生理学实验开放式教学的实践与探索

生理学实验是医学生实验课的基础课程，我们在教学中进行了开放式实验教学，并以问卷调查的形式分析学生对开放式实验的认可度以及对基本知识点的掌握；分析开放式实验前后学生的生理学实验考试成绩三方面进行教学效果评价。     

医学基础课程第二课堂教学效果的比较

目的探讨医学基础课程第二课堂教学效果。方法自行设计《医学基础课程第二课堂教学评价问卷(学生版)》,曾参加医学基础课程第二课堂的85名学生(21~23岁)分3组:基础医学组(A组,23人)、七年制临床医学组(B组,22人)及五年制临床医学组(C组,40人),接受问卷调查。结果对老师评价中,A、C组学生对老师"指导作用"(90.3±2.6;89.5±3.7)的评价较B组(82.7±13.6)高(P0.05)。在学生收获方面,B组学生在"确定研究方向"(90.0±5.7)的收获比A组(84.3±8.0)和C组(87.8±8.4)高(P0.05);C组学生在"搜集资料"(91.3±7.3)、"交流评价与表达能力"(88.5±7.9)方面收获较A组(80.9±7.9,83.3±7.8)和B组(82.7±17.0,86.4±7.6)高(P0.05)。结论学生对第二课堂教学效果整体评价较高;学生在独立科研能力及沟通能力等方面有较大收获;参与第二课堂科学研究程度越深,收获越大。     

临床实践为先导的医学免疫学实验课改革与探索

医学免疫学是生命科学的前沿学科,与临床实践紧密联系。合理设置医学免疫学实验课内容,不仅是对免疫学理论知识的验证和补充,更是培养医学生临床实践和科研素养的重要途径。因此,在此次医学免疫学实验内容改革和探索的过程中,酶联免疫吸附试验和数据统计分析被引入实验课程,力求让实验内容理论联系实际,切合当前临床和科研实践需求。问卷调查结果显示:实验内容设置合理,学生学习兴趣大、主动性很强,极大加深了学生对基础免疫学理论知识的理解深度,为进一步改进和优化医学免疫学实验教学提供了科学依据。     

临床医学类学生对卫生学课程认知情况及教学满意度调查

目的为了解临床专业预防医学教学现状,为临床专业卫生学课程的教学改革工作提供依据。方法随机选取南华大学临床医学、全科医学、口腔医学、麻醉医学、影像医学等专业的学生进行问卷调查,问卷内容包括学生对课程的认知情况、对教学设置、教学效果的评价等。结果 84.8%的学生认为有必要学习卫生学课程,85.8%的学生认为有助于今后的学习与工作,90.4%的学生认为有助于深化预防为主的观念,57.1%的学生认为本课程与临床的结合程度不够紧密。学生对理论课程中预防保健策略和措施重要性认知度最低,最感兴趣的实验内容为饮用水消毒。结论目前学生对卫生学课程教学认知度较高,但学生的学习主动性有待提高,高校应结合学生需求,积极地进行教学改革,为社会培养合格的医学人才。     

医学遗传学整合式实验课的课程改革

随着医学遗传学的迅速发展,理论课知识的迅速更新,实验课程无论从内容还是形式上都显示出了明显的滞后性,对医学遗传学进行深入改革势在必行。我们针对八年制学生进行了医学遗传学实验课程改革,开设独立的"医学遗传学实验课",强调课程的整体性和系统性。该课程已经开展五年,本文就课程设计及带教过程中的体会与大家共同探讨,以期为医学遗传学实验课程改革提供一定的思路。     

