基于MDT引导下的TBL联合CBL模式在血液内科临床教学中的实践探索  

Practice exploration of TBL combined with CBL mode guided by MDT in clinical teaching ofDepartment of Hematology

作　　者：刘媛 曾敏娟 连晓岚[3] 陈晓君 刘彦权 LIU Yuan;ZENG Minjuan;LIAN Xiaolan;CHEN Xiaojun;LIU Yanquan(The First Affiliated Hospital(the First School of Clinical Medicine)of Gannan Medical University,Ganzhou 341000,China;Guangdong Medical University:2.School of Basic Medicine,the First School of Clinical Medicine,Dongguan 523808,China;Department of Hematology,Fujian Medical University Union Hospital,Fuzhou350001,China;Department of Hematology,The Affiliated Hospital of Putian University,Putian 351100,China;Department of Hematology,the First School of Clinical Medicine,Dongguan 523808,China)

机构地区：[1]赣南医科大学第一附属医院(第一临床医学院),江西赣州341000 [2]广东医科大学基础医学院,广东东莞523808 [3]福建医科大学附属协和医院血液内科,福州350001 [4]莆田学院附属医院血液内科,福建莆田351100 [5]广东医科大学第一临床医学院血液内科,广东东莞523808

出　　处：《中国医学教育技术》2024年第4期535-542,共8页China Medical Education Technology

基　　金：2023年广东省教育厅学位与研究生教育创新计划项目(2023JGXM072);2023年广东医科大学高等教育教学研究项目(2JY23021);2022年广东医科大学社会科学重点基金项目(SZZF001)。

摘　　要：目的探讨和分析基于多学科团队协作诊疗(multi-disciplinary team,MDT)引导下的团队教学(team-based learning,TBL)联合案例教学法(case-based learning,CBL)在血液内科临床教学中的实践应用与成效,为血液内科临床教学改革探索新路径。方法选择2020年1月—2023年6月在广东医科大学第一临床医学院、福建医科大学附属协和医院、莆田学院附属医院血液内科轮转的169名专业型硕士研究生及住院医师规范化培训学员为研究对象,随机分为对照组(81名)及试验组(88名)。对照组采用传统住院医师床旁带教模式,试验组采用MDT引导下的TBL联合CBL模式予以临床教学。通过《血液内科理论试题卷(A/B卷)》理论考核、《血液内科临床技能操作考核量化题库》技能操作考核评价两组教学法的实践效果,利用学习过程问卷(study process questionnaire,SPQ)和中文版批判思维能力量表(critical thinking disposition inventory-Chinese ver⁃sion,CTDI-CV)评价两组学员学习动机和批判性思维能力,同时采用自制《轮转培训效果评价与满意度调查表》评价教学满意度。结果试验组在血液内科理论知识、临床思维与技能考核以及危重血液病案例处置能力的成绩均优于对照组,分别为(83.74±4.16)vs.(77.98±3.23)、(86.09±4.71)vs.(81.23±3.98)、(81.81±4.95)vs.(76.59±4.73),均P<0.01。通过比较两组学员学习动机SPQ评分可知,试验组表层动机、深层动机、成就动机得分以及SPQ总分均高于对照组,分别为(32.98±2.79)vs.(29.53±4.21)、(20.93±2.64)vs.(18.71±2.73)、(31.75±2.85)vs.(28.12±3.48)、(84.91±5.78)vs.(76.53±4.83),均P<0.01。与此同时,试验组在寻求真知、开放思想、分析能力、系统化能力、批判思维自信心、求知欲、认知成熟度方面的评分以及CTDI总分均优于对照组,分别为(39.17±2.63)vs.(37.02±3.15)、(42.14±3.98)vs.(39.23±4.03)、(40.91±4.38)vs.(37.15±4.24)、(41.83±3.62)vs.(38.98±3.9Objective To explore and analyze the practice application and effect of team-based learning(TBL)combined with case-based learning(CBL)teaching method under the guidance of multi-disciplinary team(MDT)in clinical teaching of the Department of Hematology,and explore a new path for clinical teaching reform of Department of Hematology.Methods A total of 169 profes⁃sional postgraduate students and standardized training trainees of resident doctors who were rotating in the Department of Hematology of the First Affiliated Hospital of Guangdong Medical University,Fu⁃jian Medical University Union Hospital and the Affiliated Hospital of Putian University from January 2020 to June 2023 were selected as the study subjects,and randomly divided into the control group(81 subjects)and the experimental group(88 subjects).The control group adopted the traditional bed⁃side teaching mode of residents,and the experimental group adopted the MDT-guided TBL com⁃bined with CBL mode for clinical teaching.The practical effects of the two groups of teaching methods were evaluated through the theoretical examination of the Theory of Hematology(A/B)and the Quan⁃titative Examination of Clinical Skill Operation in Hematology.The study process questionnaire(SPQ)and the Chinese version of critical thinking disposition inventory(CTDI-CV)were used to evaluate the learning motivation and critical thinking ability of the two groups.At the same time,the self-made“Evaluation and Satisfaction Questionnaire of Rotating Training Effect”was used to evalu⁃ate the teaching satisfaction.Results The experimental group performed better than the control group in the examination of theoretical knowledge,clinical thinking and skills in Hematology and the ability to handle cases of critical hematological diseases,and the examination scores were(83.74±4.16)vs.(77.98±3.23),(86.09±4.71)vs.(81.23±3.98),(81.81±4.95)vs.(76.59±4.73)respectively,all P<0.01.By comparing the SPQ scores of learning motivation between the two groups,it found that the scor

关 键 词：MDT TBL CBL 血液内科 血液病学 临床教学 

分 类 号：G642.0[文化科学—高等教育学]