PBL结合与情景教学在呼吸科医学生实习中的应用价值

目的:研究"以问题为基础"的学习模式(PBL)结合与情景教学在呼吸科医学生实习中的应用价值。方法:将PBL结合与情景教学应用于呼吸科医学生实习中,以此来进行带教实习。结果:PBL结合与情景教学能较好的促进学生的学习能力,使学生由被动学习角色转变为主动学习角色;学生对PBL结合与情景教学具有较高的学习兴趣,能提高学习效率,增加对基础知识掌握的灵活度。结论:PBL结合与情景教学在呼吸科医学生实习中具有较好的应用价值,能充分利用临床资源,培养学生学习能力和临床思维。     

PBL+LBL教学模式在留学生医学微生物学教学中的实践

由于留学生的特殊性导致他们对传统教学模式的不适应,医学微生物学的课程特点使留学生学习掌握相关知识较困难,有必要探索好的教学方法,提高教学质量。我国传统的LBL教学模式和国际上流行的PBL教学模式各有优缺点,我们融合PBL和LBL的优点,互补其缺点,对留学生医学微生物学课程采取PBL+LBL教学模式,既发挥PBL教学法打破学科界限,容易调动学生学习积极性,注重培养学生自主学习和团结协作能力的特点,又结合LBL教学法传授知识系统、完整,培养学生基础理论扎实等优势。教学实践证明,PBL+LBL教学法运用于留学生医学微生物学教学,能激发留学生学习兴趣,在增强留学生对医学微生物学基础理论和基本技能掌握的同时,培养留学生知识整合的能力及创新思维的医学综合能力,提高教学质量。     

Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.     

Medical student selection: a tentative attempt to establish a code of practice.

Each year medical schools in the United Kingdom select about 3800 entrants from about 12 000 applicants. The problem of selection is thus substantial, but the objectives, policies, and practices of different medical schools differ sharply and details of the procedures used are rarely made clear. There is no reliable or up-to-date information available for schools, careers of advisers, and prospective candidates to keep abreast of these practices and policies and of changes made to them. A code of practice for medical student selection might be helpful and would not only facilitate discussion about the appropriateness and fairness of the widely differing practices but make it easier to evaluate the procedures used. Such a code should list the academic and personal requirements for the school, state any quotas for types of entrants, and describe the selection procedures.     

以问题为中心的学习方法在高职社区问诊技能教学中的应用

目的:探讨以问题为中心的教学方法(problem-based learning,PBL)在高职社区问诊教学中的效果,寻求更有效的现代医学教育方法。方法:在高职社区问诊技能学习中开展以问题为中心的教学方法(PBL),分析问诊中存在的问题,以提高知识应用与沟通能力。结果:通过对62名高职医学生进行问诊技能和见习报告评分显示,成绩优良比率为89%,满意度调查显示83.87%的高职医学生对PBL教学方法满意。PBL教学可以让高职医学生灵活的利用自已的时间,进行比较主动的学习,可以更好的发现高职医学生在问诊见习中存在的问题,有利于提高高职医学生的问诊技能及医患沟通能力,但实施中所需时间较长,占用课时多。结论:PBL教学对高职医学生的主动学习能力、问诊技能及医患沟通能力的提高有利,医学生对PBL教学方法满意度高。在医学教育中可以将PBL教学和传统教学方法结合起来,以在有效的时间里达到更好的教学效果。     

提高临床实习教学质量的实践与体会

临床实习是医学生大学教育阶段的重要组成部分,是医学生向临床医生转型的过渡时期。临床实习质量的高低直接关系到医学生的培养质量。在实习期间培养出扎实的临床基本功、科学的临床思维和高尚的医德医风对于医学生而言是非常重要的。同时,临床实习教学也是医学院校及教学医院的工作重心。作为教学医院,我院多年来积极推进教学改革,不断探索提升临床实习质量的方法,部分科室率先开展了PBL等新的教学模式,并取得了卓越的成效。我院领导阶层也通过抓好教学准备、提升带教质量、严格实习考核等方面的工作,全面提升了临床实习教学质量,从而提高了医学生的综合素质,也为提高执业医师考试通过率打下了坚实的基础。     