临床医学专业医学微生物学课程的一种教学新模式

目的分析和探讨临床医学专业医学微生物课程教学新模式。方法目标人群为北京协和医学院6个年级457名学生,通过匿名问卷调查学生对现行医学微生物学课程中以框架为基础的学习模式的主观感受,并记录其在自学展示中的表现情况。通过比较自学时各小组所选主题所占百分比的情况对FBL教学方式的可推广性进行客观分析。收集学生对于与现行课程框架的建议并进行分类和整理。另外,通过测试对3种不同教学/学习方式的效果进行客观比较。在此基础上对医学微生物学课程设计以及其中的教学方法进行深入分析,初步摸索出比较符合协和生源背景和教学条件的教学模式。结果学生匿名问卷评估得分为(2.54±0.74)~(3.43±0.56)分,FBL展示记录情况各项得分为(4.22±0.32)~(4.77±0.22)分。学生分组自学时,干预年级与非干预年级相比,所选的非微生物学主题所占比例有显著性差异(P0.05),2008~2013级学生组织FBL自学时所选非微生物学主题所占比例分别为21.43%、7.14%、38.89%、57.14%、33.33%和38.89%。结论微生物教学中,以框架为基础的学习的教学效果较好,而且在其他医学学科领域具有一定的可推广性。包括传统教学方法、同伴教育以及基于FBL的自学等在内的混合式教学模式可能取得更好的教学效果。     

基于“翻转课堂”的护理专业人体解剖学的探索与实践

目的分析"翻转课堂"应用于护理专业人体解剖学课程必要性,浅析"翻转课堂"背景下护理专业人体解剖学课程的探索和实践。方法 2015级护理学本科专业5班50人为试验班(采用"翻转课堂"教学模式进行教学),6班为对照班50人(采用传统教学模式进行教学),对学生的考试成绩进行统计学分析及问卷调查对教学效果进行评价。结果试验班考试成绩为(57.78±14.41)分,与对照班(48.02±14.24)分比较,差异有统计学意义(P<0.05);试验班问卷调查结果也取得较好的教学效果。结论人体解剖学"翻转课堂"课程教学模式可取得较传统教学法更好的教学效果,学生学习时间、场地更灵活,可以应用于护理学本科及其它专业人体解剖学教学中。     

基于基础医学互动学习与实训中心的混合式教学在正常人体形态学教学中的应用

目的探讨基于基础医学互动学习与实训中心的混合式教学在护理专业正常人体形态学教学中的应用效果。方法选取2017级高职护理专业3、4班作为研究对象,研究组(3班,64人)采用混合式教学,对照组(4班,62人)采用传统教学模式,课程结束后对两组学生的总评成绩进行统计学分析(平时测验20%+期末理论成绩50%+实验课成绩30%),并收集调查问卷进行教学效果评价。结果研究组学生总评分数(83.8±4.6)高于对照组(75.3±2.4),差异有统计学意义(P0.05);研究组学生实验课成绩分数(88.7±3.0)显著高于对照组(77.0±2.8)(P0.01);问卷调查显示研究组学生对教学方法的认同程度(92.7%)高于对照组(82.5%)(P0.05)。结论将基于基础医学互动学习与实训中心的混合式教学模式应用于护理专业正常人体形态学教学中可显著提高教学效果,并能获得学生较为广泛的认可,有利于培养学生自主学习能力和团队合作能力,提升人才培养质量。     

如何给医学生开设医学统计学课程的初探

目的调查各专业医学生对于医学统计学的看法与建议,以及医学生们自己的职业规划与对医学统计学教学的需求,为教学改革提供依据。方法本研究采用自编问卷,以纸质问卷形式发放给研究对象进行调查。此次调查问卷共分为3个部分——基本信息调查、对医学统计学的认知调查以及自身学习情况与未来职业规划调查。结果大部分学生(477人,82%)对学校设置的医学统计学相关课程感到满意,且绝大部分同学认为医学统计学是一门重要的学科,但是认为自己的应用能力普遍偏弱。结论应注重统计学思维的培养、建立适合不同需求的有针对性的课程体系、推行多样化、有效的教学方法。     

微课联合CBL在护理本科药物治疗学教学中的应用及评价

目的 探讨微课联合基于案例学习(CBL)在护理本科生药物治疗学教学中的应用效果。方法 选取北京协和医学院护理学院2021级护理本科2个班学生为研究对象，分别采用微课联合CBL教学法(实验组)和传统课堂讲授式学习(LBL)法(对照组)进行教学；采集学生随堂测验及期末考试成绩，并发放问卷调查，通过分析成绩和问卷调查进行教学效果和学习体验的评价。结果 随堂测验实验组成绩为(77.52±17.68)分，对照组为(66.34±21.35)分；期末考试实验组成绩为(64.34±26.17)分，对照组为(52.33±25.55)分。实验组两次测验的成绩均明显高于对照组，差异有统计学意义(P<0.01)。问卷调查的结果显示，实验组在理论理解、知识记忆、用药实践能力、学习兴趣、课堂专注力、互动意愿方面都较对照组有所提高。结论 微课联合CBL教学法可提高护理本科生药物治疗学的学习效果，优化学习体验，值得作为一种切实可行的教学方法继续完善和推广。     

