反思性教学结合NCCBL在小儿外科规培带教中的应用

陈芳芳; 张瑜; 汪宇; 宋涛

doi:10.16766/j.cnki.issn.1674-4152.003351

反思性教学结合NCCBL在小儿外科规培带教中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003351

蚌埠医科大学第一附属医院小儿外科, 安徽蚌埠 233004

基金项目:

安徽省高等学校省级质量工程项目 2020jyxm1213

详细信息

通讯作者:
宋涛, E-mail: 1179610276@qq.com

中图分类号: R192
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- 文章访问数: 70
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- 被引次数: 0
出版历程
- 收稿日期: 2023-02-02
- 网络出版日期: 2024-03-09

Application of reflective teaching combined with NCCBL in pediatric surgical teaching

Department of Pediatric Surgery, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的探究在小儿外科规培带教中引入反思性教学与基于临床反面案例教学方法(NCCBL)相结合带教方式的效果。方法选择2021年在蚌埠医科大学第一附属医院小儿外科规培的人员作为对照组(32人), 采用传统的规培带教模式；将2022年在蚌埠医科大学第一附属医院小儿外科规培的人员作为观察组(29人)，采用反思性教学结合NCCBL带教模式。分析比较2组规培学员的出科考核成绩、自我能力提升的评价和带教满意度。结果观察组规培学员与对照组出科理论成绩分别为89.00(85.00, 93.00)分和79.59(75.00, 85.75)分，差异有统计学意义(P < 0.05)；观察组学员各项临床综合素养考核成绩均优于对照组(P < 0.05)。在对综合学习能力提升的自我评价方面，观察组学员对学习兴趣的提升、临床思维能力的提升、文献查阅能力的提升、团队协作能力的提升、反思性思维能力的提升这5个方面的自我评价均优于对照组，差异均有统计学意义(P < 0.05)。对教师教学方法的满意度调查方面，观察组学员满意度明显高于对照组, 差异有统计学意义(P < 0.05)。结论在小儿外科规培带教过程中以临床反面案例教学方式为手段，打破常规教学思维模式，用反思性教学思想贯彻带教过程，有利于提高学员学习的积极性，提升教学效果，达到以学促优、以优促研、教学相长的效果。
- 反思性教学 /
- 临床反面案例教学方法 /
- 规培带教 /
- 小儿外科
Abstract: Objective To explore the application and effect of reflective teaching combined with negative clinical case-based learning (NCCBL) in pediatric surgery teaching. Methods A total of 32 trainees who were trained in the pediatric surgery department in the First Affiliated Hospital of Bengbu Medical University in 2021 were set as a control group and the routine practice teaching method was implemented. In addition, a total of 29 trainees who were trained in the pediatric surgery department in the First Affiliated Hospital of Bengbu Medical University in 2022 were selected as the observation group, and the reflective teaching method combined with NCCBL was adopted. The results of the scientific examination, the recognition of teaching methods, and the assessment of self-ability improvement were compared between the two groups. Results The theoretical scores of the observation group and the control group were 89.00 (85.00, 93.00) and 79.59 (75.00, 85.75), respectively, with a statistically significant difference (P < 0.05). The scores of clinical comprehensive quality assessment in the observation group were better than those in the control group (P < 0.05). The observation group had higher self-evaluation of the improvement of learning interest, clinical thinking ability, literature review ability, teamwork ability, and reflective thinking ability than the control group, the differences were statistically significant (P < 0.05). The satisfaction of teaching methods in the observation group was significantly higher than that in the control group (P < 0.05). Conclusion In the process of pediatric surgery teaching, we can use reflective teaching combined with NCCBL as a means to break the conventional teaching method, which can fully mobilize the students' learning enthusiasm, improve the teaching quality, to achieve excellence as well as research. As we all know, teaching is learning.
- Reflective teaching /
- Negative clinical case-based learning /
- Teaching /
- Pediatric surgery

HTML全文

表 1 2组学员出科考核成绩比较[M(P₂₅, P₇₅), 分]

Table 1. Comparison of the scores of students in two groups[M(P₂₅, P₇₅), points]

组别	人数	理论考核成绩	临床综合素养考核成绩
组别	人数	理论考核成绩	问诊沟通能力	病历书写能力	病例分析能力	技能操作能力	医患矛盾解决能力
对照组	32	79.59(75.00, 85.75)	15.00(14.00, 16.00)	15.00(14.00, 16.00)	15.00(14.00, 15.75)	15.00(16.50, 18.00)	16.00(15.00, 16.00)
观察组	29	89.00(85.00, 93.00)	17.00(17.00, 18.00)	18.00(17.00, 18.00)	17.00(16.50, 18.00)	17.00(16.50, 18.00)	17.00(17.00, 18.00)
Z值		-4.665	-5.830	-6.015	-6.139	-6.226	-5.698
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 2 2组学员自我能力提升的评价比较(人)

