摘要
目的运用系统评价的方法,评价以问题为基础教学法联合以病例为基础教学法在国内神经内科医学生临床带教中的应用效果。方法通过计算机检索中国知网、万方、维普和中国生物医学文献服务系统自建库至2019年4月,国内期刊发表的PBL+CBL联合法对比常规授课为主的教学模式在神经内科医学生临床带教中应用效果的研究。采用Cochrane协作网RevMan 5.3软件进行分析,进行文献质量方法学评价,基于纳入研究的异质性特点选择随机效应模型,从理论学习、临床操作、临床思维、总成绩和教学满意度的比较及学生主观能力变化进行系统评价和荟萃分析,并以森林图形式展示合并后的相对危险度或标准化均数差。结果共纳入12项研究,总计970例研究对象,包括PBL+CBL联合教学组484例和传统教学组486例。荟萃分析发现,相对于传统教学,采用PBL+CBL联合教学能提高国内神经内科医学生理论学习(SMD=1.34,95%CI[0.89,1.79],Z=5.85,P<0.01)、临床操作(SMD=1.50,95%CI[0.72,2.28],Z=3.76,P<0.01)、临床思维(SMD=2.08,95%CI[1.24,2.93],Z=4.83,P<0.01)的成绩及总成绩(SMD=1.80,95%CI[0.97,2.64],Z=4.24,P<0.01),提高教学满意度(RR=1.22,95%CI[1.11,1.35],Z=3.95,P<0.01;SMD=6.51,95%CI[5.80,7.21],Z=18.01,P<0.01)。结论在国内的神经内科临床带教中,运用PBL+CBL联合教学相对传统教学方法,对不同类别的神经内科轮转学生均能提升对理论知识的理解掌握,锻炼临床思维和神经科定性定位诊断能力,提高临床实践能力,避免学生畏难情绪的产生,提升教学满意度,更好地实现教学目标。
Objective To evaluate the effectiveness of problem-based teaching combined with case-based teaching in clinical teaching of neurology medical students in China by the systematic review and meta-analysis.Methods By searching the database of CNKI,WANFANG,VIP and SinoMed until April 2019,the combined PBL combined with CBL method published in domestic journals was compared with the effectiveness of traditional teaching mode in clinical teaching of neuro-medical students.The literature quality methodological evaluation and meta-analysis were conducted using Revman 5.3 software.Based on the heterogeneity of the included study,a random effect model was selected to systematically evaluate and meta-analyze the changes of students’subjective ability and the comparison of theoretical learning,clinical operation,clinical thinking,total achievement and teaching satisfaction,and to show the relative risk or standardized mean difference of the combined model in forest graphics.Results A total of 970 subjects were included in 12 studies,including 484 in the PBL combined with CBL combined teaching group and 486 in the traditional teaching group.Meta-analysis found that compared with traditional teaching,PBL combined with CBL combined teaching could improve the theory(SMD=1.34,95%CI[0.89,1.79],Z=5.85,P<0.01),clinical thinking(SMD=3.34,95%CI[3.73,3.96],Z=4.83,P<0.01)and overall test score(SMD=5.41,95%CI[4.02,6.81],Z=4.23,P<0.01),and improve teaching satisfaction(RR=5.41,95%CI[1.02,1.35],Z=3.95,P<0.01;SMD=6.51,95%CI[5.80,7.21],Z=18.01,P<0.01),clinical operation(SMD=1.86,95%CI[0.72,2.28],Z=3.78,P<0.01).Conclusions In the clinical teaching of neurology in China,PBL combined with CBL combined teaching could promote students’understanding and mastery of theoretical knowledge,exercise their clinical thinking and ability of qualitative diagnosis of neurology,improve their clinical practice ability,avoid students’fear of difficulties,improve teaching satisfaction and better achieve teaching objectives.
作者
董兴鲁
唐璐
马斌
崔方圆
白晶
李新龙
高颖
周莉
Dong Xinglu;Tang Lu;Ma Bin;Cui Fangyuan;Bai Jing;Li Xinlong;Gao Ying;Zhou Li(不详;Dongzhimen Hospital Afiliated to Beijing University of Chinese Medicine,Beijing 100070,China)
出处
《中国病案》
2020年第1期78-83,共6页
Chinese Medical Record
基金
北京市国家中医重点专科辐射工程首都核心专科-脑病科(1+X+N).
作者简介
通信作者:周莉
