两种教学方法在骨科检查法教学中的应用与评估  

Evaluation of two teaching methods of musculoskeletal physical examination

作　　者：闵楠[1] 陈曦[1] 吕勇[1] 李文德[1] 张卓[1] 杨艺[1] 吕厚山[1] 林剑浩[1] 孙铁铮[1] 

机构地区：[1]北京大学人民医院关节病诊疗研究中心,100044

出　　处：《中华医学教育杂志》2012年第2期223-224,234,共3页Chinese Journal of Medical Education

基　　金：北京大学人民医院教学改革基金项目“临床医学八年制骨科临床技能教学模式与评估的研究与实践”（3030701）

摘　　要：目的探讨有效的骨科检查法教学方法。方法对北京大学八年制临床医学专业70名学生随机分组，分别采用结构化临床教学单元法和小组床边教学方法进行骨科检查法教学。出科时采用客观结构化临床考试评价学生骨科检查法的掌握情况，并对学生进行问卷调查以了解其对所受教学方法的评价，对学生成绩和调查结果进行统计学处理。结果医学生对结构化临床教学单元法的评价略优于小组床边教学方法；学生考核成绩，除颈肩部检查，采用结构化临床教学单元法的学生平均成绩明显高于采用小组床边教学方法的学生，差异具有统计学意义外（P=0．028），其余各项采用不同教学方法学生的成绩的差异无统计学意义（P〉0．05）。结论结构化临床教学单元法与小组床边教学方法均是有效的骨科检查教学方法，结构化临床教学单元法需要更多的临床教学资源和时间保障。Objective To assess the effecliveness of musculoskeletal physical examination teaching methods. Methods 70 long-term graduate medical students from Peking University, Health Science Center were taught randomly using the methods of structured clinical instruction modules （SCIM） and small group bedside teaching. All students were debriefed at the end of each unit of clinical skills teaching for student feedback on their teaching experience using a standardized questionnaire, and all students underwent an objective structured clinical examination （OSCE） in clinical skills. The effectiveness of the two methods of teaching on the students＇ performance was analyzed. Results The subjective evaluation of SCIM in teaching of musculoskeletal examination was better than small group bedside tutorials, but there was no difference in satisfaction and OSCE performance between small group teaching methods and SCIM. There was no statistically significant difference in the performance of students in the hip, knee and lumber spine OSCE stations （P〉0.05）, but students taught by SCIM performing better in the cervical spine and shoulder station （P = 0. 028 ）. Conclusions The SCIM is an effective method of teaching clinical skills in musculoskeletal physical examination, comparable with small group bedside teaching, but its utility in clinical skill teaching will depend on the availability of teaching resource and reallocation of time.

关 键 词：骨科检查法 结构化临床教学单元 小组床边教学 

分 类 号：R-4[医药卫生]