翻转课堂结合案例式教学模式在局部解剖学中的应用

目的分析翻转课堂结合案例教学模式在局部解剖学教学中的应用效果。方法随机选择潍坊医学院2016级临床医学专业4个班级为研究对象,两个班为实验班,另外两个班为对照班。实验班采取“翻转课堂+案例式教学”的模式,对照班全程采取传统授课方式。教学结束后通过考试及调查问卷等方法,评价两种教学模式的教学效果。结果实验班学生理论考试主观题得分、总成绩、期中测验成绩、平时成绩及最终学习成绩均高于对照班(P<0.05)。问卷调查结果显示:实验班学生在激发学习积极性、培养自主学习和临床思维能力、提高分析和解决问题能力等方面高于对照班(P<0.05)。结论在局部解剖学教学中采用翻转课堂结合案例教学模式,可以提高教学效果,对于局部解剖学教学改革具有较大启发。     

基于项目的探究性学习模式在医用物理中的教学效果评价

目的：评价基于项目的探究性学习模式在医用物理中的教学效果,为今后更好地进行教育教学改革提供可靠依据。方法：将本院2010级医学影像专业和预防医学专业两个本科教学班分别作为实验班和对照班。实验班部分授课内容采用基于项目的探究性学习模式教学,对照班的全部内容都采用传统教学模式授课。利用期末考试成绩和问卷调查两种方式对本次教学效果进行了评价。结果：实验班与对照班学生基础知识部分成绩比较无显著性差异（P〉0.05）,但实验班同学总成绩及综合应用分数都高于对照班,两教学班学习成绩具有极其显著性差异（P〈0.01）;基于项目的探究性学习模式不仅激发了同学们的学习兴趣,还培养了同学的的大部分能力,例如PPT课件制作技能、信息技术能力、自主探究能力、与他人协作能力、拓宽了专业知识面、创新能力、实践能力、人际交往能力、综合运用能力等。结论：基于项目的探究性学习模式对学生医用物理教学的学习有着显著的积极影响。     

General pathology teaching at the University of Washington

I have provided a brief overview of our experience teaching undergraduate general pathology at the University of Washington School of Medicine. Our course is part of a pathology curriculum that is somewhat unusual in light of the amount of time we devote to general, as opposed to organ system pathology. We think this makes sense in relation to the way medical teaching and practice are changing. Resources and curriculum time needed to teach an extensive, morphology-based organ system pathology curriculum are no longer available. In addition, experimental biology and medicine are beginning to improve the way human diseases are diagnosed and treated. Many of these advances are the result of new information on disease aetiology and pathogenesis. Students and practitioners of medicine need an understanding of disease processes that will allow them to rapidly assimilate and rationally apply this new information. The particular strengths of our course, as we view them, are an opportunity to discuss the small number of processes that underlie most human disease in some depth, and thus to emphasize general pathology as a conceptual and practical foundation for the practice of medicine; our laboratory sessions, which in a sense illustrate and summarize the course; and early placement of the course in the curriculum, which allows us to capitalize on concurrent basic science courses and a high level of interest among students in applying basic science knowledge to understanding human disease. Problems we face include the need for more 'active' learning exercises in the lecture and laboratory format we are bound to; the need, given the scope of general pathology, to present more 'take home messages' and fewer systematic reviews of evidence than we would like; the limited clinical knowledge of first year students, which restricts the scope of our laboratory and disease example presentations; and an inability to consistently challenge the abilities of the best students in each class. Organizing and teaching the course described above has been in large part satisfying and stimulating. I hope this overview has provided useful ideas for others teaching or contemplating courses in general pathology.     

