改良TBL结合模拟教学在医学生早期临床思维教学中的应用

目的 探讨改良以团队为基础的教学(team-based learning，TBL)结合模拟教学的方法对低年级医学生早期临床思维能力培养的效果。方法 采用对照试验的方法，选择2020年秋季学期40名选课医学生为试验组，采用改良TBL结合模拟教学的方法，以2017年秋季和2018年秋季两学期选课的各40名医学生分别为对照组1和对照组2，分别已实施传统理论授课教学(lecture-based learning，LBL)和LBL结合案例为基础的教学(case-based learning，CBL)，比较三组学生的急诊临床思维模拟演练成绩和问卷调查结果，根据数据类型不同分别使用单因素方差分析和χ²检验分析比较各组的教学效果。结果 试验组在初步诊断正确性方面与对照组2无显著差别，但在急诊处理决策能力、团队合作能力和模拟演练总成绩方面均高于对照组1和对照组2(P < 0.05)。问卷调查结果显示，在赞同“增强团队合作意识”和“增强沟通能力”两个方面，试验组的正面评价均高于对照组1和对照组2，其差异有统计学意义(P < 0.05)。试验组和对照组2在赞同“喜欢该教学方...

Application of Modified TBL Combined with Simulation Teaching Method in Early Clinical Thinking Teaching for Medical Students

Objective To investigate the effect of modified team-based learning combined with simulation teaching method for developing early clinical thinking of junior medical students.Methods Controlled trial was used.Totally of 40 elective medical students in the autumn semester of 2020 were selected as the experimental group,Who received modified TBL combined with simulation teaching method.Both 40 medical students enrolled in the autumn semesters of 2017 and 2018 were selected as control group 1 and control group 2 respectively,who had implemented lecture-based learning and LBL combined with case based learning respectively.Results of emergency clinical thinking simulation exercise and questionnaire survey were compared among the three groups.One-way analysis of variance test and Chi-square test were used to analyze and compare the teaching effect of three groups according to different data types.Results There are no statistical differences between experimental group and control group 2 in the accuracy of initial diagnosis,but the experimental group was higher than the control group 1 and the control group 2 in the clinical decision-making ability of emergency management,teamwork ability and the total score of simulation exercise(P<0.05).The results of the questionnaire survey showed that the positive evaluation of the experimental group was higher than that of the control group 1 and 2 in the two aspects of“enhancing the sense of teamwork”and“enhancing the communication ability”,and the difference was statistically significant(P<0.05).Both experimental group and control group 2 were better than control group 1 in agreeing with“liking this teaching method”and“stimulating learning interest”(P<0.05).Conclusion Modified TBL combined with simulation teaching method can improve the clinical decision-making ability,teamwork ability and communication ability of the junior medical students who have received the clinical theory by LBL,which is suitable for the cultivation of early clinical thinking of medical students and worthy of gradual application and promotion.