序贯式三明治案例教学法提高临床医学八年制见习生交流自信心:以乳腺癌综合治疗教学培训为例

  目的  经微格教学后, 将三明治教学法与案例教学法(case-based learning, CBL)相组合序贯用于临床医学八年制见习生, 评估其在学生交流自信心提升中的作用。  方法  以2013年就读于北京协和医学院临床医学八年制且进入外科见习的全部医学生为研究对象。分别在微格教学前、微格教学后、三明治+CBL教学后进行匿名书面问卷调查, 评估见习生在4种预设场景中的交流自信心, 并收集其对该教学模式的反馈。  结果  共纳入28名临床医学八年制见习生。与微格教学前比较, 见习生经微格教学、三明治+CBL教学后在4种预设场景中的交流自信心评分均升高, 其中以国际会议场景下交流自信心评分增加较为显著(P=0.009)。三明治+CBL教学后, 92.9%(26/28)的见习生认为该教学法对提高自信心有帮助; 认为多元化教学方式占教学总学时的最优比应为20%(14人选择), 其次为10%(7人选择)、40%(7人选择)。  结论  经微格教学后, 序贯式三明治+CBL教学法可提高临床医学八年制见习生的沟通交流自信心。

Case-based Sandwich Teaching Improves Communication Confidence of Eight-year Undergraduates: Treatment of Breast Cancer

  Objective  After micro-teaching, sandwich teaching method and case-based learning (CBL) method were successively applied to training eight-year clinical medical students and evaluating the effects of sandwich +CBL teaching in improving communication confidence.  Methods  All medical students who studied in the eight-year clinical medicine of Peking Union Medical College and entered the surgery internship were selected as the research objects. Anonymous written questionnaire survey was conducted before and after micro-teaching, and after sandwich +CBL teaching to evaluate the trainees' score of communication confidence in 4 preset scenarios, and their feedback on the teaching mode was collected.  Results  A total of 28 eight-year clinical medical interns were enrolled. After micro-teaching and sandwich +CBL teaching, thestudents' scores of communication confidence increased in the 4 preset scenarios, especially in the international conference scenario (P=0.009). After sandwich +CBL teaching, 26 students (92.8%) felt that the teaching method was helpful to improve their confidence. The optimal time ratio of the diversified teaching method to total teaching was 20% (chosen by 14 students), followed by 10% (chosen by 7 students) and 40% (chosen by 7 students).  Conclusions  Combination of sandwich +CBL teaching and micro-teaching sequentially would improve the confidence of eight-year medical undergraduates in expression and communication during clerkship and be of potential value in surgical teaching.