翻转课堂联合案例教学法在心内科住院医师规范化培训中的应用

葛君; 宣玲; 沙莎; 陆宇; 王茂松; 汪朝晖; 李逸峰; 汝冬梅

doi:10.16766/j.cnki.issn.1674-4152.002787

翻转课堂联合案例教学法在心内科住院医师规范化培训中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002787

葛君^1, ,,
宣玲²,
沙莎¹,
陆宇¹,
王茂松¹,
汪朝晖¹,
李逸峰¹,
汝冬梅¹

1.
蚌埠医学院第二附属医院心内科，安徽蚌埠 233000
2.
蚌埠医学院第一附属医院心内科，安徽蚌埠 233004

基金项目:

蚌埠医学院校级质量工程重点项目 2020fsjyxm13

安徽省高等学校省级质量工程项目 2021jyxm0949

详细信息

通讯作者:
葛君，E-mail: 1410430235@qq.com

中图分类号: R192.3R54
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- 被引次数: 0
出版历程
- 收稿日期: 2022-06-26
- 网络出版日期: 2023-02-07

Application on flipped classroom combined with Case-based learning in the standardized training of residents in cardiology

1.
Department of Cardiology, the Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

摘要: 目的案例教学法(case-based learning，CBL)是以案例为主导的教学方法，翻转课堂是教学结构与教学流程颠覆的教学方法，本文旨在探讨翻转课堂联合CBL在心内科住院医师规范化培训中的应用效果，以提高教学质量。方法选取2021年4月—2022年7月于蚌埠医学院第二附属医院心内科进行3个月规范化培训的60名住院医师为研究对象, 按随机数字表法分为观察组和对照组, 每组各30名。观察组采用翻转课堂联合CBL，对照组采用传统教学法，对比分析2种教学方法的教学效果。3个月规范化培训结束后，对规培医师进行基础理论考试、实践技能操作及病例分析的考核并采用问卷调查形式评估2种教学方法的效果。结果观察组的基础理论知识成绩[(93.1±5.3)分]、技能操作成绩[(89.2±10.1)分]及病例分析考核[(90.2±6.7)分]结果明显高于对照组的基础理论知识成绩[(88.5±8.9)分]、技能操作成绩[(81.3±11.4)分]及病例分析考核[(85.3±5.9)分]，差异有统计学意义(均P < 0.05)。问卷调查满意度调查评分也明显高于对照组，差异有统计学意义(P < 0.05)。结论翻转课堂联合CBL有利于提升心内科规培医师规范化培训的质量，激发规培医师的学习兴趣，提升教学满意度，提高规培医师的临床解决问题能力、自主自学能力、实践操作技能，有利于未来学习，对提升临床教学效果起促进作用。
- 住院医师 /
- 规范化培训 /
- 案例式教学法 /
- 翻转课堂
Abstract: Objective Case-based learning (CBL) is a case oriented teaching method, and flipped classroom is a teaching method that is loose in teaching and subversive in teaching process. This article aims to explore the effect of the application of flipped classroom combined with CBL in the standardized training of cardiology residents, so as to improve the teaching quality. Methods A total of 60 trained doctors who received 3-month standardized training in the Department of Cardiology of the Second Affiliated Hospital of Bengbu Medical College from April 2021 to July 2022 were selected as the subjects. They were divided into observation group and control group according to random number table method, with 30 doctors in each group. The observation group adopted the flipped classroom combined with CBL, and the control group adopted the traditional teaching method teaching mode. The teaching effects of the two teaching modes were compared and analyzed. After three months of standardized training, residents were assessed in the form of basic theory examination, practical skills and case analysis, and questionnaire survey to evaluate the effects of the two teaching methods. Results The basic theory scores [(93.1±5.3) points], skill operation scores [(89.2±10.1) points] and case analysis examination scores [(90.2±6.7) points] in the observation group were significantly higher than those in the control group [(88.5±8.9) points, (81.3±11.4) points, (85.3±5.9) points], the differences were statistically significant (all P < 0.05). The scores of questionnaire survey satisfaction were also significantly higher than that in the control group, the difference was statistically significant (P < 0.05). Conclusion Flipped classroom combined with CBL is conducive to improving the quality of standardized training for cardiology residents, stimulating residents' interest in learning, increasing teaching satisfaction, improving their ability to solve clinical problems, and improving their independent self-study ability and practical operation skills, which is conducive to future learning and improving the clinical teaching effect.
- Residents /
- Standardized training /
- Case-based learning /
- Flipped classroom

