基于OBE理念的混合式教学模式在中西医结合胸外科临床教学中的应用

徐朝军; 张胜康; 王兆礼; 朱伟; 逯晶; 宋岚

doi:10.16766/j.cnki.issn.1674-4152.004465

基于OBE理念的混合式教学模式在中西医结合胸外科临床教学中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004465

徐朝军¹,
张胜康¹,
王兆礼¹,
朱伟²,
逯晶²,
宋岚^2, ,

1.
湖南中医药大学第一附属医院胸心大血管外科, 湖南长沙 410007
2.
湖南中医药大学医学院, 湖南长沙 410208

基金项目:

湖南省普通高等学校教学改革研究项目 HNJG-2022-0718

详细信息

通讯作者:
宋岚，E-mail: songlan311492@163.com

中图分类号: R192 R655
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- 被引次数: 0
出版历程
- 收稿日期: 2025-09-13

The application of mixed teaching mode based on OBE concept in clinical teaching of integrated traditional Chinese and western medicine in thoracic surgery

1.
Department of Thoracic and Cardiovascular Surgery, First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China

摘要

摘要: 目的 “创新性中西医结合诊疗服务模式”背景下，传统临床教学很难达成培养卓越中西医结合医生的目标。该研究以“中西医结合胸外科诊疗岗位胜任力”为导向，构建并实施中西医结合胸外科混合式教学模式，以期提升教学效果，助力卓越中西医结合医生培养。方法选取2022年1—12月湖南中医药大学第一附属医院胸外科实习生114名，按随机数字表法分为对照组和实验组，每组57人。实验组采用OBE指导的混合式教学模式，对照组采用传统教学模式。2组均采用理论考核、操作技能考核、Mini-CEX评估模式进行测评，使用问卷调查评价教学效果。结果实习结束时，实验组和对照组学生理论考核成绩分别为(84.6±3.2)分和(73.8±4.0)分(P < 0.05)，操作技能考核成绩分别为(84.2±4.6)分和(76.1±5.4)分(P < 0.05)；2组学生临床接诊、体格检查、临床诊断、人文关怀、沟通技巧、组织效果和整体表现mini-CEX评分实习前差异无统计学意义，实习后评分均高于实习前；实习后实验组各项评分均高于对照组(P < 0.05)；实验组学生带教满意度和教学方法满意度得分高于对照组(P＜0.05)。结论基于OBE理念的混合式教学模式能提升中西医结合胸外科临床教学效果。
- 成果导向教育 /
- 混合式教学 /
- 中西医结合胸外科 /
- 教学改革
Abstract: Objective Under the background of the innovative service model integrating traditional Chinese and Western medicine in diagnosis and treatment, traditional clinical teaching has difficulty achieving the goal of cultivating outstanding physicians in integrated traditional Chinese and Western medicine. Guided by the concept of "competence in the diagnosis and treatment of integrated traditional Chinese and Western medicine in thoracic surgery", this study aimed to construct and implement a blended teaching model for thoracic surgery integrating traditional Chinese and Western medicine, in order to improve teaching effectiveness and facilitate the cultivate of outstanding integrated Chinese and Western medicine physicians. Methods A total of 114 interns from the Department of Thoracic Surgery, First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, from January to December 2022 were selected and randomly divided into a control group and an experimental group, with 57 participants in each group, using a random number table method. The experimental group adopted a blended learning model based on the OBE concept, and theoretical assessment, operational skills assessment, and Mini-CEX evaluation model were used for evaluation. A questionnaire survey was conducted to evaluate the teaching effectivenes. The control group adopted the traditional teaching mode and used the same assessment methods as the experimental group. Results At the end of the internship, the theoretical assessment scores of the experimental group and the control group were 84.6±3.2 and 73.8±4.0, respectively (P < 0.05), and the operational skills assessment scores were 84.2±4.6 and 76.1±5.4, respectively (P < 0.05). Prior to the internship, no significant differences were observed between the groups in mini-CEX scores for clinical reception, physical examination, clinical diagnosis, humanistic care, communication skills, organizational effectiveness, and overall performance. After the internship, the scores were higher than those before the internship; however, the scores of the experimental group were higher than those of the control group (P < 0.05). The results of the questionnaire survey showed that teaching satisfaction and satisfaction with teaching methods in the experimental group were higher than those in the control group (P < 0.05). Conclusion The blended teaching mode in thoracic surgery clinical teaching based on the OBE concept can improve the clinical teaching effectiveness of integrated traditional Chinese and Western medicine in thoracic surgery.
- Outcome-based education /
- Blended teaching mode /
- Thoracic surgery with integrated traditional Chinese and Western medicine /
- Teaching evaluation
利益冲突 无