在线开放课程在《医学免疫学》教学中的应用与思考

在线开放课程是一种信息技术与教学资源融合的新型教学模式,在促进教学改革方面具有重要作用。医学 免疫学是医学院校临床及相关专业的主干课程之一,具有理论抽象、内容繁杂、知识点多的特点。因此,充分利用网络平台, 提供学生和相关人员能够随时在线学习的便利性对于该课程的学习及普及具有重要意义。新乡医学院的《医学免疫学》课程 是首个在中国大学MOOC 上线运行的免疫学在线开放课程,开课第一学期,选课总人数1 734 人。本文以我校在线开放课程 《医学免疫学》课程为例,从课程规划、内容设计、微课制作、推广使用及效果评价等多方面详细阐述了在线开放课程的建设情 况,并对在线开放课程的建设及运行存在的问题进行了探讨。     

Anatomy teaching: students’ perceptions

The goal of this study was to analyse students’ perceptions of anatomy teaching. A questionnaire was distributed to two classes of first year dental students taught anatomy in both problem-based learning (PBL) and traditional formats. The questionnaire explored the students’ most preferred techniques for learning anatomy, their examination preferences and their perceived level of mastery of anatomy. Fifty-seven (95%) students completed the survey. The most commonly used study aids were atlases, dissection and lecture notes (in descending order). Students expressed the desire for the final examination to include both written and oral components. Six months after the final examination, the students reported their perceived level of mastery of anatomy as either “very good” or “OK”. Even in the PBL curriculum 39% of both classes felt it is necessary to have quizzes during the course to motivate and guide them in studying anatomy.     

Basic and immediate paediatric cardiopulmonary resuscitation training in medical students

BackgroundTo analyse the effectiveness of Paediatric Basic Life Support (PBLS) and Paediatric Immediate Life Support (PILS) courses to train medical students in paediatric cardiopulmonary resuscitation (CPR).MethodsEighteen courses (13 in PBLS and 5 in PILS) were delivered to 1214 medical students. Two theory tests and one practical test were performed. Students filled in an anonymous questionnaire after each course.ResultsThe mean scores (out of 20) in the theory tests of the PBLS course were 11.4 before the course, and 19.2 upon completion (P < 0.0001). Infant BLS skills were achieved by 98.4% of students, and children BLS skills by 97% of them. The mean scores (out of 30) in the PILS courses were 17.3 before the course, and 29.1 at the end of the course (P < 0.0001). PBLS skills were achieved by 99% of students and PILS skills by 98.3% of them. The scores (out of 5) in the anonymous questionnaire were: theory classes, 4.5; teaching methods, 4.5; practice sessions, 4.7; instructor teaching skills, 4.8; and coordination of theory and practice and between instructors, 4.7. There were no significant differences between basic and intermediate CPR courses.ConclusionsPBLS and PILS courses are useful methods for delivering theory and practice training to medical students, and should be mandatory in the paediatric curriculum of medical studies.     

基于蓝墨云班课的高职《急危重症护理》教学改革研究

目的 探讨高职《急危重症护理》课程使用蓝墨云班课进行教学改革的效果。方法 以我校护理专业2016级学生为对照组、2017级学生为实验组。基于蓝墨云班课对《急危重症护理》课程在课前预习、课堂测验、小组讨论、实训教学环节进行教学改革,通过问卷调查和访谈探究评价教学情况。结果 实验组在教学方法模块中“教学方法灵活多样,教学方法与教学内容间衔接得当”及“充分利用信息化教学手段”条目得分高于对照组,差异有统计学意义（P＜0.05）;实验组在教学过程模块中“对学生提出的问题进行辅导,及时解惑,学生收获较大”得分高于对照组,差异有统计学意义（P＜0.05）;实验组课堂氛围模块中“课堂形象生动,吸引学生兴趣课堂形象生动,吸引学生兴趣”得分高于对照组,差异有统计学意义（P＜0.05）;实验组在教学效果模块中的所有条目得分均高于对照组,差异有统计学意义（P＜0.05）;访谈结果显示学生对蓝墨云班课应用于课程教学很感兴趣,且此方法能提升学生学习兴趣,促进师生课后实时互动等。结论 基于蓝墨云班课的高职《急危重症护理》教学改革研究有利于提升教学质量、提高教学效果,更受到学生的广泛认同。     

A randomized trial of a problem-based learning approach for teaching epidemiology.