What can experience add to early medical education? Consensus survey

Objective To provide a rationale for integrating experience into early medical education (“early experience”).Design Small group discussions to obtain stakeholders'' views. Grounded theory analysis with respondent, internal, and external validation.Setting Problem based, undergraduate medical curriculum that is not vertically integrated.Participants A purposive sample of 64 students, staff, and curriculum leaders from three university medical schools in the United Kingdom.Results Without early experience, the curriculum was socially isolating and divorced from clinical practice. The abruptness of students'' transition to the clinical environment in year 3 generated positive and negative emotions. The rationale for early experience would be to ease the transition; orientate the curriculum towards the social context of practice; make students more confident to approach patients; motivate them; increase their awareness of themselves and others; strengthen, deepen, and contextualise their theoretical knowledge; teach intellectual skills; strengthen learning of behavioural and social sciences; and teach them about the role of health professionals.Conclusion A rationale for early experience would be to strengthen and deepen cognitively, broaden affectively, contextualise, and integrate medical education. This is partly a process of professional socialisation that should start earlier to avoid an abrupt transition. “Experience” can be defined as “authentic human contact in a social or clinical context that enhances learning of health, illness or disease, and the role of the health professional.”     

八年制医学生妇产科临床实习教学法探讨

八年制医学生临床实习是理论应用于临床实践的过程,是八年制医学生教学的重点。传统”填鸭式”的教学方法限制了八年制医学生的进一步发展,不能满足高素质教育的要求。PBL教学法是以问题为基础的教学方法。大多研究表明,PBL影响知识的应用而不影响知识的获得,而EBM一循证医学的思维恰好是医学生获取知识的最佳指导思想。本文将PBL教学法和EBM思维结合到八年制医学生妇产科实际临床教学中发现,虽然在理论考试成绩上无明显差异,但在临床病例分析能力、临床证据采集能力、教学方式满意程度等方面均优于仅用PBL或者是仅用EBM的教学组。PBL教学法联合EBM思维更能提高八年制医学生分析问题、解决问题的能力,值得进一步推广应用。     

LBL联合PBL教学法在临床医学专业药理学教学中的应用

LBL联合PBL的教学模式是一种"教为主导,学为主体,教与学并重"的综合教学方法。在临床医学专业的药理学教学中合理应用LBL联合PBL教学法,即采用LBL教学法讲授完理论知识后开设PBL病例讨论课。选取2011级五年制临床医学专业的学生为实验组,采用LBL联合PBL教学模式,2010级五年制临床医学专业的学生为对照组,采用传统LBL教学模式,对两组进行教学效果评估比较。结果显示与传统LBL教学法相比较,LBL联合PBL的教学法能显著提高学生的学习成绩,问卷调查分析结果显示LBL联合PBL的教学法能明显提高学生的综合能力。药理学授课中应用LBL联合PBL教学法充分调动了学生的积极性,培养了学生自主学习能力,分析问题、解决问题的能力和临床思维能力,对培养创新型医学人才具有重要意义。     

Problem-based learning and the medical school: another case of the emperor's new clothes?

For almost four decades, problem-based learning (PBL) has been the stated cornerstone of learning in many medical schools. Proponents of PBL cite the open nature of the learning experience where students are free to study in depth, unencumbered by the burdens of broad courses based on the memorization of facts; detractors, on the other hand, cite the lack of breadth and factual knowledge required for professional qualification. Both points of view have merit. Professional schools have a different set of needs and requirements, and it is these that drive the curriculum and learning philosophies. The constraints of the professional school are so different from those of the purely academic environment that PBL, while admirably suited to the latter, is just problem solving in the former.     

