以整合医学为导向的教学模式在消化内科疾病教学中的应用及其效果评价

马振增; 寿广丽; 顾林; 朱玉; 燕善军; 王启之; 邓敏; 汪建超; 赵睿; 王猛

doi:10.16766/j.cnki.issn.1674-4152.002520

以整合医学为导向的教学模式在消化内科疾病教学中的应用及其效果评价

doi: 10.16766/j.cnki.issn.1674-4152.002520

蚌埠医学院第一附属医院消化内科，安徽蚌埠 233004

基金项目:

安徽省高等学校质量工程项目 2020jyxm1195

详细信息

通讯作者:
马振增, E-mail: mazhenzeng1979@sina.com

中图分类号: R192 R57
计量
- 文章访问数: 104
- HTML全文浏览量: 35
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-06
- 网络出版日期: 2022-09-21

Application and effect evaluation of integrated medicine-oriented teaching mode in gastroenterology teaching

Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的消化科疾病错综复杂，传统的教学方式很难提高学生的学习水平及解决临床实际问题的能力。本研究评估以整合医学为导向的教学模式在消化内科疾病教学中的教学效能。方法选取2021年1—12月蚌埠医学院第一附属医院消化内科实习的140名本科生为研究对象，随机区组法分为对照组(传统教学模式)和实验组(以整合医学为导向的教学模式)，2组教学内容相同，每组70人。比较2组消化系疾病的理论考核和病案分析成绩及迷你临床演练评估(Mini-CEX)考试成绩、教学效果及教学满意度。结果实验组消化系疾病理论考核、病案分析成绩分别为(45.16±4.37)分及(42.71±5.05)分，显著高于对照组[(43.57±3.81)分、(40.44±4.32)分，均P＜0.05)]；实验组Mini-CEX考核病史采集、体格检查、疾病诊断、医患沟通技巧、人文关怀、组织效能及整体表现方面的成绩均高于对照组(均P＜0.01);实验组非常满意29人，满意35人，对照组非常满意20人，满意29人，实验组满意度高于对照组(P＜0.01)。以整合医学为导向的教学模式显著提高实验组学生的病史采集及解决实际问题能力、加深了理论知识的理解、有利于将理论知识结合临床实践、发挥学习能动性(P＜0.01)。结论在消化系疾病教学中，以整合医学为导向的教学模式教学效果显著，提高了学生理论考核和病案分析成绩，有利于培养学生病史采集能力。
- 整合医学 /
- 教学模式 /
- 消化内科
Abstract: Objective Digestive diseases are so complex that the traditional method of teaching cannot easily improve the level of students' learning and problem-solving ability in clinical practice. The purpose of this study is to investigate the application and evaluate the effect of integrated medicine-oriented teaching mode in gastroenterology teaching. Methods From January 2021 to December 2021, 140 medical students practicing in the gastroenterology department were included as research subjects and randomly divided into the control (n=70) and experimental groups (n=70). The control group was given the same teaching content of the experimental group via traditional teaching method. However, the experimental group was taught with integrated medicine as the guiding ideology. The results were analysed via theoretical examination of digestive diseases and medical record analysis and mini-CEX, and questionnaire was used to evaluate students' teaching effect and satisfaction. Results The scores of theoretical examination and medical record analysis in the experimental group were (45.16±4.37) points and (42.71±5.05) points, respectively. However, those in the control group were (43.57±3.81) points and (40.44±4.32) points, respectively. The scores in the experimental group were higher than those in the control group (all P < 0.05). For the mini-CEX test, the scores of the experimental group, including medical history collection, physical examination, disease diagnosis, doctor-patient communication skills, humanistic care, organisational efficiency and overall performance, were higher than those in the control group (all P < 0.01). The results showed that there were 29 very satisfied and 35 satisfied persons in the experimental group, respectively; while there were 20 very satisfied and 29 satisfied persons in the control group, respectively; and the satisfaction in the experimental group was higher than that in the control group (P < 0.01). The integrative medical-oriented teaching mode significantly improved the medical history collection and practical problem-solving ability, deepened the understanding of theoretical knowledge, facilitated the combination of theoretical knowledge with clinical practice, and improved their learning initiative (P < 0.01). Conclusion Integrated medicine-oriented teaching mode has significant teaching effect in the teaching of digestive diseases, which is beneficial to improve the theoretical examination results and the ability of analysing medical records and to cultivate students' ability of medical history collection.
- Integrative medicine /
- Teaching mode /
- Department of Gastroenterology

