“三三三制”课堂教学在《全科医学概论》课程中的应用效果研究

背景　如何将《全科医学概论》课程中艰涩难懂的理论知识转变为医学生的内在全科思维和能力，是目前全科医学教育研究中的热点和难点问题。本研究尝试将课堂授课、学生自学、翻转课堂授课方法融为一体，探索提高《全科医学概论》课程教学效果的有效模式。目的　探讨“三三三制”课堂教学在《全科医学概论》课程中的应用效果。方法　于2018年2—7月，以广西医科大学2016级临床医学（国家农村订单定向免费医学生）专业本科生为研究对象，以本科46班学生为研究组（n=50），以本科47班学生为对照组（n=50）。教材采用《全科医学概论》（第4版），理论授课时间为48学时，对照组学生采用传统授课模式（均为课堂授课），研究组采用“三三三制”授课模式（包括课堂授课、学生自学、翻转课堂3个环节）。比较两组学生对教学的效果评价、期末考试成绩。结果　研究组学生对总体教学效果评价，以及对教学在激发学习兴趣、培养自学能力、促进同学间交流、增强师生间互动、培养团队合作能力、培养解决问题能力、培养表达能力方面的效果评价优于对照组（P<0.05）；两组学生对教学在培养批判性思维、培养创新能力方面的效果评价比较，差异无统计学意义（P>0.05）。研究组学生的期末考试成绩高于对照组（P<0.05）。结论　“三三三制”授课模式可以有效提高《全科医学概论》课程的教学效果，激发学生学习全科医学、了解基层卫生的兴趣，并促进多项素质能力培养，是《全科医学概论》课程有效的教学模式。

Effectiveness of Three-point System Model in Teaching Introduction to General Practice

Background　One focus and difficult problem in general practice education research is how to make students effectively learn and assimilate the difficult theoretical knowledge in Introduction to General Practice，and use it to improve their general practice ideas and clinical performance capabilities.This study attempted to explore a model to improve the teaching effectiveness of Introduction to General Practice by integrating class teaching，self-learning and flipped classroom.Objective　To investigate effect of three-point system model in teaching Introduction to General Practice.Methods　This study was carried out from February to July 2018.Participants were 100 undergraduate students（who enjoy five-year free education in clinical medicine and will work for rural health centers in central and western China upon graduation），including 50 from Class 46（study group） and 50 from Class 47（control group）.For teaching Introduction to General Practice（Fourth Edition） within 48 class hours，traditional teaching model（lecture style） was used for the control group，while three-point system model（consisting of class teaching，self-learning and situational performance） was used for the study group.Subjective-evaluated teaching effectiveness and final examination scores were compared between the two groups.Results　Compared with the control group，study group gave higher mean total score for the overall teaching effectiveness，and gave higher mean scores for teaching effectiveness on sparking the interest in learning，cultivating self-study ability，promoting communications between classmates，enhancing teacher-student interactions，cultivating team cooperation ability，problem-solving ability and expressive language ability（P<0.05）.But in terms of teaching effectiveness on cultivating critical thinking and creative ability，both groups gave similar mean scores（P>0.05）.The study group achieved higher mean final examination scores than did the control group（P<0.05）.Conclusion　The three-point system teaching model is effective in teaching Introduction to General Practice，which can improve the teaching effectiveness，spark the interest in learning general practice and primary care，and promote the cultivation of multiple qualities required by medical education for students.