Supervision of online theory courses of clinical medicine in the context of the COVID-19 epidemic
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摘要:
目的 探讨在新型冠状病毒疫情背景下临床医学线上理论课程新型督导方案，为提高临床医学线上授课质量提供保障。 方法 2020年3—5月，以广东医科大学第一临床医学院19门线上理论课程(其中18门专业临床课程，1门选修课程)为研究对象，通过调查研究，前瞻性分析线上理论课程的特点；回顾性分析传统教学督导模式契合度和适用性；针对当前线上教学督导的目标和要求，调查分析传统教学督导模式与线上教学督导模式的衔接策略，应用形成性评价方法，尝试建立和完善新型线上教学督导模式的架构；通过调查问卷评价新型教学督导模式下的教学效果在学生中的认可度。 结果 临床医学线上理论课程模式因采用“三段式”教学而出现众多新变化、新差异；传统教学督导模式固化，已不能匹配和对接新型冠状病毒疫情背景下线上理论教学的模式；初步构建了广东医科大学第一临床医学院临床医学相关线上理论课程的新型教学督导架构与流程，基本解决当前教学督导面临的基础性问题；新型线上教学督导模式对教学效果的作用受到多数学生的认可；通过对新型教学督导模式的初步实际应用，获得了后续教学督导工作改革和完善的基础资料。 结论 广东医科大学第一临床医学院建立的新型教学督导模式基本适合新型冠状病毒疫情下临床医学相关线上理论课程的教学需求，能满足对线上教学进行有效监督和保证教学质量的要求，可供借鉴。 Abstract:Objective To investigate the new supervision scheme on online theory courses of clinical medicine (OTCCMs) in the context of the COVID-19 epidemic, so as to provide a guarantee for improving the quality of online teaching of clinical medicine. Methods From March 2020 to May 2020, 19 OTCCMs (18 professional courses and 1 elective course) of the First Clinical College of Guangdong Medical University (GDMU) were taken as the research objects. The characteristics of OTCCMs were prospectively analysed through investigation and research. The suitability and applicability of the traditional teaching supervision (TTS) mode were analysed retrospectively. In view of the objectives and requirements of the current online teaching supervision (OTS), the strategies linking the TTS mode with the OTS mode were analysed through a series of investigations, and formative evaluation method was applied. Then, the framework of the new OTS mode was established and improved. Students' recognition degree on the teaching effect under the new teaching supervision mode was evaluated through questionnaires. Results There were many new changes and differences in the OTCCMs due to the adoption of three-stage teaching. The TTS model had solidified, and no longer matched and connected the online theory teaching models in the context of the COVID-19 epidemic. The new teaching supervision framework of OTCCMs in the First Clinical College of GDMU was established initially, which basically solved the basic problems faced by current teaching supervision. The effect of the new OTS mode on the teaching effect was recognised by most students. Through the preliminary practical application of the new teaching supervision mode, the basic data for the reform and improvement of the follow-up teaching supervision work were obtained. Conclusion The new supervision mode established by the First Clinical College of GDMU is basically suitable for the current teaching needs of OTCCMs, and can meet the requirements of effective supervision of online teaching and guarantee the teaching quality. -