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表 1 2组规培医师的一般资料比较

Table 1. General information of two groups of trained residents

组别	人数	性别(男/女，人)	年龄(x±s，岁)	规培前考试成绩(x±s，分)
观察组	30	12/18	27.65±1.02	82.02±8.56
对照组	30	13/17	27.53±0.86	80.35±7.03
统计量		0.069^a	0.493^b	0.826^b
P值		0.793	0.624	0.412
注：^a为χ²值，^b为t值。

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表 2 2组规培医师考核成绩比较(x±s，分)

Table 2. Comparison of examination results between two groups of trained residents

组别	人数	基础理论	技能操作	病例分析
观察组	30	93.1±5.3	89.2±10.1	90.2±6.7
对照组	30	88.5±8.9	81.3±11.4	85.3±5.9
t值		2.432	2.841	3.006
P值		0.018	0.006	0.004

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表 3 2组规培医师满意度问卷调查结果[人(%)]

Table 3. Questionnaire survey results of two groups of trained residents

组别	人数	认可教学方法	提高自主自学能力	激发学习兴趣	提高实践操作技能	提高解决临床问题能力	有利于未来学习
观察组	30	29(96.6)	28(93.3)	28(93.3)	27(90.0)	28(93.3)	27(90.0)
对照组	30	20(66.6)	18(60.0)	18(60.0)	19(63.3)	20(66.6)	19(63.3)
χ²值		9.017	9.317	9.317	5.963	6.667	5.963
P值		0.003	0.002	0.002	0.015	0.010	0.015

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参考文献(15)

