线上教学模式在八年制消化科临床医学教学中的应用与实践探索

目的：探索线上教学模式在临床医学八年制消化科床旁教学中的应用。 方法：对72名临床医学八年制学生开展线上消化科床旁教学。我们应用“超星学习通”和“腾讯会议”相结合的网络教学平台进行线上床旁教学。同时，我们联合以案例为基础的学习法（CBL）、以问题为基础的学习法（PBL）教学模式及教师模拟标准化病人（TSP）模拟实训教学法进行教学。利用“问卷星”设计线上调查问卷，以无记名方式请这72名学生完成问卷。 结果：大部分学生适应线上教学，并对线上教学总体表示满意。线上教学在教师授课质量、对临床思维的培养、师生互动方面不差于线下教学；而在临床动手能力培养、代入感方面差于线下教学。学生最喜欢的排前三位的线上教学模式是与TSP互动、案例分析、与老师互动讨论。不能近距离接触患者是线上教学最大的不足。 结论：线上教学的多样性受到了较高的接受度和认可度。线上线下相结合的教学模式是值得探索的新的教学方法。     

全科医学及PBL教学对医学生综合素质的影响

目的探讨全科医学课程、以问题为基础的教学方法（problem based learning,PBL）在医学生教育中的应用与作用.方法以分数及语言统计两种形式评估课程的效果.结果通过对不同层次医学生这门课程的教育表明：①全科医学对医学生的综合素质产生深刻影响,PBL方法也受到学生的欢迎,说明全科医学教育对医学生培养尤为重要,教学亟待以PBL方法改进;②素质评价不可依照简单的分数计量,应以其认知、精神升华评估;③通过文字描述、分数、图表,展示此门课程的设置、PBL方法的应用达到了设置课程的预期目的.结论应呼吁高校重视全科医学的人文教育,培养高素质的医学人才.     

PBL教学法在《内外科护理学》课程中的应用与效果分析

PBL教学模式在我国护理教育中的应用仍处于探索阶段。本文详述了PBL在《内外科护理学》课程中的实施步骤．分析了此种教学方法的教学效果。问卷调查结果显示：PBL有利于学习从“知识中心型”向“能力中心型”转变，有助于顺利实现临床护理课程教学目标，而优质、丰富的教育资源则是有效开展PBL教学的有力保障。     

PBL教学模式在骨科临床实习课中的应用探讨

目的探讨以问题为基础的学习（PBL）教学模式在骨科临床实习课教学中应用的可行性及现实意义。方法以中国医科大学2002级88期315名学生为研究对象，在骨科临床实习课教学中实施PBL教学模式。采用主观问卷调查和综合能力考核方式对教学效果进行初步评价，比较在不同学习阶段开展PBL对教学资源的需求情况，分析PBL教学模式在实习课阶段应用的可行性及现实意义。结果在PBL教学模式下学生能够处于学习主导地位，学习主动性提高；可提高学生发现问题、分析问题和解决问题等方面的能力，有助于培养和提高学生医学临床思维能力；可初步缓解理论课PBL教学所遇到的一些问题和矛盾。结论在骨科临床实习课阶段开展PBL教学具有一定的优越性和现实意义，适合目前的医学教学资源状况。     

以问题为基础的教学模式与医生品质的培养

目的评价以问题为基础(problem-based learning,PBL)的教学模式对医生品质培养的作用。方法将我校2004届七年制的240名学生分为PBL教学组与传统大课教学对照组,每组120名学生。教学结束后对两组学生进行PBL,教学方式的问卷调查,逐题统计分析。结果与传统大课教学相比,PBL教学模式是以学生为主导,对病例提出问题,通过查找资料、寻找证据、小组讨论,进而寻求问题解决的教学模式。其主要特点为重学习过程、重学生多方面能力的培养,而不只是知识技术的讲授,这一崭新的教学模式更加符合全球医学教育最低标准对现代医学教育的要求。结论PBL教学模式对医生品质的培养具有重要作用。     

