不同教学模式在临床诊断见习教学中的应用评价  

Evaluation of different instructional methods in clinical diagnosis probation teaching

作　　者：达静静[1] 皮明婧[1] 杨霞[1] 吴静[1] 李倩[1] 胡英[1] 袁静[1] 査艳 

机构地区：[1]贵州医科大学附属人民医院诊断学教研室,贵州贵阳550002

出　　处：《中国现代医学杂志》2016年第17期130-133,共4页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:81200539)

摘　　要：目的探讨不同类型教学模式在临床诊断见习教学中的应用效果，为提高临床医学教学质量提供循证依据。方法研究对象为贵州医科大学本科四年级，自愿参加该项研究的90例见习生，随机分为3组，接受不同的教学模式。以授课为中心（LBL）组以授课为基础的教学模式，以提出问题为中心（PBL）组以提出问题为基础的教学模式，以病例为中心（CBL）组以病例为基础的教学模式。3组研究对象以肾病综合征为教学内容，通过问诊考核及理论考核分别评价问诊的教学质量及理论知识的掌握情况，单因素方差分析3种不同教学模式的应用效果。行x列x2检验比较高分、均分及低分在3种教学模式中的构成比。结果90例研究对象均完成该项研究。PBL组、CBL组及LBL组间各项指标比较，差异有统计学意义（P〈O．05）。PBL组、CBL组的问诊内容[（62．13±6．20）和（65．20±5．57）分]、问诊技巧[（15．80±1．47）和（18．10±209）分]、基础知识[（36．97±4．99）和（43．00±4．47）分]、病历分析[（41．17±4．68）和（42．67±4．50）分]得分均高于LBL组[（52．53±6．78）、（12．83±170）、（31．70±2．79）和（33．67±6．29）分]，差异有统计学意义（P〈0．05）。与PBL组比较，CBL组的问诊技巧及病例分析得分增高。无论是低分组还是高分组，接受CBL教学模式的研究对象均有较高的问诊技巧和理论成绩得分（P〈0．05）。高分、均分和低分在PBL组、CBL组及LBL组中的构成比比较，差异有统计学意义（P〈0．05）。结论在医学教育过程中，应根据不同的授课环境选择合理的教学模式。以病例为先导、以问题为基础、以学生为主体、以教师为主导的CBL教学模式适用于见习生的临床诊断见习教学。Objective To explore the efficiency of different instructional methods in clinical diagnosis pro- bation teaching so as to provide evidence for improving the quality of clinical medical education. Methods Ninety student volunteers from Guizhou Medical University were randomly divided into 3 groups to accept dif- ferent instructional methods： lecture-based learning （LBL group）, problem-based learning （PBL group） and case-based learning （CBL group）. The teaching content was Nephrotic Syndrome. Teaching quality of interro- gation and the theoretical knowledge were evaluated by interrogation assessment and theoretical examination, respectively. One-way ANOVA analysis was used to analyze the effectiveness of the instructional methods in clinical diagnosis probation teaching. Chi-square test for RxC contingency table was used to compare the con- stituent ratios of high, average and low scores in the three groups. Results All subjects completed the study. The differences of 6 indicators between the PBL group the CBL group and the LBL group were statistically significant （P〈0.05）. In the PBL group and the CBL group, the interrogation content score was （62.13 ± 6.20）and （65.20 ± 5.57）, the interrogation technique score was （15.80 ± 1.47） and （18.10 ± 2.09）, the basic knowl- edge score was （36.97 ±4.99） and （43.00± 4.47）, and the case analysis score was （41.17 ± 4.68） and （42.67 ± 4.50） respectively, which were significantly higher than those [（52.53 ± 6.78）, （12.83 ± 1.70）, （31.70 ± 2.79） and （33.67 ± 6.29） respectively] of the LBL group （P 〈 0.05）. Compared with the PBL group, the interrogation technique and ease analysis scores in the CBL group were significantly higher （P〈 0.05）. Both in the highscore group and the low-score group, the students accepting ease-based learning had higher interrogation technique and theory scores （P 〈 0.05）. The constituent ratios of high, average and low scores in the 3 groups were significan

关 键 词：以病例为中心 以提出问题为中心 诊断学 医学教育 

分 类 号：R44[医药卫生—诊断学]