[1]	邓婵翠, 张巍, 邓文文, 等. PBL联合CBL教学法在心内科住院医师规范化培训中的应用[J]. 中国继续医学教育, 2022, 14(5): 73-77. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202205020.htm DENG C C, ZHANG W, DENG W W, et al. Application of PBL combined with CBL in standardized training of cardiology residents[J]. China Continuing Medical Education, 2022, 14(5): 73-77. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202205020.htm
[2]	袁伟, 周晓枢, 赵鑫. CBL联合角色模拟在留学生骨科实习课教学的应用[J]. 中国继续医学教育, 2020, 12(5): 45-47. doi: 10.3969/j.issn.1674-9308.2020.05.017 YUAN W, ZHOU X S, ZHAO X. Application of CBL joint role simulation in orthopaedic practice teaching for foreign students[J]. China Continuing Medical Education, 2020, 12(5): 45-47. doi: 10.3969/j.issn.1674-9308.2020.05.017
[3]	张萍, DING L, 张文硕, 等. 翻转课堂的理念、演变与有效性研究[J]. 教育学报, 2017, 13(1): 46-55. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJY201701008.htm ZHANG P, DING L, ZHANG W S, et al. Research on the concept, evolution and effectiveness of flipped classroom[J]. Journal of Education, 2017, 13(1): 46-55. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJY201701008.htm
[4]	LIU A, ZHOU L L, LAM A, et al. Case-based learning in dermatology[J]. J Cutan Med Surg, 2018, 22(3): 273-279. doi: 10.1177/1203475417752368
[5]	张晨冉, 沈宏亮, 胡国汉. 反转课堂结合CBL在神经外科教学中的应用探索[J]. 教育教学论坛, 2016(24): 167-168. doi: 10.3969/j.issn.1674-9324.2016.24.078 ZHANG C R, SHEN H L, HU G H. The application of flipped classroom combined with CBL in neurosurgery teaching[J]. Education and Teaching Forum, 2016(24): 167-168. doi: 10.3969/j.issn.1674-9324.2016.24.078
[6]	程守全. CBL联合PBL教学法在心内科住院医师规范化培训中的应用效果观察[J]. 特别健康, 2021, 33(9): 33. CHENG S Q. Observation on the application of CBL combined with PBL teaching method in standardized training of cardiology residents[J]. Special Health, 2021, 33(9): 33.
[7]	QAMAR K, REHMAN S, KHAN M A. Effectiveness of case-based learning during small groups sessions at army medical college[J]. J Coll Physicians Surg Pak, 2016, 26(3): 232-233.
[8]	THISTLETHWAITE J E, DAVIES D, EKEOCHA S, et al. The effectiveness of casebased learning in health professional education. A BEME systematic review: BEME Guide No. 23[J]. Med Teach, 2012, 34(6): e421-444. doi: 10.3109/0142159X.2012.680939
[9]	陶言言, 郭晋, 张弘, 等. PBL联合CBL教学法在急诊医学临床教学中的应用价值[J]. 中华全科医学, 2021, 19(1): 128-130, 140. doi: 10.16766/j.cnki.issn.1674-4152.001748 TAO Y Y, GUO J, ZHANG H, et al. Application value of PBL combined with CBL teaching method in clinical teaching of emergency medicine[J]. Chinese Journal of General Practice, 2021, 19(1): 128-130, 140. doi: 10.16766/j.cnki.issn.1674-4152.001748
[10]	王莹, 郝伟. CBL联合PBL教学模式在心血管内科临床教学中应用效果评价[J]. 中国病案, 2017, 18(9): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGBN201709029.htm WANG Y, HAO W. Evaluation of the effect of CBL combined with PBL teaching model in clinical teaching of cardiovascular medicin[J]. China Medical Records, 2017, 18(9): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGBN201709029.htm
[11]	NIE CARR V P, LUDEMAN E, LEE M C, et al. Anintegrative review of flipped classroom teaching modelsin nursing education[J]. J Prof Nurs, 2017, 33(2): 133-144.
[12]	RAMNANAN C J, POUND L D. Advances in medical education and practice: Student perceptions of the flipped classroom[J]. Adv Med Educ Pract, 2017, 8: 63-73.
[13]	李亮, 周旺, 张超学, 等. 新形式下基于网络平台的翻转教学模式在超声影像学教学中的应用效果[J]. 中华全科医学, 2021, 19(8): 1386-1389. doi: 10.16766/j.cnki.issn.1674-4152.002067 LI L, ZHOU W, ZHANG C X, et al. The application effect of flipped teaching mode based on network platform in ultrasonic imaging teaching under the new situation[J]. . Chinese Journal of General Practice, 2021, 19(8): 1386-1389. doi: 10.16766/j.cnki.issn.1674-4152.002067
[14]	聂亚雄, 陈金智, 江丽萍, 等. 翻转课堂在临床医学本科生《神经病学》的应用与探讨[J]. 教育教学论坛, 2020(11): 225-226. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJU202011101.htm NIE Y X, CHEN J Z, JIANG L P, et al. Application and discussion of flipped classroom in Neurology for clinical medical undergraduates[J]. Education and Teaching Forum, 2020(11): 225-226. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJU202011101.htm
[15]	李双喜, 李洁, 张优, 等. CBL联合翻转课堂教学模式在临床教学中的应用[J]. 中国继续医学教育, 2021, 13(7): 17-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202107006.htm LI S X, LI J, ZHANG Y, et al. Application of CBL joint flipped classroom teaching model in clinical teaching[J]. China Continuing Medical Education, 2021, 13(7): 17-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202107006.htm