混合式教学模式在心血管内科临床医学实习中的场景化组合应用^*

The scenario-based application of blended teaching model in clinical medical internship of cardiovascular medicine

摘要

目的 探索叙事医学模式下案例式教学(CBL)联合小组式教学(TBL)的情景模拟混合式教学在心血管内科临床医学实习中的场景化组合应用。方法 选取2024年7月—11月于吉林大学第一医院心血管内科实习的90名本科生作为研究对象,随机分为对照组(传统授课式教学)和研究组(叙事医学模式下CBL联合TBL的情景模拟混合式教学)各45人。结果 实习结束后,研究组理论成绩和技能成绩均高于对照组(P<0.05),且技能成绩中心电图阅读成绩和临床综合技能成绩均高于对照组(P<0.05)。调查问卷结果显示,研究组的综合能力自我评价各项评分均高于对照组(P<0.05);研究组对于本轮实习收获达到期望值、精心设计程度、实习过程生动能够激发学习兴趣、有助于个人能力提升、赞成这种实习方式、认为该模式实习值得推广的评价等级均高于对照组(P<0.05)。结论 灵活应用叙事医学模式下CBL联合TBL的情景模拟混合式教学场景化的组合不仅可有效强化实习生的临床思维与诊疗胜任力,还对医学实践教育改革具有推广价值。

Abstract

Objective To explore the contextualized integration of scenario-based simulation teaching combining case-based learning (CBL) with team-based learning (TBL) under the narrative medicine model during clinical internships in cardiovascular medicine. Methods A total of 90 undergraduate students undergoing clinical rotations in the Department of Cardiovascular Medicine at the First Hospital of Jilin University from July to January 2024 were randomly assigned to either a control group (lecture-based teaching) or an experimental group (scenario-based simulation blended teaching integrating CBL and TBL under the narrative medicine model), each comprising 45 participants. Results Post-internship assessments revealed that the experimental group outperformed the control group in both theoretical scores and skill assessments (P<0.05). Specifically, the experimental group demonstrated superior performance in electrocardiogram interpretation and clinical comprehensive skills (P<0.05). Survey results indicated that the experimental group scored higher than the control group on all self-assessment items of comprehensive competence (P<0.05). The experimental group also rated higher than the control group in the following areas: meeting expectations for the internship, level of meticulous design, vividness of the internship process in stimulating learning interest, contribution to personal competence enhancement, approval of this internship approach, and belief that this model is worth promoting (P<0.05). Conclusion The flexible application of a scenario-based blended teaching approach combining CBL with TBL under the narrative medicine model not only effectively strengthens interns' clinical reasoning and diagnostic competence but also holds significant value for promoting reforms in medical practice education.

关键词

教学模式 / 叙事医学 / 案例式教学 / 小组式教学 / 情景模拟

Key words

Clinical teaching / Narrative medicine / Case-based learning / Team-based learning / Scenario-based simulation

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基金资助

^*吉林省教育科学规划课题(ZD24100,GH24716);吉林省高教科研资助项目(JGJX24D0050,JGJX25D0031);吉林大学课程思政“学科育人示范课程”(SK2023061);吉林大学人工智能赋能本科教育教学改革专项课题(24AI062Y)