Table 2. Comparison of evaluation on self-ability improvement of two groups of students (people)

组别	人数	学习兴趣的提升	临床思维能力的提升	文献查阅能力的提升	团队协作能力的提升	反思性思维能力的提升
对照组	32	25	23	15	17	10
观察组	29	29	29	28	27	29
P值		0.011	0.002	＜0.001	0.001	＜0.001
注：2组间比较采用Fisher精确检验。

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参考文献(18)

[1]	王伟, 徐家丽, 陈晓晖, 等. 住院医师规范化培训学员过程考核的建立和实施[J]. 中国继续医学教育, 2022, 14(7): 125-129. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202207034.htm WANG W, XYU J L, CHEN X H, et al. Establishment and Implementation of Process Assessment System for Standardized Training of Resident Physicians[J]. China Continuing Medical Education, 2022, 14(7): 125-129. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202207034.htm
[2]	谢璇, 仇莹莹, 李璐. 住院医师规范化培训政策对医学生就业及考研影响的研究[J]. 卫生职业教育, 2022, 40(2): 25-26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202202012.htm XIE X, CHOU Y Y, LI L. Research on the influence of residents' standardized training policy on medical students' employment and postgraduate entrance examination[J]. Educational Management and Student Development, 2022, 40(2): 25-26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202202012.htm
[3]	涂真真, 温晟, 华燚. 浅谈小儿外科专业型研究生科研创新能力的培养[J]. 中国继续医学教育, 2021, 13(31): 116-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202131030.htm TU Z Z, WEN C, HUA Y. Consideration on the Cultivation of Scientific Research Ability of Professional Degree Postgraduate in Pediatric Surgery[J]. China Continuing Medical Education, 2021, 13(31): 116-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202131030.htm
[4]	曾莉, 向波, 徐畅, 等. 区域疑难病例讨论在小儿外科住院医师培养中的实践[J]. 继续医学教育, 2020, 34(10): 19-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202010011.htm ZENG L, XIANG B, XU C, et al. The practice of regional difficult case discussion in cultivating pediatric surgical residents[J]. Continuing Medical Education, 2020, 34(10): 19-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202010011.htm
[5]	林路, 胡晓文, 何玉. PBL结合CBL及情景式教学在妇产科实习带教中的应用[J]. 中华全科医学, 2022, 20(9): 1579-1582. doi: 10.16766/j.cnki.issn.1674-4152.002653 LIN L, HU X W, HE Y. Application of PBL combined with CBL and situational teaching in practice teaching of obstetrics and gynecology[J]. Chinese Journal of General Practice, 2022, 20(9): 1579-1582. doi: 10.16766/j.cnki.issn.1674-4152.002653
[6]	都晓英, 唐文波, 宋涛, 等. PBL联合CBL在超声医学教学中的应用研究[J]. 中华全科医学, 2021, 19(11): 1943-1945. doi: 10.16766/j.cnki.issn.1674-4152.002207 DU X Y, TANG W B, SONG T, et al. Application of PBL and CBL in ultrasonic medical teaching[J]. Chinese Journal of General Practice, 2021, 19(11): 1943-1945. doi: 10.16766/j.cnki.issn.1674-4152.002207
[7]	彭涛, 汤镇海, 邹川, 等. 全科医师规范化培训中医患沟通现状调查[J]. 中华全科医学, 2022, 20(1): 134-137, 168. doi: 10.16766/j.cnki.issn.1674-4152.002295 PENG T, TANG Z M, ZOU C, et al. Investigate on status quo of doctor-patient communication skills in standardized training of general practice[J]. Chinese Journal of General Practice, 2022, 20(1): 134-137, 168. doi: 10.16766/j.cnki.issn.1674-4152.002295
[8]	李悦, 宋宇尘, 孙东东, 等. 住院医师规范化培训制度下三级综合性医院儿科人才队伍建设的对策[J]. 成都中医药大学学报: 教育科学版, 2022, 24(1): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-CDYY202201013.htm LI Y, SONG Y C, SUN D D, et al. Countermeasures of pediatric talent team construction in tertiary general hospitals under the standardized training system of resident physicians[J]. Journal of Chengdu University of TCM(Education Science Edition), 2022, 24(1): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-CDYY202201013.htm
