摘要
目的精准医学是医学未来发展的方向,探讨以精准问题(precisequestion,PQ)设置联合PBL(Problem based learning)教学法是否有利于提高学生对精准医学知识的掌握。方法将昆明医科大学本科临床专业四年级的学生60名随机分为2组:PBL教学组(对照组)和精准问题设置联合PBL教学组(PQ-PBL组)。分别应用PBL教学和PQ-PBL教学对2组同学进行4周教学。其中PQ-PBL组采取精准问题的设置模式:以临床为导向,临床问题与基础问题双向互动,以发展学生的临床推理能力;高层次问题与低层次问题相结合、开放式问题与闭合式问题相结合,以促进学生批判性思维的形成和高层次知识体系的构建。PBL组不采取精准问题设置模式。所有入组学生教学前后分别进行病例分析考核,考核满分为10分。比较2次考核的得分,评估教学前后2组学生对基础知识及精准医学知识的掌握情况,以评价教学效果。结果共60人(PBL组,n=30;PQ-PBL组,n=30)完成研究。2组的年龄差异无统计学意义[PBL组:(23.17±1.05)岁;PQ-PBL组:(23.07±1.03)岁,P=0.736],性别构成亦无差异(P=0.606);教学前2组比较,无论是基础知识或精准医学知识方面,2组得分均差异无统计学意义。教学前后组内比较显示,PBL组的基础知识得分高于教学前[教学后:(6.00±1.31)分;教学前:(5.13±1.43)分,P=0.020],PBL组的精准医学知识得分亦明显高于教学前[教学后:(4.40±2.06)分;教学前:(3.53±1.28)分,P=0.035];PQ-PBL组的基础知识得分高于教学前[教学后:(6.70±1.24)分;教学前:(5.47±1.33)分,P=0.001],PQ-PBL组的精准医学知识得分亦明显高于教学前[教学后:(5.57±1.48)分;教学前:(3.67±1.54)分,P<0.001]。教学后组间比较显示,PQ-PBL组的基础知识得分明显高于PBL组[PQ-PBL组:(6.70±1.24)分;PBL组:(6.00±1.31)分,P=0.038],精准医学知识得分亦显著高于PBL组[PQ-PBL组:(5.57±1.48)分;PBL组:(4.40±2.06)分,P=0.015]。结论精准问题设置结合PBL教学法可以使学生更好地掌握精准医学知识,有利于未来精准医学的发展。
Objective To explore whether the problem based learning(PBL) teaching based on problem setting is conducive to improve students’ grasp of precision medical knowledge. Methods Sixty undergraduates were the fourth grade students of Kunming Medical University and were randomly assigned to PBL teaching group(PBL group) and precise question setting combined with PBLteaching group(PQ-PBL group) equally. All enrolled students were assessed in week 1 to assess their grasp of basic knowledge and precisely medical knowledge.Then the two groups were taught for 4 weeks with different teaching methods.In the PQ-PBL group, the setting of precise questions was clinically oriented, and the two-direction interaction between clinical and basic questions was set to improve students’ clinical reasoning ability. In addition, the combination of high-and low-level questions and the combination of open questions and closed questions were designed to promote the formation of critical thinking and the construction of high-level knowledge system.The PBL group did not adopt the precise problem setting.Review again in sixthweek.Compare the assessment scores of the two groups. Results A total of 60 people(PBL group,n = 30;PQ-PBL group,n = 30) completed the study. There was no difference in age between the two groups[PBL group:(23.17±1.05) years old;PQ-PBL group: (23.07±1.03) years old,P = 0.736]. There was no difference in scores between the two groups before teaching, no matter it was basic knowledge or precisely medical knowledge.The results of intra-group comparison showed that the score of basic knowledge in post-teaching of PBL group was higher than that in pre-teaching[(6.00±1.31) vs(5.13±1.43), P = 0.020], the score of precision medical knowledge in post-teaching of PBL group was also significantly higher than that in pre-teaching [(4.40±2.06) vs(3.53±1.28), P = 0.035];The score of basic knowledge in post-teaching of PQ-PBL group was higher than that in pre-teaching [(6.70 ±1.24) vs(5.47 ±1.33), P = 0.001], the precision medical knowledge score in post-teaching of PQ-PBL group was also significantly higher than that pre-teaching [(5.57 ± 1.48) vs(3.67 ±1.54), P < 0.001].The results of comparison between groups in post-teaching showed that the score of basic knowledge in the PQ-PBL group was significantly higher than that in the PBL group[PQ-PBL group: (6.70 ±1.24);PBL group:(6.00± 1.31),P = 0.038 ]. Most importantly, the score of precision medical knowledge in PQ-PBL group was significantly higher than that in PBL group [(5.57 ± 1.4) vs(4.40 ± 2.06),P = 0.015].Conclusion PQ-PBL method can help students master precision medical knowledge better. It may be conducive to the development of precision medicine in future.
作者
孙士波
胡笑甜
何慧琳
业秀林
汪矗
杜晓华
罗壮
方雁
张冬先
SUN Shi-bo;HU Xiao-tian;HE Hui-lin;YE Xiu-lin;WANG Chu;DU Xiao-hua;LUO Zhuang;FANG Yan;ZHANG Dong-xian(Dept.of Pulmonary and Critical Care Medicine,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Basic Medical College,Kunming Medical University,Kunming Yunnan 650500,China;Institute of Forensic,Kunming Medical University,Kunming Yunnan 650500,China)
出处
《昆明医科大学学报》
CAS
2019年第12期140-145,共6页
Journal of Kunming Medical University
基金
云南省教育厅科学研究基金资助项目(2017zzx201)
云南省教育科学“十二五”规划基金资助项目(BD14005)
昆明医科大学教研教改基金资助项目(2017-JY-Y-040)
关键词
教育策略
问题建立
问题式学习
精准医学
Educational strategies
Question establish
Problem-based learning
Precision medicine