PBL教学模式在老年科临床学生实习中效果分析

目的探讨以问题为基础的学习（PBL）教学模式在老年科临床教学中的应用,以提高老年科临床教学质量,适应现代社会对医学人才的要求。方法将重庆医科大学2013级5年制学生65人分为实验组和对照组,实验组采用PBL教学模式,以临床病例为基础,进行小组讨论式学习,对照组采用传统教学模式,比较分析两组教学效果差异。结果实验组基础理论知识考试成绩（83.19±6.11）分,对照组基础理论知识考试成绩（82.55±7.22）,两组差异无统计学意义（P＞0.05）;实验组学生病例分析主观题考试成绩（80.55±6.17）分,明显优于对照组的（65.84±4.20）分,两组差异有统计学意义（P〈0.05）。PBL教学组学生对PBL教学评价较高,在医学知识掌握、自主学习、临床实践、团队合作及参与情感等多个方面均有显著效果,95%以上学生持肯定态度。结论 PBL教学方法优于传统教学,有助于医学生临床思维能力培养,且不影响对专业理论知识的掌握。     

提高七年制医学生急诊医学教学质量方法的探讨

急诊医学是七年制医学生的一门重要课程,如何提高教学质量,培养急诊临床思维能力是摆在各医学院校临床教学医院亟待解决的问题。1七年制医学生特点相对于临床医学五年制学生,七年制学生有其自身的特点：（1）七年制医学生生源质量较好,基础知识扎实,英语水平较高。（2）横向联系能力和领悟能力强,思维较为活跃,接受能力快,知识面相对较广。（3）由于距离毕业的时间较长,相对于五年制的学生,就业压力比较小,所受干扰少,学习积极性高。（4）学习强度大、持续时间长,心理状态复杂[1]。2应用多种教学方法提高教学质量2.1合理应用PBL以问题为基础的教学法（P rob lem-B asedL earn ing,PBL）是近年来国际上受到广泛重视的一种教学模式,包括“提出问题—建立假设—收集资料—论证假设—总结”五段式教学过程[1]。七年制的学生学习能力强,思维活跃,而且英语较好,比较适合应用PBL。具体做法是把学生分成若干个小组,老师根据急诊医学教学内容创设急诊常见病例,如急性冠脉综合征、上消化道出血和心脏骤停等病例,根据此病例信息进行讨论,提出假设,然后,根据学生所提出的问题,归纳为若干几个集中的问题,每个学生选择一个问题去查找资料...     

护理教学中PBL模式的发展历程

“以问题为中心”的教学模式（problem—based learning，PBL）是一种新的教学模式，强调以学生的主动学习为主，直指知识的运用和未来职业技能的培养，并充分体现了建构主义的思想。PBL教学模式是以临床病人问题为基础的学习，由8名～10名学生和1名导师组成多个讨论小组，围绕某一具体病例的疾病诊治问题进行讨论。在小组讨论过程中，学生就问题进行思考、推理和分析。     

PBL教学模式在骨科教学中的实践

目的 探索PBL教学模式在骨科教学中的实践与应用。 方法 针对80名南方医科大学南方医院（八年制）在南方医院骨科实习的学生采用PBL教学模式并进行问卷调查。 结果 共回收有效问卷76份,其中72名（94.7%）认为PBL教学模式是非常必要的,71名（93.4%）认为PBL教学模式吸引力强,69名（90.7%）认可其有效性。大多数学生认为PBL教学模式具有多方面的优势,包括培养学习兴趣和主动学习能力、提高临床思维和综合运用能力、提高表达沟通能力和团队合作能力、激发创新性思维等。 结论 PBL教学模式在骨科教学的应用取得良好的效果和显著的优势;但在国内目前的医学教学条件下,具有一定的局限性需要进一步完善。       

