PBL教学模式对医学教育环境影响的Meta分析

目的 评价PBL对医学教育环境的改善效果.方法 广泛检索1969年1月—2018年12月间发表的与PBL和医学教育环境相关的研究.最后入选9项PBL与传统教学法比较的随机对照研究.采用Cochrane偏倚风险评估工具对入选研究的质量进行评价.采用Review Manager(RevMan)5.3版软件进行数据统计分析.对医学教育环境影响的效应量用加权均数差(MD)和95%可信区间(CIs)表示.异质性评价采用Cochrane'sχ2检验和I2值.发表偏倚的评价应用漏斗图法.结果 由于教学研究的特点,对参与者施盲方面9项研究均为高风险,5项研究的测量偏倚存在高风险.其余方面的偏倚均为低风险.PBL对医学教育环境指标(DREEM评分)的影响优于传统教学法,差异具有统计学意义.结论 本研究表明PBL对医学教育环境的影响优于传统教学模式.

A Meta-analysis of The Effect of Problem-based Learning on the Medical Educational Environment

Objective To evaluate the effect of problem-based learning on the medical educational environment.Methods Widely searched all articles published from January 1969 to December 2018 that relating to PBL and medical educational environment.Cochrane risk of bias tool was used to assess the quality of the included studies,and Review Manager(RevMan)version 5.3 for data analysis.The effective size was calculated as mean difference and 95%confidence interval.Cochrane’sχ2 test and I2 was used to assess the Heterogeneity and funnel plot to assess the publication bias.Results All of the 9 included studies were at high risk of performance bias since it was hard to perform blinding on the students and teachers during the teaching process.5 studies of them were at relative high risk on the detection bias since they didn’t declare whether blinding is used while outcomes were assessed.All of the other domains of bias were at low risk.The pooled effect size showed that,compared with lecture-based learning,PBL was better on improving the medical educational environment(using the DREEM scale),the differences were statistically significant.Conclusion This study showed that PBL had a better effect on the improvement of medical educational environment as calculated by DREEM.