[9]	梁海燕, 孙宁. 国内外小儿外科专科医生培训的现状及展望[J]. 继续医学教育, 2018, 32(5): 2-4. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201805003.htm LIANG H Y, SUN N. Current situation and prospect of training of pediatric surgery specialists at home and abroad[J]. Continuing Medical Education, 2018, 32(5): 2-4. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201805003.htm
[10]	杨济桥, 张梓桐, 李浪. 儿童外科实习带教的难点与策略反思[J]. 中国继续医学教育, 2022, 14(17): 176-180. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202217045.htm YANG J Q, ZHANG Z D, LI L. Difficulties and strategies of internship teaching in pediatric surgery department[J]. China Continuing Medical Education, 2022, 14(17): 176-180. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202217045.htm
[11]	林晓兰. 高师院校反思型专业教师的培养[J]. 教育理论与实践, 2022, 42(24): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-JYLL202224010.htm LIN X L. The cultivation of reflective professional teachers in senior university colleges and universities[J]. Theory and Practice of Education, 2022, 42(24): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-JYLL202224010.htm
[12]	陶立红. 教学反思: 强化教师教学能力的必经之路[J]. 教学管理与教育研究, 2022, 7(8): 111-112. https://www.cnki.com.cn/Article/CJFDTOTAL-JXGN202208048.htm TAO L H. Teaching reflection: The only way to strengthen teachers' teaching ability[J]. Teaching Management and Educational Research, 2022, 7(8): 111-112. https://www.cnki.com.cn/Article/CJFDTOTAL-JXGN202208048.htm
[13]	陈韶华, 陈蓬来, 王权, 等. 基于临床反面案例分享的反思性教学研究和实践[J]. 中国毕业后医学教育, 2021, 5(3): 258-260, 264. https://www.cnki.com.cn/Article/CJFDTOTAL-BHYJ202103016.htm CHEN S H, CHEN P L, WANG Q, et al. Research and practice of reflective teaching based on sharing clinical negative cases[J]. Chinese Journal of Graduate Medical Education, 2021, 5(3): 258-260, 264. https://www.cnki.com.cn/Article/CJFDTOTAL-BHYJ202103016.htm
[14]	姜丹, 任理仙, 汪胜, 等. 从本科毕业考核专业理论考试中反思临床医学实践教学的改革[J]. 中国继续医学教育, 2022, 14(7): 8-12. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202207003.htm JIANG D, REN L X, WANG S H, et al. Reflection on the reform of clinical medicine practice education from the professional theory examination of graduation[J]. China Continuing Medical Education, 2022, 14(7): 8-12. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202207003.htm
[15]	吉振宏, 李君. 区域教研反思性教学研究[J]. 中学政史地: 教学指导, 2023(3): 95-96. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZSD202303039.htm JI Z H, LI J. Research on Reflective Teaching in Regional Teaching Research[J]. Middle School Political History and Geography: Teaching Guidance, 2023(3): 95-96. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZSD202303039.htm
[16]	陈蓬来, 陈韶华, 沈洁, 等. 基于临床反面案例教学方法的研究与初探[J]. 中国高等医学教育, 2020(4): 96-97. https://www.cnki.com.cn/Article/CJFDTOTAL-ZOGU202004054.htm CHEN P L, CHEN S H, SHEN J. Using case study medthod with negative clinical cases[J]. Higher Medical Education in China, 2020(4): 96-97. https://www.cnki.com.cn/Article/CJFDTOTAL-ZOGU202004054.htm
[17]	菲鲁热·艾力. 教师的新角色: 反思性实践者[J]. 教育进展, 2022, 12(12): 5781-5785. https://www.cnki.com.cn/Article/CJFDTOTAL-JSBK202235011.htm FEILURE A L. The New Role of the Teacher: Reflective Practitioner[J]. Advances in Education, 2022, 12(12): 5781-5785. https://www.cnki.com.cn/Article/CJFDTOTAL-JSBK202235011.htm
[18]	赵嘉钰. 反思助力专业成长[J]. 河南教育: 教师教育, 2023(2): 49-50. https://www.cnki.com.cn/Article/CJFDTOTAL-HNJX202302031.htm ZHAO J Y. Reflection Helps Professional Growth[J]. Henan Education: Teacher education, 2023(2): 49-50. https://www.cnki.com.cn/Article/CJFDTOTAL-HNJX202302031.htm