PBL结合CBL教学法在住院医师规范化培训中的系统评价  

Systematic Evaluation of PBL Combined with CBL Teaching Method in Standardized Training of Residents

作　　者：王岩[1] 刘江涛[2] WANG Yan;LIU Jiangtao(Department of Radiology,the First Medical Center of the PLA General Hospital,Beijing,100853 China;Depart-ment of Gastroenterology,Hainan Hospital of the PLA General Hospital,Sanya,Hainan Province,572013 China)

机构地区：[1]解放军总医院第一医学中心放射诊断科,北京100853 [2]解放军总医院海南医院消化内科,海南三亚572013

出　　处：《中国卫生产业》2024年第3期6-9,21,共5页China Health Industry

基　　金：海南省自然科学基金(822MS195)。

摘　　要：目的系统评价基于问题的学习模式(Problem-Based Learning,PBL)结合基于病例的学习模式(Case-Based Learning,CBL)在国内住院医师规范化培训(简称规培)中的效果。方法检索知网、万方、维普全文数据库,纳入PBL结合CBL教学对比单纯传统讲座式教学(Lecture-Based Learning,LBL)的随机对照研究或队列研究,研究对象为住院医师规范化培训医师,结局指标为理论考试成绩与实践操作的总成绩。获得目标文献后,提取数据进行Meta分析,合并指标以标准化均数差(Standardized Mean Difference,SMD)和95%置信区间(Confidence Interval,CI)表示。结果最终纳入23篇文献,共计1384名规培医师,其中观察组698名、对照组686名。Meta分析结果显示:与LBL教学法相比,PBL联合CBL教学法能够提高规培医生的考核总成绩(SMD=1.79,95%CI:1.45~2.12,P<0.001)。结论基于现有研究数据,与传统LBL教学模式比较,PBL结合CBL教学能显著提高住院医师规范化培训的效果,但未来仍需要设计良好的高质量随机对照研究证实现有结果。Objective To systematically evaluate the effect of problem-based learning model(PBL)combined with case-based learning model(CBL)in the standardized training of resident physicians in China.Methods The randomized controlled study or cohort study of PBL combined with CBL teaching compared with lecture-based learning(LBL)teaching alone was searched through CNKI,Wanfang and VIP full-text databases.The subjects of the study were standardized training physicians for resident doctors,and the outcome indexes were theoretical examination scores and total scores of practical operations.After the target literature was obtained,the data were extracted for meta-analysis,and the combined indicators were expressed as standardized mean difference(SMD)and 95%confidence interval(CI).Results Finally,23 literatures were included,with a total of 1384 trained physicians,including 698 in the observation group and 686 in the control group.The results of meta-analysis showed that compared with LBL teaching method,PBL combined with CBL teaching method could improve the total test scores of trained doctors(SMD=1.79,95%CI:1.45-2.12,P<0.001).Conclusion Based on the existing research data,compared with the traditional LBL teaching mode,PBL combined with CBL teaching can significantly improve the effect of standardized resident training,but in the future,well-designed high-quality randomized controlled studies are still needed to confirm the existing results.

关 键 词：基于问题的学习 基于病例的学习 讲座式教学 住院医师规范化培训 Meta分析 教学法 

分 类 号：R7[医药卫生—临床医学]