PURPOSE: To conduct a controlled trial of traditional and problem-based learning (PBL) methods of teaching epidemiology. METHOD: All second-year medical students (n = 136) at The University of Western Australia Medical School were offered the chance to participate in a randomized controlled trial of teaching methods for an epidemiology course. Students who consented to participate (n = 80) were randomly assigned to either a PBL or a traditional course. Students who did not consent or did not return the consent form (n = 56) were assigned to the traditional course. Students in both streams took identical quizzes and exams. These scores, a collection of semi-quantitative feedback from all students, and a qualitative analysis of interviews with a convenience sample of six students from each stream were compared. RESULTS: There was no significant difference in performances on quizzes or exams between PBL and traditional students. Students using PBL reported a stronger grasp of epidemiologic principles, enjoyed working with a group, and, at the end of the course, were more enthusiastic about epidemiology and its professional relevance to them than were students in the traditional course. PBL students worked more steadily during the semester but spent only marginally more time on the epidemiology course overall. Interviews corroborated these findings. Non-consenting students were older (p < 0.02) and more likely to come from non-English-speaking backgrounds (p < 0.005). CONCLUSIONS: PBL provides an academically equivalent but personally far richer learning experience. The adoption of PBL approaches to medical education makes it important to study whether PBL presents particular challenges for students whose first language is not the language of instruction.     

The relationships between learning outcomes and methods of teaching anatomy as perceived by medical students

The best method to teach anatomy continues to be widely debated. Many UK medical schools have recently changed their course structure with the use of cadaveric dissection declining. A recent study by Patel and Moxham ([ 2008] Clin. Anat. 21:182-189) found that professional anatomists viewed dissection to be the most suitable method to fulfil anatomical learning outcomes. The opinion of 580 second year medical students across two UK medical schools was surveyed. A methodology similar to that employed by Patel and Moxham ([ 2008] Clin. Anat. 21:182-189) aimed to explore which teaching methods students considered best to fulfil a prescribed set of anatomical learning outcomes. A total of 302 responses were returned (52%). Difference in students' opinion with regard to the teaching methods was statistically significant (P < 0.0001). A statistically significant agreement was found between the opinions of students from Imperial and Nottingham, and between the anatomists and the students, regarding the effectiveness of all teaching methods at meeting learning outcomes. Dissection was overall most "fit for purpose" in meeting learning outcomes, but no single teaching modality met all aspects of the curriculum. Dissection should remain a leading teaching modality in modern medical school anatomy courses. In addition to its role in the teaching of anatomy, it enables learning in a social context and holds broader learning opportunities to help future doctors best fulfill Good Medical Practice guidelines (General Medical Council, 2006). This, however, should be in the context of a multi-modal approach to the teaching of anatomy.     

A multi-institutional randomized controlled trial of adjuvant Web-based teaching to medical students.

PURPOSE: To investigate the impact of an adjuvant Web-based teaching program on medical students' learning during clinical rotations. METHOD: From April 2003 to May 2004, 351 students completing clinical rotations in surgery-urology at four U.S. medical schools were invited to volunteer for the study. Web-based teaching cases were developed covering four core urologic topics. Students were block randomized to receive Web-based teaching on two of the four topics. Before and after a designated duration at each institution (ranging one to three weeks), students completed a validated 28-item Web-based test (Cronbach's alpha = .76) covering all four topics. The test was also administered to a subset of students at one school at the conclusion of their third-year to measure long-term learning. RESULTS: Eighty-one percent of all eligible students (286/351) volunteered to participate in the study, 73% of whom (210/286) completed the Web-based program. Compared to controls, Web-based teaching significantly increased test scores in the four topics at each medical school (p < .001, mixed analysis of variance), corresponding to a Cohen's d effect size of 1.52 (95% confidence interval [CI], 1.23-1.80). Learning efficiency was increased three-fold by Web-based teaching (Cohen's d effect size 1.16; 95% CI 1.13-1.19). Students who were tested a median of 4.8 months later demonstrated significantly higher scores for Web-based teaching compared to non-Web-based teaching (p = .007, paired t-test). Limited learning was noted in the absence of Web-based teaching. CONCLUSIONS: This randomized controlled trial provides Class I evidence that Web-based teaching as an adjunct to clinical experiences can significantly and durably improve medical students' learning.