The application of flipped classroom combined with MDT teaching model in breast cancer teaching of residents in standardized training
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摘要:
目的 分析和探讨翻转课堂联合多学科协作诊疗(MDT)教学模式在住院医师规范化培训乳腺癌教学中的应用效果，为住院医师规范化培训教学探索新的教学模式。 方法 选择2022年5月—2023年5月于蚌埠医科大学第一附属医院肿瘤外科进行住院医师规范化培训的学员70名，按随机数字表法分为观察组(35人)和对照组(35人)，对照组学生采用翻转课堂联合临床实习进行教学，观察组学生采用翻转课堂联合MDT教学模式进行教学。比较2组学员出科理论成绩、实践成绩(专科检查、影像学资料判读、相关文献及指南考核)、自我评价(增强学习兴趣、提高团队协作意识、开阔临床诊断思维)和对教学模式满意度。 结果 观察组学生出科理论成绩、实践成绩明显好于对照组[(93.5±2.1)分vs. (91.9±1.8)分；(94.5±1.8)分vs. (92.2±2.3)分；(93.5±2.2)分vs. (86.4±2.2)分；(93.3±2.3)分vs. (85.2±3.2)分]，2组比较差异均有统计学意义(P < 0.05)。观察组学生自我评价(增强学习兴趣、提高团队协作意识、开阔临床诊断思维)及对教学模式满意度均高于对照组(P < 0.05)。 结论 在乳腺癌的住院医师规范化培训教学中，翻转课堂联合MDT教学模式明显提升了学员的专业成绩，增强了学员的学习兴趣，提高了团队协作意识，开阔了临床诊断思维，同时实现了教学相长，教学满意度得到很大的提高，值得在临床教学中推广使用。 Abstract:Objective To analyze and discuss the application of flipped classroom combined with multi-disciplinary treatment (MDT) teaching model in breast cancer teaching of standardized training for residents, and to explore a new teaching model for residential training. Methods A total of 70 students who received standardized resident training in the Surgery Department of the First Affiliated Hospital of Bengbu Medical University from May 2022 to May 2023 were selected and randomly divided into observation group and control group according to the numerical random table method, with 35 students in each group. The students in the control group were taught by flipped classroom combined with clinical practice. The students in the observation group were taught in the flipped classroom and MDT teaching mode. The two groups of students were compared in terms of their theoretical scores, practical scores (specialty examination, interpretation of imaging data, examination of relevant literature and guidelines), self-evaluation (enhancing learning interest, improving teamwork awareness, broadening clinical diagnosis thinking) and satisfaction with teaching mode. Results The theoretical achievement and practical achievement of students in the observation group were much better than those in the control group [(93.5±2.1) points vs. (91.9±1.8) points, (94.5±1.8) points vs. (92.2±2.3) points, (93.5±2.2) points vs. (86.4±2.2) points, (93.3±2.3) points vs. (85.2±3.2) points], the difference between the two groups was statistically significant (P < 0.05). The students ' self-evaluation (enhancing learning interest, improving teamwork consciousness, broadening clinical diagnosis thinking) and satisfaction with teaching mode in observation group were higher than those in control group (P < 0.05). Conclusion In the standardized training for residents of breast cancer teaching, the flipped classroom combined with MDT teaching mode significantly improves the students ' professional scores, enhances their learning interest, enhances their teamwork awareness, broadens their clinical diagnosis thinking, and realizes teaching and learning, and greatly improves their teaching satisfaction, which is worthy of promotion and use in clinical teaching. -
表 1 2组肿瘤外科住院医师规范化培训学员基本资料比较
Table 1. Comparison of the basic data between the two groups of standardized training students of surgical oncology residents
组别 人数 学历(人) 住培入学成绩优秀率(%) 年龄(x±s, 岁) 性别(人) 本科 硕士 男性 女性 观察组 35 25 10 80.0(28/35) 25.26±1.29 20 15 对照组 35 26 9 82.9(29/35) 25.00±1.53 21 14 统计量 0.072a 0.094a 0.759b 0.059a P值 0.788 0.759 0.451 0.808 注: a为χ2值，b为t值。 
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表 2 2组肿瘤外科住院医师规范化培训学员出科考核理论、实践成绩比较(x±s，分)
Table 2. Comparison of the theoretical and practical scores between the two groups of the standardized training students of surgical oncology residents (x±s, points)
组别 人数 基础理论 专科检查 影像学资料判读 相关文献及指南考核 观察组 35 93.5±2.1 94.5±1.8 93.5±2.2 93.3±2.3 对照组 35 91.9±1.8 92.2±2.3 86.4±2.2 85.2±3.2 t值 3.566 4.711 13.598 12.127 P值 0.001 ＜0.001 ＜0.001 ＜0.001
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表 3 2组肿瘤外科住院医师规范化培训学员自我评价及对教学模式满意度比较[人数(%)]
Table 3. Comparison of self-evaluation and satisfaction with teaching mode between the two groups of the standardized training students of surgical oncology residents [cases (%)]
组别 人数 增强学习兴趣 提高团队协作意识 开阔临床诊断思维 教学模式满意度 观察组 35 31(88.6) 31(88.6) 33(94.3) 34(97.1) 对照组 35 23(65.7) 22(62.9) 26(74.3) 26(74.3) χ2值 5.185 6.293 5.285 7.467 P值 0.023 0.012 0.022 0.006
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