关于在神经外科实习教学中采用Web-CPBL教学模式的探讨

在医学生临床实习带教过程中,神经外科实习教学由于其教学内容具有专业性强、信息量大、知识更新快的特点,与其它专业相比更具难度,教学效果往往难达到预期水平。Web-CPBL教学模式,是将传统的PBL教学理念与网络信息技术有机融合,延伸和发展出的一种新型教学模式。在神经外科实习教学中,巧妙得当的借力于网络资源平台,有助于打破临床师资缺乏、实操场地不足的局限,能更充分的发挥PBL教学的优势。此模式在培养和锻炼医学生临床思维能力的同时,也帮助他们尽早养成主动学习、善于协作、乐于共享的良好学习习惯,提高其医学人文素养。     

组织学与胚胎学PBL教学对学生创新能力的培养

中国医科大学组织学与胚胎学教研室承担了CMB03-#793项目,连续五年在临床医学七年制日文班实施了PBL（problem based learning）的教学模式,根据其教学特点确立了组织学与胚胎学（组胚）PBL教程,编写了＂组织学与胚胎学PBL病例集＂并制作了多媒体课件。学生在PBL中受到启发,激发了主动学习积级性,也制作了多媒体课件。同学课下查阅文献,准备资料。讨论病例分组进行,同学主持。大家踊跃发言,举证说明,用学得的知识,联系组胚理论去解释生命现象并和疾病相联系。我们对实施过PBL教学的几个年级的学生257人进行了追踪问卷调查,结果看出得到明显提高的依次是学生的主动学习的能力,独立查阅资料的能力、拓宽知识面、对相关领域感兴趣、分析解决问题的能力及对知识的理解能力。提高的相关指标就是创新思维的基础和前提。学生拓宽了知识面、开阔了视野,自然就会产生兴趣迸发出学习的生机去主动思维,也就有了分析解决问题的能力。由此产生不同以往的看法和想法,有了新的认识、新的观点和新的所为,丰富的想像力就会迸发出创造力,这些就是创新的萌芽。这是PBL教学带给学生的新的理念。刷新理念将会产生更多的创新。     

浅谈PBL+CBL的教学方法在临床生物化学检验技术教学中的应用

临床生物化学检验技术是医学检验专业学生的必修课之一,是一门实践性和应用性非常强的课程。然而单一的传统教学模式已经不能满足国家应用型人才培养的需求,本文探讨了"问题"结合"案例"的教学方法(PBL+CBL)在临床生物化学检验技术教学中的应用,为培养高素质的医学检验人才提供了教育思路。     

浅谈对医学生临床思维与临床技能提高的培养

为适应目前医学事业发展的需要,医学生的临床思维与临床技能的培养至关重要。在教学中,应不断提高教师自身的业务水平和自身素质,给予学生适当引导和启发,采取灵活多样的教学方式,并鼓励学生学会独立思考能力,激发学生的主动性和创造性,同时理论与实践相结合,推出模拟教学,由此激发学生的学习兴趣;并通过病例的采集归纳和整理,加强基本功的训练。从而提高学生临床思维能力与标准实践技能。     

医学微生物学PBL教学中常见问题与解决对策

PBL(Problem-Based Learning, PBL)是以问题为导向的教学方法, 是一种有效的教学补充手段, 对提高学生的自学能力、交流与合作能力、分析问题解决问题的能力有重要帮助。在PBL教学过程中, 应注意两个重要问题: 一个是教师角色的转换, 从讲授者转为引导者, 教师要把握好角色, 避免过多干涉学生的活动, 防止影响学生的热情与积极性; 同时要时刻让学生意识到自己是PBL教学的主体, 不应过份依赖教师; 另一个重要问题是学生教学活动与教学目标的偏离, 教师要认识、分析影响教学目标实现的常见问题, 有效引导教学活动沿主线向教学目标前进。     

Can learning style predict student satisfaction with different instruction methods and academic achievement in medical education?