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图 1 中西医结合胸外科临床实习带教混合式教学方案

Figure 1. Blended teaching scheme for clinical internship in integrated traditional Chinese and Western medicine thoracic surgery

下载: 全尺寸图片幻灯片

图 2 基于OBE的胸外科临床实习带教教学流程图

Figure 2. Teaching flowchart for clinical internship in thoracic surgery based on OBE

下载: 全尺寸图片幻灯片

表 1 2组学生实习前后综合考核成绩比较(x ±s，分)

Table 1. Comparison of comprehensive assessment scores before and after internship between two groups of students (x ±s, points)

组别	人数	理论考试成绩		实践考试成绩
组别	人数	实习前	实习后	实习前	实习后
对照组	57	71.5±2.6	73.8±4.0^b	71.9±3.8	76.1±5.4^b
实验组	57	72.2±4.4	84.6±3.2^b	71.8±3.9	84.2±4.6^b
统计量		1.000^a	243.440^c	0.122^a	74.582^c
P值		0.318	< 0.001	0.904	< 0.001
注：^a为t值，^c为F值; 与同组实习前比较，^bP < 0.05。

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表 2 2组学生实习前后Mini-CEX评分比较(x ±s，分)

Table 2. Comparison of Mini-CEX scores before and after internship between two groups of students (x ±s, points)

组别	人数	临床接诊		体格检查		临床诊断		人文关怀
组别	人数	实习前	实习后	实习前	实习后	实习前	实习后	实习前	实习后
对照组	57	4.25±0.66	6.41±0.82^b	4.51±0.83	6.36±0.95^b	3.74±0.91	5.97±0.74^b	4.62±1.24	6.47±0.69^b
实验组	57	4.29±0.74^d	7.39±0.86^b	4.59±1.26^d	7.81±0.99^b	3.85±1.21^d	7.13±1.11^b	4.57±1.17^d	7.05±0.71^b
统计量		0.305^a	38.050^c	0.399^a	74.736^c	0.549^a	43.208^c	0.221^a	19.856^c
P值		0.761	< 0.001	0.690	< 0.001	0.585	< 0.001	0.825	< 0.001

组别			人数	沟通技巧		组织效果		整体表现
组别			人数	实习前	实习后	实习前	实习后	实习前	实习后
对照组			57	5.08±0.78	6.71±0.81^b	4.71±0.95	6.15±0.82^b	4.05±1.14	6.03±0.72^b
实验组			57	5.10±0.73^d	7.37±0.95^b	4.76±0.94^d	6.84±0.73^b	4.02±1.26^d	6.92±0.94^b
统计量				0.141^a	15.379^c	0.283^a	22.216^c	0.133^a	32.334^c
P值				0.888	< 0.001	0.778	< 0.001	0.894	< 0.001
注：^a为t值，^c为F值; 与同组实习前比较，^bP < 0.05。

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表 3 2组学生带教满意度和教学质量评价比较(x ±s)

Table 3. Comparison of teaching satisfaction and teaching quality evaluation between two groups of students (x ±s)

项目	对照组(n=57)	实验组(n=57)	t值	P值
课程安排合理度	4.31±0.36	4.40±0.33	1.383	0.160
提高团队合作能力	3.86±0.63	4.30±0.60	3.855	< 0.001
提高医患沟通能力	3.83±0.65	4.18±0.53	3.066	0.003
增进知识点理解记忆	3.78±0.64	4.17±0.53	3.598	0.001
提高操作技能	3.83±0.52	4.20±0.53	3.833	< 0.001
提高临床诊治能力	3.80±0.53	4.14±0.57	3.221	0.001
提高逻辑思维能力	3.85±0.54	4.26±0.57	3.936	< 0.001
提高解决问题能力	3.75±0.50	4.03±0.59	2.727	0.007
提高自学能力	3.67±0.47	3.98±0.55	3.138	0.002
教学满意度	4.05±0.46	4.28±0.39	2.980	0.004

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