HTML全文

表 1 2组医学生理论考核及病案分析成绩比较(x±s，分)

Table 1. Comparison of theoretical examination and medical record analysis between the two groups(x±s, scores)

组别	人数	理论考核	病案分析	总分
对照组	70	43.57±3.81	40.44±4.32	79.52±7.17
实验组	70	45.16±4.37	42.71±5.05	87.87±7.19
t值		2.295	2.861	6.880
P值		0.024	0.005	0.001

下载: 导出CSV

表 2 2组医学生Mini-CEX考核成绩比较(x±s，分)

Table 2. Comparison of Mini-CEX scores between two groups of medical students(x±s, scores)

组别	人数	医疗面谈/病史采集	体格检查	疾病诊断与治疗	医患沟通技巧	人文关怀及医德医风	组织效能	整体表现
对照组	70	5.71±1.54	5.75±0.80	5.26±0.94	4.64±1.02	5.83±1.30	5.51±1.03	4.82±1.36
实验组	70	6.44±1.54	6.27±1.03	5.89±1.37	6.04±1.07	6.47±1.24	6.11±1.21	6.04±1.42
t值		2.804	3.340	3.165	7.919	2.989	3.156	5.240
P值		0.006	0.001	0.002	＜0.001	0.003	0.002	＜0.001

下载: 导出CSV

表 3 2组医学生教学效果评价[人(%)]

Table 3. Evaluation of teaching effect of medical students between two groups [sample (%)]

组别	人数	加深理论知识理解	利于理论知识结合临床实践	提高病史采集能力	利于培养整体临床思维	利于提高解决实际问题	利于发挥学习能动性	提高文献查阅能力	活跃了课堂气氛	愿意接受这种教学模式
对照组	70	50(71.43)	45(64.29)	52(74.29)	43(61.43)	46(65.71)	49(70.00)	48(68.57)	45(64.29)	44(62.86)
实验组	70	65(92.86)	60(85.72)	67(95.71)	64(91.43)	62(88.57)	65(92.86)	62(88.57)	65(92.86)	61(87.14)
χ²值		10.957	8.571	12.605	17.485	10.296	12.092	8.315	16.849	11.010
P值		0.001	0.003	＜0.001	＜0.001	0.001	＜0.001	0.003	＜0.001	0.001

下载: 导出CSV

参考文献(15)

