以问题为导向的教学模式在住院医师规范化培训中应用的Meta分析  

Meta-analysis of learning outcomes with problem-based learning teaching method in clinical talent standardization training

作　　者：马敬[1] 郭建华[1] 张涛[1] 叶玮[1] 周莹[1] 戚晟雯 吴晶嘉 MA Jing;GUO Jianhua;ZHANG Tao;YE Wei;ZHOU Ying;QI Chengwen;WU Jingjia(Surgery Intensive Care Unit,Shanghai East Hospital,Tongji University,Shanghai 200123,China)

机构地区：[1]同济大学附属东方医院外科监护室,上海200123

出　　处：《转化医学杂志》2017年第5期280-284,290,共6页Translational Medicine Journal

摘　　要：目的评价以问题为导向的教学模式(problem-based learning,PBL)在住院医师规范化培训教学中应用效果。方法制定原始文献的纳入标准及检索策略,计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库、万方数据库以及PubMed数据库,搜索有关住院医师规范化培训教学的资料,提取试验组干预措施为PBL、对照组为传统教学法(lecture-based learning,LBL)的对照研究文献,评价纳入研究的文献质量,并提取有效数据后采用RevMan 5.3软件进行Meta分析。结果纳入研究文献18篇,研究对象1 003人,其中试验组(PBL组)506人、对照组(LBL组)497人。Meta分析显示:2组出科考试理论笔试成绩比较,加权均数差3.41(2.02~4.81),差异有统计学意义(P<0.001);2组出科考试能力考核成绩比较,加权均数差4.55(3.01~6.09),差异有统计学意义(P<0.001);2组问卷调查激发学习兴趣比较,比值比及95%可信区间为5.80(3.74~9.00),差异有统计学意义(P<0.001);2组问卷调查增强临床分析能力比较,比值比及95%可信区间为8.82(3.15~24.66),差异有统计学意义(P<0.001)。综合分析比较教学成果的4项指标,PBL组均显著优于LBL组。结论在住院医师规范化培训过程中,PBL值得推广应用。Objective To evaluate the effect of problem-based learning(PBL)teaching method in clinical talent standardization training.Methods We established the standard and retrieval strategy of original literature,then collected literature on learning outcomes of PBL compared with lecture-based learning(LBL)teaching method from Chinese Periodical Full Text Database,Chinese BioMedical Literature Database,Full Text Database of Chinese Sci-Tech Periodical,Wanfang Database and PubMed Database.All the data were analyzed with RevMan 5.3 software.Results Eighteen articles were included in this study,and 1 003 clinical talents were took in,506 were in PBL group,497 were in LBL group.The final exams showed that PBL and LBL had significantly di-fferent effects on the theoretical examination scores weighted mean difference(WMD)value[3.41(2.02-4.81),P<0.001],and on the operational examination scores WMD value[4.55(3.01-6.09),P<0.001].The questionnaires showed that the two methods also had significantly different effects on the improving learning motivation odds ratio(OR)and its 95%confidence interval(CI)were 5.80(3.74-9.00),P<0.001,and on the enhancing clinical analysis ability OR and its 95%confidence interval(CI)were 8.82(3.15-24.66),P<0.001.PBL was superior to LBL teaching method.Conclusion In our clinical talent standardization training,PBL is worthy of po-pularization and application.

关 键 词：规范化培训 以问题为导向的教学模式 META分析 住院医师 

分 类 号：R-42[医药卫生]