翻转课堂结合基于案例的协作学习在新型临床医学八年制教学中的应用

  目的  评估翻转课堂结合基于案例的协作学习(case-based collaborative learning, CBCL)模式在新型临床医学八年制(“4+4”试点班)学生教学中的实施效果。  方法  选取北京协和医学院2019、2020级“4+4”试点班全体学生为研究对象。将翻转课堂结合CBCL的小组教学模式应用于内科消化病学(炎性肠病)授课中。基于课堂上CBCL小组讨论前后的知识测验结果评估学生对相关知识的掌握程度，并采用Likert量表对教学效果进行量化反馈。  结果  共纳入45名“4+4”试点班医学生，其中2019级20人、2020级25人; 课前完成知识测验42人，课后完成知识测验45人。经翻转课堂结合CBCL的小组教学后，学生对炎性肠病发病年龄，溃疡性结肠炎内镜下严重程度、病变范围、鉴别诊断、治疗原则以及克罗恩病临床表现、治疗原则相关题目的回答正确率均有显著提高(P均＜0.001);13道知识测验题回答正确率显著提高33.3(26.2, 85.7)%比93.3(71.1, 95.6)%, P=0.001]。30名(66.7%，30/45)医学生完成教学效果反馈，其对翻转课堂教学形式的认可度评分为(4.00±0.74)分。  结论  翻转课堂结合CBCL小组教学模式可明显提高新型临床医学八年制学生的教学效果，学生反馈对该教学模式整体较满意。

Application of Flipped Classroom Combined with Case-based Collaborative Learning in Medical Teaching in the Experimental Eight-year Medical Doctor Program

  Objective  To evaluate the effect of flipped classrooms combined with case-based collaborative learning (CBCL) in teaching internal medicine in the experimental eight-year medical doctor programnew academic "4+4" pilot class(NAPC)].  Methods  Medical students from the class 2019 and class 2020 of NAPC in Peking Union Medical College were selected as the objects. A teaching method of flipped classroom combined with CBCL was applied in the course of internal medicine (inflammatory bowel disease). Through the knowledge test before and after class discussion, the students' mastery of relevant knowledge was evaluated, and the Likert scale was used to give quantitative feedback on the teaching effect.  Results  A total of 45 medical students from NAPC were enrolled, including 20 students from class 2019 and 25 students from class 2020.A total of 42 students completed the knowledge test before class and 45 students completed the knowledge test after class.After the flipped classroom combined with CBCL, the students' correct answer rate had significantly increased on questions about the age of inflammatory bowel disease onset, severity of ulcerative colitis endoscopy, lesion range, differential diagnosis, treatment principles, clinical manifestations of Crohn's disease, and treatment principles(all P < 0.001); the median correct answer rate of all questions significantly increased 33.3(26.2, 85.7)% vs. 93.3(71.1, 95.6)%, P=0.001]. Thirty students(66.7%, 30/45)completed the post-class feedback; the overall satisfaction score of the teaching mode of flipped classroom was (4.00±0.74) points.  Conclusions  The teaching mode of flipped classroom combined with CBCL can significantly improve learning outcome in medical students of the experimental eight-year program. Students are generally satisfied with the teaching mode.