临床八年制呼吸系统整合教学的实践与探索

目的:观察以器官系统为中心的医学整合课程(organ-system based curriculum,OSBC)教学在临床医学八年制专业课程教学中的效果,探讨其可行性。方法:以上海交通大学医学院2015级临床医学八年制的150名学生作为教学对象,采用课后考核和问卷调查的方式了解学生对呼吸系统知识的掌握情况和对OSBC教学及教师的满意度反馈。结果:问卷调查结果显示,学生对OSBC教学的综合满意度为97.6%。学生的考核总成绩及格率为100%,理论卷面考核及格率为96%。在学生评价中,学生知识点得分率高的课程的授课教师,在教学仪表、教学内容、教学方法、课堂氛围、教学效果5个方面的评分均显著高于得分率低的教师组;运用双语教学知识点的模块得分率明显高于非双语教学知识点;以问题式学习(problem-based learning, PBL)案例中涉及相关知识点的得分率明显高于未涉及知识点模块;整合课程教学相关知识点掌握度高于传统内科学教学。结论:采用以疾病为中心、以临床诊疗路径为导向的OSBC教学模式,对教学内容、教学团队进行多学科重组和融合,提高了教学效率和学生的考核成绩。该教学模式得到学生的普遍好评。     

PBL教学法在医学生护理技能训练中的应用

[目的]探讨基于问题的学习(PBL)教学法在医学生护理技能教学中的应用效果。[方法]将100名医学硕士生随机分为观察组和对照组各50名,观察组采用PBL教学法,对照组采用传统教学方法,课程结束后采用客观结构化临床考试(OSCE)对两组学生进行成绩评定,通过自行设计的调查问卷调查学生对指导老师教学质量的评价。[结果]观察组学生成绩优于对照组(P<0.05);观察组总分课堂教学质量评估总分、教学方法、教学内容项目得分优于对照组(P<0.05)。[结论]在医学生护理技能训练教学中应用PBL教学法,效果优于传统的教学方法。     

Analysis of Curricular Reform Practices at Chinese Medical Schools

Background: A comprehensive search of the literature published between 2001 and 2010 was performed to gain a greater understanding of curricular reform practices at Chinese medical schools. Summary: There were 10,948 studies published between 2001 and 2010 that were retrieved from the database. Following preliminary screening, 76 publications from 49 different medical schools were selected. Thirty-one publications regarding clinical medicine curricular reforms were analyzed further. Of the 76 studies, 53 described curricular reforms that were instituted in theoretical courses, 22 described curricular reforms that were instituted in experimental courses, and 1 described curricular reforms that were instituted in a clinical skills training course. Of the 31 clinical medicine publications, 2 described reforms that were implemented for 3-year program medical students, 12 described reforms that were implemented for 5-year program medical students, 6 described reforms that were implemented for 7-year program medical students, and 2 described reforms that were implemented for 8-year program medical students. Currently, the majority of medical schools in China use the discipline-based curriculum model. Thirteen studies described transition to an organ-system-based curriculum model, 1 study described transition to a problem-based curriculum model, and 3 studies described transition to a clinical presentation-based curriculum model. In 7 studies educators decided to retain the discipline-based curriculum model while integrating 1 or several new courses to remedy the weaker aspects of the traditional curriculum, in 7 studies educators decided to integrate the preclinical courses with the clinical courses by using the systemic-integrating curricular system that dilutes classical disciplines and integrates material based on organ systems, and in 2 studies educators limited reforms to clinical courses only. Eight studies discussed the implementation of a formative evaluation system, 4 studies discussed faculty training, and 15 studies discussed the application of various instructional methods. Other issues that were also addressed include enhancing research, improving patient–doctor communication, developing interpersonal and teamwork skills, cultivating independent lifelong learning habits, and improving problem-solving capabilities. Conclusions: The medical schools in our study have adopted various comprehensive curricular changes, moving from a knowledge-based to a competency-based model, and from traditional standards to international standards. Many institutions face challenges when implementing curricular reforms, such as what to integrate and how to do so, the unintended omission of important material, ensuring coordination between different organizations and departments, and the training of faculty.     

改良PBL结合微格教学法在基层医院临床护理带教技能培训中的应用

目的采用改良PBL结合微格教学法对临床带教老师进行带教技能培训,探索其教学效果以及在教学过程中具体的实施步骤和方法。方法2017年1月至2018年12月,选取如东县人民医院26个护理单元,经护理部考核合格的科带教老师50人为研究对象,随机分为观察组和对照组。观察组采取改良PBL结合微格教学法实施带教技能的培训,对照组采取传统教学方法进行培训,培训结束后对科带教老师的教学技能、教学培训效果、教学能力进行测评。结果培训结束后,观察组带教老师的教学技能评分明显高于培训前(P<0.05);观察组带教老师的教学培训效果、教学能力评价也明显高于对照组(P<0.05)。结论在基层医院临床护理带教技能培训中,应用改良PBL结合微格教学法能够提高临床带教老师的带教技能,增强教学自信心和教学技巧等,对促进护理带教能力的培养具有积极作用。     

