摘要
目的探讨改良案例教学(CBL)联合分层递进教学在核医学住院医师规范化培训中的应用效果。方法选取2018年至2023年在本院核医学基地轮转的43名住培医师为研究对象,按入科顺序分为试验组(n=22)和对照组(n=21)。对照组采用传统以教师为中心的教学模式,按培训年限分为低年级和高年级组。试验组实施“改良CBL联合分层递进教学”:首先通过多维评估(理论测试+标准化病例分析)将学员科学划分为初阶、中阶、高阶三个层级;随后为不同层级设定递进式教学目标,并发布嵌入阶梯化学习任务的真实临床案例;教学过程中采用同质分组与异质分组相结合的动态讨论模式,并由教师提供个性化指导;最后通过过程性评价实行动态层级调整。培训结束后,比较两组学员的出科考核成绩(包括专业基础理论和实践技能)及教学满意度。结果试验组学员的出科考核总成绩高于对照组[(86.90±6.78)vs.(75.09±8.45)],差异有统计学意义。在实践技能考核方面,试验组学员在影像征象描述[(22.34±2.56)vs.(19.85±3.12)]、定位诊断[(23.01±2.11)vs.(20.12±2.98)]、定性诊断[(22.89±2.67 vs.18.67±3.45)]和鉴别诊断[(21.56±2.89)vs.(17.23±3.78)]等模块得分均高于对照组(P<0.01)。教学满意度调查显示,试验组学员在理论知识掌握、临床思维、影像判读、学习主动性等9个方面的满意度评分均高于对照组(P<0.05)。结论改良CBL联合分层递进教学能有效提升核医学住培医师的出科考核成绩、临床实践技能及教学满意度,值得推广。
Objective To explore the application effects of improved case-based learning(CBL)combined with hierarchical and progressive teaching in the standardized training of nuclear medicine resident physicians.Methods A total of 43 resident physicians who rotated in the nuclear medicine base of our hospital between 2018 and 2023 were selected as the research subjects and divided into an experimental group(n=22)and a control group(n=21)according to the order of enrollment.The control group received the traditional teacher-centered teaching model and was divided into junior and senior subgroups according to the training years.The experimental group received the improved CBL combined with hierarchical and progressive teaching.First,through multidimensional evaluation(theoretical testing+standardized case analysis),the students were scientifically divided into preliminary,intermediate,and advanced levels.Subsequently,progressive teaching objectives were set for different levels,and real clinical cases embedded with hierarchical learning tasks were published.During the teaching process,a dynamic discussion mode combining homogeneous and heterogeneous grouping was adopted,and personalized guidance was provided by the teachers.Finally,dynamic hierarchical adjustment was implemented through process evaluation.After the training,the two groups were compared in terms of exit assessment performance(including professional basic theory and practical skills)and teaching satisfaction.Results The total score of the exit assessment of the experimental group was higher than that of the control group[(86.90±6.78)vs.(75.09±8.45)],and the difference was statistically significant.In terms of practical skill assessment,the experimental group scored higher than the control group in modules such as imaging symptom description[(22.34±2.56)vs.(19.85±3.12)],localization diagnosis[(23.01±2.11)vs.(20.12±2.98)],qualitative diagnosis[(22.89±2.67 vs.18.67±3.45)],and differential diagnosis[(21.56±2.89)vs.(17.23±3.78)](P<0.01).The teaching satisfaction survey showed that the satisfaction scores of the experimental group were higher than those of the control group in nine domains,including theoretical knowledge mastery,clinical thinking,image interpretation,and learning initiative(P<0.05).Conclusions The improved CBL combined with hierarchical and progressive teaching can effectively improve the exit assessment performance,clinical practice skills,and teaching satisfaction of nuclear medicine resident trainees,and is worthy of promotion.
作者
张君
郭烽
文涛
康菁芬
吴琼
袁玮
孙阳
梁英魁
Zhang Jun;Guo Feng;Wen Tao;Kang Jingfen;Wu Qiong;Yuan Wei;Sun Yang;Liang Yingkui(Department of Nuclear Medicine,The Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China;Xinxing Bridge Clinic of Southern Medical District,Chinese PLA General Hospital,Beijing 100084,China)
出处
《中华医学教育探索杂志》
2025年第10期1357-1364,共8页
Chinese Journal of Medical Education Research
基金
解放军总医院第六医学中心创新培育基金项目(CXPY202325)
首都临床特色诊疗技术研究及转化应用项目(Z221100007422128)。
关键词
核医学
住院医师规范化培训
案例教学
分层递进
教学改革
Nuclear medicine
Standardized training of residents
Case-based learning
Hierarchical and progressive
Teaching reform