The curriculum of our medical school has a hybrid structure including both traditional training (lectures) and problem-based learning (PBL) applications. The purpose of this study was to determine the learning styles of our medical students and investigate the relation of learning styles with each of satisfaction with different instruction methods and academic achievement in them. This study was carried out with the participation of 170 first-year medical students (the participation rate was 91.4%). The researchers prepared sociodemographic and satisfaction questionnaires to determine the characteristics of the participants and their satisfaction levels with traditional training and PBL. The Kolb learning styles inventory was used to explore the learning styles of the study group. The participants completed all forms at the end of the first year of medical education. Indicators of academic achievement were scores of five theoretical block exams and five PBL exams performed throughout the academic year of 2008-2009. The majority of the participants took part in the "diverging" (n = 84, 47.7%) and "assimilating" (n = 73, 41.5%) groups. Numbers of students in the "converging" and "accommodating" groups were 11 (6.3%) and 8 (4.5%), respectively. In all learning style groups, PBL satisfaction scores were significantly higher than those of traditional training. Exam scores for "PBL and traditional training" did not differ among the four learning styles. In logistic regression analysis, learning style (assimilating) predicted student satisfaction with traditional training and success in theoretical block exams. Nothing predicted PBL satisfaction and success. This is the first study conducted among medical students evaluating the relation of learning style with student satisfaction and academic achievement. More research with larger groups is needed to generalize our results. Some learning styles may relate to satisfaction with and achievement in some instruction methods.     

Learning styles of medical students change in relation to time

The aim of the present study was to investigate if any changes exist in the learning styles of medical students over time and in relation to different curriculum models with these learning styles. This prospective cohort study was conducted in three different medical faculties, which implement problem-based learning (PBL), hybrid, and integrated curriculum models. The study instruments were Kolb's Learning Style Inventory (LSI) and a questionnaire describing the students' demographic characteristics. Sample selection was not done, and all first-year students (n = 547) were targeted. This study was designed in two phases. In the first year, the study instruments were delivered to the target group. The next year, the same instruments were delivered again to those who had fully completed the first questionnaire (n = 525). Of these, 455 students had completed the instruments truly and constituted the study group. The majority of the students were assimilators and convergers in both the first and second years. A change in learning style was observed between 2 yr in 46.9% of the students in the integrated curriculum, in 49.3% of the students in the hybrid curriculum, and 56.4% of the students in the PBL curriculum. The least and most changes observed between the learning style groups were in assimilators and divergers, respectively. Curriculum models and other independent variables had no significant effect on the change between learning styles. The learning styles of medical students may change over time. Further followup studies in larger groups are needed to clarify this relation.     

实验动物学教学内容及方法的探索与改进

实验动物学是生命科学研究的基础和支撑条件之一。在医学院校实验动物学的教学中,应以实验动物与动物实验标准化为中心,增加和完善动物模型、分子遗传、胚胎工程及转基因动物等理论内容,紧跟生命科学的发展趋势;同时注重理论教学与实验教学的相互结合,充分利用现代先进的教育技术,以基本实验、综合实验和自主设计实验培养学生的操作能力和创新思维。这些改革措施将对改进实验动物学的教学质量,提高医学院学生的科研水平有重要意义。     

PBL教学法在肾科临床见习中的应用

目的：探讨以问题为基础的教学法（Problem Based learning,PBL）在肾科临床见习教学中的应用价值。方法：首都医科大学宣武医院63名参加内科学肾脏病临床见习的七年制学生随机分成对照组和观察组,对照组采用传统的基于授课的教学法进行教学,观察组用PBL教学法进行教学,比较2组学习成绩的差异;向学生发放问卷调查,调查学生对2种教学方法的认可程度。结果：2组学生的填空题、选择题及简答题成绩比较无显著性差异（P〉0.05）;观察组病例分析题成绩好于对照组（P=0.001）;培养临床思维、激发学习兴趣方面和自主学习能力方面PBL教学法优于传统教学法（P〈0.01）。结论：PBL教学法有助于学生临床思维和临床技能的培养,从而使教学质量得到提高。