[1]	杨文领. 整合教学在医学生毕业后培养中的应用与思考[J]. 中国继续医学教育, 2020, 12(22): 1-2. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202022001.htm YANG W L. Integrated learning model in the postgraduate medical training: current status and considerations[J]. China Continuing Medical Education, 2020, 12(22): 1-2. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202022001.htm
[2]	王继伟, 张桃, 王麦建, 等. PBL联合TBL教学法在胃肠外科实习临床教学中的应用[J]. 中国继续医学教育, 2021, 13(31): 25-29. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202131007.htm WANG J W, ZHANG T, WANG M J, et al. Application of PBL Combined With TBL teaching method in clinical teaching of gastrointestinal surgery practice[J]. China Continuing Medical Education, 2021, 13(31): 25-29. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202131007.htm
[3]	CHI G Y. Toward a logical integrative medicine: Beyond data accumulation[J]. Integr Med Res, 2020, 9(4): 100414. doi: 10.1016/j.imr.2020.100414
[4]	靳建亮, 吴俊, 赵英明, 等. 基础与临床整合的心血管解剖教学探讨[J]. 基础医学教育, 2020, 22(9): 621-625. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYD202009001.htm JIN J L, WU J, ZHAO Y M, et al. Exploration of basic and clinical integration in cardiovascular anatomy teaching[J]. Basic Medical Education, 2020, 22(9): 621-625. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYD202009001.htm
[5]	章洁, 谢振平, 夏鸿斌, 等. 探究线上线下教学背景下计算机通识教学的有效开展[J]. 电子元器件与信息技术, 2021, 5(8): 255-256. https://www.cnki.com.cn/Article/CJFDTOTAL-DYXU202108115.htm ZHANG J, XIE Z P, XIA H B, et al. Explore the effective development of computer general education under the background of online and offline Teaching[J]. Electronic Components and Information Technology, 2021, 5(8): 255-256. https://www.cnki.com.cn/Article/CJFDTOTAL-DYXU202108115.htm
[6]	刘浩, 刘文, 韩岩智, 等. 混合式教学应用于消化系统疾病教学的探索[J]. 农垦医学, 2019, 41(2): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-NKYX201902028.htm LIU H, LIU W, HAN Y Z, et al. Study on the application of blended teaching in the teaching of digestive diseases[J]. Journal of Nongken Medicine, 2019, 41(2): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-NKYX201902028.htm
[7]	MATTAI S A D, HUI K P. Reframing palliative care: An east-west integrative palliative care model[J]. Chin J Integr Med, 2021, 27(10): 723-728. doi: 10.1007/s11655-021-3500-9
[8]	FITZGERALD D A, SCOTT K M, RYAN M S. Blended and e-learning in pediatric education: Harnessing lessons learned from the COVID-19 pandemic[J]. Eur J Pediatr, 2022, 181(2): 447-452. doi: 10.1007/s00431-021-04149-1
[9]	唐文波, 都晓英, 高涌, 等. PBL教学法联合血管腔内模拟器在血管外科临床实习教学中的应用[J]. 中华全科医学, 2021, 19(12): 2124-2126, 2145. doi: 10.16766/j.cnki.issn.1674-4152.002252 TANG W B, DU X Y, GAO Y, et al. Application of PBL teaching method combined with endovascular simulator in clinical practice teaching of vascular surgery[J]. Chinese Journal of General Practice, 2021, 19(12): 2124-2126, 2145. doi: 10.16766/j.cnki.issn.1674-4152.002252
[10]	SUN C J, QI X K. Evaluation of problem-and simulator-based learning in lumbar puncture in adult neurology residency training[J]. World Neurosurg, 2018, 109: e807-e811. doi: 10.1016/j.wneu.2017.10.093
[11]	KANHERKAR R R, STAIR S E, BHATIA-Dey N, et al. Epigenetic mechanisms of integrative medicine[J]. Evid Based Complement Alternat Med, 2017, 2017: 4365429. DOI: 10.1155/2017/4365429.
[12]	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 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
[13]	张微. Mini-CEX结合CBL教学法在骨科护理带教中的应用效果[J]. 安徽卫生职业技术学院学报, 2019, 18(5): 107-109. https://www.cnki.com.cn/Article/CJFDTOTAL-AHWZ201905054.htm ZHANG W. Effect of Mini-CEX combined with CBL teaching method in clinical nursing teaching of orthopedics department[J]. Journal of Anhui Health Vocational and Technical College, 2019, 18(5): 107-109. https://www.cnki.com.cn/Article/CJFDTOTAL-AHWZ201905054.htm
[14]	杨荣, 马静, 常海霞. 观察min-CEX在护理实习生临床能力评价中的应用效果[J]. 实用临床护理学电子杂志, 2020, 5(11): 145. https://www.cnki.com.cn/Article/CJFDTOTAL-SLHL202011132.htm YANG R, MA J, CHANG H X. To observe the clinical ability evaluation of min-CEX in nursing interns[J]. Electronic Journal of Practical Clinical Nursing Science, 2020, 5(11): 145. https://www.cnki.com.cn/Article/CJFDTOTAL-SLHL202011132.htm
[15]	朱玉, 邓敏, 薛永举, 等. MDT为导向的CBL+PBL模式在消化内科住院医师规范化培训教学中的应用及效果评价[J]. 齐齐哈尔医学院学报, 2021, 42(7): 602-606. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202107014.htm ZHU Y, DENG M, XUE Y J, et al. Application of MDT oriented CBL plus PBL model in standardized training of residents in gastroenterology department and its effect evaluation[J]. Journal of Qiqihar Medical College, 2021, 42(7): 602-606. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202107014.htm