Application of CBCL in Standardized Training of Resident Doctors
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摘要:
目的 探讨案例式协作教学法（case-based collaborative learning，CBCL）在住院医师规范化培训教学中的作用。 方法 64名参加内科住院医师规范化培训的学员纳入研究。将64名学员随机分为2组，即实验组（n = 32）和对照组（n = 32）。应用CBCL教学法对实验组学员进行教学，应用PBL教学法对对照组学员进行教学。完成8周教学后，对2组学员进行考核及问卷调查，获得2组学员的考核得分及学员对2种教学法的评价得分。比较2组学员的得分差异。 结果 实验组考核总得分明显高于对照组[（70.40±5.85）分 vs （60.90±5.34）分，P < 0.05]；实验组的分项得分（基础理论知识、病例分析知识、新进展知识以及实践相关知识得分）均高于对照组（ P < 0.05）；问卷得分显示，实验组对教学方法的总体评价及分项评价均明显高于对照组[总体评价（ P < 0.001），激发学习兴趣评价（ P < 0.05），实践能力提高的评价（ P < 0.05），诊断能力提高的评价（ P < 0.05），治疗方案改进的评价（ P < 0.05）]。 结论 CBCL教学法可应用于住院医师规范化培训教学。 Abstract:Objective To explore the role of case-based collaborative learning （CBCL） in the standardized training of residents. Methods All 64 residents included in this study were randomly divided into two groups: the experimental group （n = 32） and the control group （n = 32）. The experimental group adopted CBCL teaching method and the control group adopted PBL teaching method. After 8 weeks of teaching, the two groups of residents were assessed and questionnaires were conducted to obtain the assessment scores of the two groups of residents and the evaluation scores of the residents on the two teaching methods. The scores difference between the two groups of residents were compared. Results The total scores of the experimental group were significantly higher than that of the control group （70.40±5.85 vs. 60.90±5.34, P < 0.05）. The subitem scores of the experimental group （basic theoretical knowledge, case analysis knowledge, new progress knowledge and practice-related knowledge scores） were higher than those of the control group （ P < 0.05）. The results of the questionnaire showed that the experimental group presented higher scores than the control group （general evaluation of teaching methods, P < 0.001; Evaluation of teaching methods stimulating interest in learning, P < 0.05; Evaluation of teaching methods improving practical ability, P = 0.008; Evaluation of teaching methods to improving diagnostic ability, P < 0.05; Evaluation of teaching methods to improving treatment, P < 0.05）. Conclusion CBCL teaching method can be used in standardized training of residents. -
表 1 2组学员基本情况及教学前考核成绩（分）的比较[n（%）/（ $ \bar x \pm s $）]
Table 1. Comparison of baseline characteristics of resident and assessment scores of pre-teaching （scores） in the two groups [n（%）/（ $ \bar x \pm s $）]
类别 对照组 实验组 t /χ2 P 例数（n） 32 32 性别[ 男（%）] 13（40.63） 10（31.25） 0.611 0.603 年龄（岁） 24.59 ± 1.58 24.94 ± 1.29 −0.951 0.345 考核总分（分） 56.69 ± 8.68 60.31 ± 8.45 −1.692 0.096 基础理论知识（分） 15.81 ± 3.48 16.63 ± 2.78 −1.032 0.306 病例分析知识（分） 14.44 ± 2.54 15.59 ± 2.37 −1.884 0.064 新进展知识（分） 11.97 ± 2.39 12.59 ± 3.39 −0.863 0.392 实践相关知识（分） 14.47 ± 3.61 15.50 ± 3.10 −1.226 0.225 
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表 2 教学后CBCL学员的理论知识、实践知识、病例分析知识和新进展知识的考核得分[（ $ \bar x \pm s $），分]
Table 2. Assessment scores of CBCL residents in theoretical knowledge，practical knowledge，case analysis knowledge，and new progress knowledge after teaching in the two groups [（ $ \bar x \pm s $），scores]
考核得分 对照组 实验组 t P 考核总得分 60.90 ± 5.34 70.40 ± 5.85 −6.782 < 0.001* 基础理论知识） 17.28 ± 2.95 19.63 ± 2.79 −3.262 0.002* 病例分析知识 15.03 ± 2.73 18.13 ± 3.57 −3.893 < 0.001* 新进展知识 12.22 ± 2.66 14.21 ± 2.89 −2.878 0.005* 实践相关知识 16.38 ± 3.07 18.43 ± 3.41 −2.545 0.013* *P < 0.05。
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表 3 2组学员对2种教学方法在激发学习兴趣、提高实践能力、提高诊断能力、改进治疗方案方面作用的评价[（ $ \bar x \pm s $），分]
Table 3. Evaluation of residents on the role of the two teaching methods in stimulating learning interest，improving practical ability，improving diagnostic ability，and improving treatment plan in the two groups [（ $ \bar x \pm s $），scores]
学员对教学方法的评价 对照组 实验组 t P 教学方法的总体评价 5.84 ± 1.17 7.31 ± 1.09 −5.202 < 0.001* 激发学习兴趣 5.90 ± 1.99 7.00 ± 1.90 −2.249 0.028* 实践能力的提高 5.88 ± 1.56 6.84 ± 1.22 −2.766 0.008* 诊断能力的提高 5.66 ± 1.58 6.91 ± 1.47 −3.282 0.002* 治疗方案的改进 6.41 ± 1.29 7.47 ± 1.27 −3.319 0.002* *P < 0.05。
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