PBL或PBL联合其他教学模式对医学教育环境影响的Meta分析  

The Effect of PBL or PBL Combining With Other Teaching Method on the Medical Educational Environment:A Meta-Analysis

作　　者：于凯[1] 齐殿君[1] 祁慧萌[1] 陈歆悦[1] 王爽[1] 于晓松[1] YU Kai;QI Dianjun;QI Huimeng;CHEN Xinyue;WANG Shuang;YU Xiaosong(Department of General Practice,The First Affiliated Hospital of China Medical University,Shenyang Liaoning 110001,China)

机构地区：[1]中国医科大学附属第一医院全科医学科,辽宁沈阳110001

出　　处：《中国继续医学教育》2020年第15期10-13,共4页China Continuing Medical Education

基　　金：辽宁省教育科学“十三五”规划课题(JG18DB525);中华医学会全科医学教育分会、中国高等教育学会医学教育专业委员会医学教育立项课题(2016B-RC042)

摘　　要：目的评价PBL或PBL联合其他教学模式对医学教育环境的影响效果。方法检索1969年1月-2018年12月间发表的关于PBL与医学教育环境的相关随机对照研究。最终有9项PBL或PBL联合其他教学模式与传统教学法比较的研究入选。对所入选研究质量的评价应用Cochrane偏倚风险评估工具。数据的统计分析应用Review Manager5.3软件。教学模式对医学教育环境影响的效应量用加权均数差(MD)和95%可信区间(CI)表示。采用Cochrane’sχ^2检验和I^2值进行异质性评价。漏斗图法用来评价发表偏倚。最后根据教学法,将研究分为PBL和PBL联合其他教学模式两个亚组进行分析。结果对参与者进行盲法设计,9项研究均为高风险,5项研究的测量偏倚存在高风险。其余方面的偏倚均为低风险。相较于传统教学法,PBL明显改善DREEM评分(医学教育环境指标)。亚组分析结果显示两个亚组的异质性均大大降低,且PBL教学法对医学教育环境的影响优于传统教学法[MD=9.12,95%CI(5.97,12.26)];PBL联合其他教学法优于传统教学法[MD=33.10,95%CI(31.23,34.96)],结果均有统计学意义(P<0.05)。结论本研究表明PBL及PBL联合其他教学模式对医学教育环境的影响优于传统教学模式。Objective To evaluate the effect of problem-based learning or problem-based learning combining with other teaching method on the medical educational environment.Methods Widely searched all articles published from January 1969 to December 2018 that relating to PBL and medical educational environment.Cochrane risk of bias tool was used to assess the quality of the included studies.Using Review Manager version 5.3 for data analysis.The effective size was calculated as mean difference and 95%confidence interval.Cochrane’sχ^2 test and I^2 was used to assess the Heterogeneity.Using funnel plot to assess the publication bias.Subgroup analysis was conducted,according to teaching method of the intervention group,that’s either PBL or PBL combining with other teaching method.Results All of the 9 included studies were at high risk of performance bias since it was hard to perform blinding on the students and teachers during the teaching process.5 studies of them were at relative high risk on the detection bias since they didn’t declare whether blinding is used while outcomes were assessed.All of the other domains of bias were at low risk.The pooled effect size showed that,compared with lecturebased learning,PBL was better on improving the medical educational environment(using the DREEM scale),the differences were statistically significant.The subgroup analysis showed that in both of the subgroups,the heterogeneity was decreased.The result showed that either PBL or PBL combining other teaching method had a better effect on the improvement of DREEM.Conclusions This study showed that PBL had a better effect on the improvement of medical educational environment as calculated by DREEM.

关 键 词：PBL 医学教育环境 DREEM LBL META分析 亚组分析 

分 类 号：G642[文化科学—高等教育学]