2012, 45(1): 71-81.
[8]Sanfilippo J S. Infertility classification: a work in progress sounds like SOAP revisited [J]. Fertility and sterility, 2005, 83(4): 842-843.
[9]美国中华医学基金会.全球医学教育最低基本要求 [J]. 医学教育杂志, 2002(4): 23-25.
[10]董骏, 代春燕, 余照明. 在临床带教中帮助实习生实现角色转换 [J]. 世界最新医学信息文摘(连续型电子期刊),2014(33): 334-335. DOI:10.3969/j.issn.1671-3141.2014.33.312.
[11]Dalton M, Davidson M, Keating J. The assessment of physiotherapy practice (APP) is a valid measure of professional competence of physiotherapy students: a cross-sectional study with rasch analysis [J]. Journal of Physiotherapy, 2011, 57(4): 239-46.
[12]周敏,吴建军,徐春岳.高职护生元认知能力与护理临床决策自信水平的相关性研究 [J]. 护理与康复, 2018, 17(8): 27-30.
[13]孙崇勇.儿童元认知发展对推理能力的影响 [J]. 陕西学前师范学院学报, 2016(1):69-74. DOI: 10.11995/j.issn.2095-770X.2016.01.018.
