基于OBE理念的临床医学生公共卫生能力教学改革与实践

OBE-based teaching reform and practice for enhancing public health abilities of clinical medical students

摘要

针对临床医学教育中“医防融合”教学薄弱、临床医学生公共卫生能力培养不足的问题,本研究以成果导向教育(OBE)理念为指导,开展了教学改革与实践。研究确立了“知识筑基-应用赋能-反馈闭环-能力内化”层层递进的OBE培养目标,并据此反向设计了课程体系:构建模块化课程,重构递进式教学内容,创新多元化教学方法,以及建立形成性与终结性相融合的评价体系。从实践效果看,85%的学生认为教学对其知识应用有“明显的促进和帮助”,88.5%的学生对教学活动表示满意。医师资格考试成绩分析也显示,预防医学模块的知识掌握率优于全国平均水平,应用能力呈逐年上升趋势,初步验证了教学改革的有效性。然而,教学改革仍然面临深层惯性制约、运行困境和制度性短板等现实挑战。本研究为破解“医防融合”教学困境、提升临床医学生公共卫生岗位胜任力提供了可借鉴的经验,后续将围绕理念引领、实施保障和评价机制3个方向持续优化。

Abstract

In response to the challenges of "clinical-preventive integration" in clinical medical education and the insufficient development of students′ public health abilities,a series of teaching reforms and practices were carried out under the guidance of the Outcome-Based Education (OBE) concept. A progressive OBE training goal system was constructed,following the trajectory of "Learn-Master-Improve-Foster". Based on this goal,we backward-designed the curriculum system,including the construction of OBE-oriented modular courses,the restructuring of progressive teaching content,the innovation of diversified teaching methods,and the formation of an integrated formative-summative evaluation system. The results showed that 85% of students believed the teaching had "significant promotion" in deepening their mastering,and 88.5% of students expressed satisfaction with the teaching activities. Meanwhile,the analysis of the National Medical Licensing Examination results indicated that the mastery rate of the preventive medicine module exceeded the national average level,with an upward trend in application abilities year by year,which preliminarily verifies the effectiveness of the reform. However,the reform still faces practical challenges such as deep-seated inertial constraints,operational difficulties,and institutional shortcomings. This study provides a reference experience for solving the teaching dilemma of "clinical-preventive integration" and enhancing the public health professional competence of clinical medical students. Subsequent efforts will focus on three continuous optimization directions:strengthening concept guidance,improving implementation safeguards,and perfecting evaluation mechanisms.

关键词

成果导向教育 / 公共卫生能力 / 临床医学生 / 教学改革

Key words

Outcome-Based Education (OBE) / Public health competence / Clinical medical students / Teaching reform

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基金资助

安徽省高等学校质量工程重点教学研究项目(2020jyxm0885)

安徽医科大学公共卫生学院学科建设项目实验教学课程体系与优化子项目(AHMUSPH-202514)