CAJ | 학술논문

目的探讨医学生作为标准化病人(student as standardized patients,SSP)在外科学见习中开展以问题为基础的学习(problem-based learning,PBL)的教学效果.方法选取2008级本科临床医学专业161名学生为研究对象,按自然班随机分为PBL组和以授课为基础的学习(lecture-based learning,LBL)组.PBL组(81人)引入SSP开展PBL教学,LBL组(80人)按LBL进行见习.见习结束时对2组学生进行理论考核,并对PBL组学生进行问卷调查;数据录入SPSS13.0软件进行统计分析,比较2组差异,计量资料采用t检验,计数资料用频数与构成比描述.结果理论考核结果显示PBL组病案分析平均成绩为(37.35±5.95)分,明显高于LBL组的(33.25±4.89)分(P=0.001);PBL组总评成绩为(71.20±8.67)分,亦高于LBL组的(67.79±9.87)分(P=0.018);2组选择题平均成绩分别为(33.85±5.05)、(34.24±6.87)分,两者比较差异无统计学意义(P=0.658).问卷调查的10个条目,回答为“好”的比例均超过75％,其中SSP的配合程度、SSP无暗示性语言或动作、能激发学习兴趣3个条目,回答为“好”的比例超过90％.结论引入SSP开展PBL教学能明显提高学生临床分析、解决问题的能力,但对于学生的基础理论知识掌握度影响不明显;SSP可以替代职业标准化病人进行PBL教学.
목적 탐토의학생작위표준화병인(student as standardized patients,SSP)재외과학견습중개전이문제위기출적학습(problem-based learning,PBL)적교학효과.방법 선취2008급본과림상의학전업161명학생위연구대상,안자연반수궤분위PBL조화이수과위기출적학습(lecture-based learning,LBL)조.PBL조(81인)인입SSP개전PBL교학,LBL조(80인)안LBL진행견습.견습결속시대2조학생진행이론고핵,병대PBL조학생진행문권조사;수거록입SPSS13.0연건진행통계분석,비교2조차이,계량자료채용t검험,계수자료용빈수여구성비묘술.결과 이론고핵결과현시PBL조병안분석평균성적위(37.35±5.95)분,명현고우LBL조적(33.25±4.89)분(P=0.001);PBL조총평성적위(71.20±8.67)분,역고우LBL조적(67.79±9.87)분(P=0.018);2조선택제평균성적분별위(33.85±5.05)、(34.24±6.87)분,량자비교차이무통계학의의(P=0.658).문권조사적10개조목,회답위“호”적비례균초과75％,기중SSP적배합정도、SSP무암시성어언혹동작、능격발학습흥취3개조목,회답위“호”적비례초과90％.결론 인입SSP개전PBL교학능명현제고학생림상분석、해결문제적능력,단대우학생적기출이론지식장악도영향불명현;SSP가이체대직업표준화병인진행PBL교학.
Objective To investigate the effect of taking medical students as standardized patients(SSP) on problem based leaming(PBL) teaching in clerkship.Methods Totally 161 students (grade 2008) selected from clinical medical department was divided into PBL group(n=81) and lecture-based learning(LBL) group(n=80).SSP was introduced into PBL teaching and LBL group was taught by LBL.After the clerkship,theory test was conducted in two groups and questionnaire was given to LBL group.Statistical analyses were conducted by SPSS 13.0,measurement data were analyzed by t test and enumeration data were described by frequency and constituent ratio.Results Theory test results showed that the average score of medical record analysis was (37.35 ± 5.95) in PBL group,much higher than (33.25 ± 4.89) in LBL group(P=0.001) ;the total score was (71.20 ± 8.67) in PBL group,much higher than that of (67.79 ± 9.87) in LBL group(P=0.018) as well.The average scores of choice question in 2 groups were (33.85 ± 5.05) and (34.24 ± 6.87),without significant differences(P=0.658).The constituent ratio of answer ‘OK' regarding 10 entries in questionnaire was more than 75％.The constituent ratio of answer ‘OK' regarding 3 entries(SSP matching degree,SSP without implied language or action,stimulating the learning interest) was more than 90％.Conclusions Introducing SSP PBL teaching can improve students' ability of clinical analysis and problem solving but not so effective for the basic theoretical knowledge grasp.SSP could replace standardized patients in PBL teaching.