Key words:
- Supervision /
- Clinical medicine /
- Theory course /
- Online
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图 1 广东医科大学第一临床医学院既往临床医学理论课程教学督导流程及内容
Figure 1. The teaching supervision process and content of the previous clinical medicine theory course in the First Clinical Medical College of Guangdong Medical University
图 2 临床医学线上理论课程教学的督导流程及内容架构
注：红色字体标注内容为相对图 1新增的流程内容。
Figure 2. Supervision process and content structure of clinical medicine online theory course teaching
表 1 既往临床理论课程教学督导环节的主要特点
Table 1. The main characteristics of teaching supervision of clinical theory course in the past
既往教学督导涉及环节 每个督导环节主要特点 1.督导前期组织环节 组建督导团队是此环节重要工作内容之一；选择成员纳入团队的标准常以教学水平为主。 2.督导实施环节 (1)督导成员前往授课现场是此环节核心主体部分；(2)常只对2~3个学时的授课情况进行督导；(3)督导理论课程地点是在指定的教室，且时间固定；(4)督导评估内容及标准以框架、条款为主；督导成员实施时，因客观工具少，导致在督导考核中主观占比较高；(5)由于督导员时间有限，只能通过观察现场互动以及随机抽查学生进行短暂交流等途径，完成对学生的督学环节考核，因此督学占比低。 3.督导后期管理环节 (1)督导结果上报方式主要通过人工层层上报完成；(2)实现一次完整的反馈常需要汇总后的层层转达流程，耗时过多且复杂。 
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表 2 传统线下模式与当今线上模式主要差异
Table 2. The main differences between traditional offline mode and today ' s online mode
模式 线上课程教学3个阶段 课程时间安排 课程地点安排 督导团队要求 1.课程前 2.课程中 3.课程后 传统模式 (1)课前准备及任务：简单、量少，甚至缺乏；(2)下达形式：形式单一(常通过下发教学进度表、教学大纲，人员口头通知，看书本教材等方式完成)。 以老师“满堂灌”形式为主，授课时间紧张。 课后环节，教学内容形式单一、跟进不足，甚至缺失；课后作业往往流于形式；课后反馈及师生互动匮乏。 (1)通过2~3个学时完成；(2)具有时间指定性和固定性。 在指定教室授课，具有空间局限性。 (1)教学水平良好即可；(2)教学督导考核的同质化较好。 当今线上模式 (1)课前准备及任务：开展线上课程必备环节，内容及数量丰富、形式多样；(2)下达形式：通过线上学习平台下发形式(包括有学习任务、提供各类型资料、组织自学、师生讨论、线上测试等众多方式)。 将讲授重点转移至学生在课前学习时遇到的难点上来，做到有的放矢的讲解。 线上课程的重要环节。通过线上学习平台，将布置批改作业、反馈收集、答疑解惑、提升学生能力或补齐短板等重要教学内容充实到课后环节。同时，架设了学生课后找老师答疑和反馈的桥梁。 (1)因线上教学“三段式”模式，致一次全程授课在时间跨度上明显延长，传统督导仅利用80~120 min就完成的模式不能匹配，时间必须随之增加；(2)因线上授课教师教学设计不同，导致每阶段所需时长安排不同，督导时间呈现机动性和灵活性。 转移至网络平台；督导工作场所随之突破了在教室进行的局限。 (1)教学水平良好的同时，必须具备熟练掌握和应用各类线上教学平台功能与众多教学信息技术的能力；(2)因对线上督导方案的理解和执行存在偏差，导致督导考核结果同质化不理想。
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表 3 临床医学理论线上课程督导下线上教学模式与传统教学模式学生学习效果评价(%)
项目 学习效果评价项目 线上教学模式优势明显 传统教学模式优势明显 没有差别 课前部分 1.快速查看学习进度安排 88.7 0.3 11.0 2.参与师生互动机会 75.5 5.9 18.6 3.反馈便利性 82.5 2.2 15.3 4.测试及成绩反馈即时性 91.8 0.1 8.1 课中部分 1.掌握考勤情况 20.3 16.0 63.7 2.师生互动环节参与度 22.6 56.7 20.7 3.测试及成绩反馈即时性 75.6 1.5 22.9 4.课中信息反馈便利性 81.2 1.6 17.2 课后部分 1.课后师生答疑便利性 68.3 15.1 16.6 2.获得和完成作业简便性 78.0 16.8 5.2 3.获得复习资源方便性 90.0 2.3 7.7 4.课程学情反馈即时性 85.2 0.8 14.0 对学习效果的助力 61.4 6.4 32.2
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