四川大学华西临床医学院PBL教学剪影

四川大学对PBL的研究始于20世纪90年代,学校先后派出教师赴北美医学院校学习PBL,并在组织胚胎学、生物化学、外科学、护理学、检验医学等课程和专业教育中初步使用了这一方法。     

A faculty development program evaluation: from needs assessment to long-term effects, of the teaching skills improvement program

BACKGROUND: We evaluated whether the faculty development program, the Teaching Skills Improvement Program, met medical educators' needs at Hacettepe University Faculty of Medicine, Turkey. In a 1997 needs assessment survey, large proportions of 178 medical educators assessed their knowledge of educational issues and teaching skills as good or excellent. Nonetheless, 86% of the respondents stated they would like to participate in a future training program focused on the content indicated in the survey. DESCRIPTION AND EVALUATION: In 1998, 83 faculty members took part in the program and expressed a high degree of satisfaction with its content and organization, as well as the course trainers' teaching. Most of the participants got high scores on a test of knowledge related to the course content and performed proficiently in a microteaching session. CONCLUSION: Six months to a year later, large proportions of the participants reported using many of the training techniques in their teaching program.     

Teaching cardiopulmonary resuscitation to CEGEP students in Quebec--a pilot project

In order to increase CPR training in Quebec, we designed a pilot study to test out the efficacy of training CEGEP (junior college) students in CPR. We tried out four different methods of teaching CPR on students (Group A 'control', 4 h course, manikin to student ratio 1:4; Group B, 4 h course, manikin to student ratio 1:1; Group C, 2 h course, manikin to student ratio 1:1; Group D, video-assisted CPR instruction, manikin to student ratio 1:1). CPR skills were tested on a computerized manikin at the end of the initial course and again at the end of the semester in order to evaluate short and long-term retention of skills. There were no significant differences between the test groups and the control group in terms of compressions or ventilations at the beginning and end of the semester, however groups C and D performed significantly better primary surveys (Airway, Breathing, Circulation - ABC sequences) during the initial testing. The most common reasons reported by students for not taking CPR courses were the cost of courses (49.2%) and the inconvenience of courses (26.2%), similarly the two most common incentives which could get students to take CPR courses were; free courses (65.6%) and greater accessibility of courses (54.1%). Video-assisted CPR training appears to be feasible, enjoyable and as, if not more effective than traditional CPR courses. Instituting a mandatory video-assisted CPR program in the CEGEP system in Quebec and in high schools and colleges throughout the world, would be a cost-effective way to train massive amounts of young people in CPR.     

Evaluation of general and traditional internal medicine residencies utilizing a medical records audit based on educational objectives

Residency programs in general internal medicine must ensure that skills relevant to the care of both ambulatory and hospitalized patients are taught effectively. The authors evaluated both a general and a traditional internal medicine training program at the same institution. They employed a medical records audit technique based on educational objectives that assessed the approach of residents in each program in dealing with five inpatient and five outpatient problems. Inpatient performance also was assessed by subjective faculty evaluations. Resident physicians in the general program more closely reflected the educational objectives in two of five outpatient audits. There were no differences between the programs for inpatient audits or subjective evaluations. These findings support the argument that the emphasis on teaching ambulatory medicine need not jeopardize inpatient training, and they demonstrate the feasibility of a medical records audit based on educational objectives for program evaluation.     

实习记录单在临床教学中的应用

目的 改进临床教学方法，提高临床教学质量。方法 对121名不同学历层次的护生应用实习记录单规范监控临床教学工作。结果 (1)较好完成教学任务；(2)本科护生、专科护生对实习效果评价高于中专护生；(3)各层次护生对带教老师的理论水平和表达能力评价较低。结论 实习记录单体现了教育层次与培养目标相匹配的理论，有利护生顺利实现职业角色化，也有助于教学过程的全程监控。