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Application of Flipped Classroom Combined with Case-based Collaborative Learning in Medical Teaching in the Experimental Eight-year Medical Doctor Program
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摘要:
目的 评估翻转课堂结合基于案例的协作学习(case-based collaborative learning, CBCL)模式在新型临床医学八年制(“4+4”试点班)学生教学中的实施效果。 方法 选取北京协和医学院2019、2020级“4+4”试点班全体学生为研究对象。将翻转课堂结合CBCL的小组教学模式应用于内科消化病学(炎性肠病)授课中。基于课堂上CBCL小组讨论前后的知识测验结果评估学生对相关知识的掌握程度，并采用Likert量表对教学效果进行量化反馈。 结果 共纳入45名“4+4”试点班医学生，其中2019级20人、2020级25人; 课前完成知识测验42人，课后完成知识测验45人。经翻转课堂结合CBCL的小组教学后，学生对炎性肠病发病年龄，溃疡性结肠炎内镜下严重程度、病变范围、鉴别诊断、治疗原则以及克罗恩病临床表现、治疗原则相关题目的回答正确率均有显著提高(P均＜0.001);13道知识测验题回答正确率显著提高[33.3(26.2, 85.7)%比93.3(71.1, 95.6)%, P=0.001]。30名(66.7%，30/45)医学生完成教学效果反馈，其对翻转课堂教学形式的认可度评分为(4.00±0.74)分。 结论 翻转课堂结合CBCL小组教学模式可明显提高新型临床医学八年制学生的教学效果，学生反馈对该教学模式整体较满意。 Abstract:Objective To evaluate the effect of flipped classrooms combined with case-based collaborative learning (CBCL) in teaching internal medicine in the experimental eight-year medical doctor program[new academic "4+4" pilot class(NAPC)]. Methods Medical students from the class 2019 and class 2020 of NAPC in Peking Union Medical College were selected as the objects. A teaching method of flipped classroom combined with CBCL was applied in the course of internal medicine (inflammatory bowel disease). Through the knowledge test before and after class discussion, the students' mastery of relevant knowledge was evaluated, and the Likert scale was used to give quantitative feedback on the teaching effect. Results A total of 45 medical students from NAPC were enrolled, including 20 students from class 2019 and 25 students from class 2020.A total of 42 students completed the knowledge test before class and 45 students completed the knowledge test after class.After the flipped classroom combined with CBCL, the students' correct answer rate had significantly increased on questions about the age of inflammatory bowel disease onset, severity of ulcerative colitis endoscopy, lesion range, differential diagnosis, treatment principles, clinical manifestations of Crohn's disease, and treatment principles(all P < 0.001); the median correct answer rate of all questions significantly increased [33.3(26.2, 85.7)% vs. 93.3(71.1, 95.6)%, P=0.001]. Thirty students(66.7%, 30/45)completed the post-class feedback; the overall satisfaction score of the teaching mode of flipped classroom was (4.00±0.74) points. Conclusions The teaching mode of flipped classroom combined with CBCL can significantly improve learning outcome in medical students of the experimental eight-year program. Students are generally satisfied with the teaching mode. 作者贡献：羽思负责数据收集、论文撰写; 李玥、钱家鸣负责研究设计、课程设计与实施、论文修订; 李骥、谭蓓、杨莹韵、李航参与课程与研究设计。利益冲突：所有作者均声明不存在利益冲突 -
表 1 翻转课堂结合CBCL小组讨论问题
问题序号 具体内容 1 患者病史、体格检查、辅助检查 2 患者主要症状的病理生理机制及病因 3 患者的诊断和鉴别诊断 4 患者疾病严重程度评估 5 主要治疗原则 CBCL：基于案例的协作学习 
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表 2 翻转课堂结合CBCL小组教学课堂前后IBD知识测验结果比较
问题序号 测验内容 课前知识测验回答正确率[n=42，n(%)] 课后知识测验回答正确率[n=45，n(%)] P值 1 IBD发病年龄 14(33.3) 32(71.1) ＜0.001 2 IBD治疗目标 38(90.5) 43(95.6) 0.423* 3 UC临床表现 9(21.4) 15(33.3) 0.214 4 UC内镜下严重程度 6(14.3) 42(93.3) ＜0.001 5 UC内镜下病变范围 12(28.6) 42(93.3) ＜0.001 6 UC鉴别诊断 12(28.6) 38(84.4) ＜0.001 7 UC治疗原则 11(26.2) 27(60.0) ＜0.001 8 CD临床表现 7(16.7) 25(55.6) ＜0.001 9 CD诊断依据 39(92.9) 44(97.8) 0.349* 10 CD内镜下鉴别诊断 36(85.7) 43(95.6) 0.148* 11 CD内镜下鉴别诊断 36(85.7) 43(95.6) 0.148* 12 CD内镜下鉴别诊断 41(97.6) 41(91.1) 0.362* 13 CD治疗原则 20(47.6) 42(93.3) ＜0.001 CBCL：同表 1; IBD：炎性肠病; CD：克罗恩病; UC：溃疡性结肠炎; *采用Fisher精确概率法
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表 3 教学效果评估内容及反馈结果(n=30)
编号 教学效果反馈评估内容 分值(分) 1 翻转课堂整体架构合理 3.80±1.13 2 课前学习炎症性肠病课件视频的时间长度适宜 2.93±1.17 3 课前学习炎症性肠病课件内容对课上讨论有很大帮助 4.13±0.82 4 课堂病例讨论的问题具有一定挑战性 3.70±0.79 5 课前、课后测验对重要知识点的掌握有帮助 3.90±1.03 6 对翻转课堂形式整体满意 4.00±0.74 7 对指导老师能力满意 4.63±0.49 8 对小组讨论的形式满意 3.77±1.04 9 是否同意将课堂讨论发言的参与程度纳入形成性评价 3.76±1.17
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[1] Lage MJ, Platt GJ, Treglia M. Inverting the Classroom: A Gateway to Creating an Inclusive Learning Environment[J]. J Econ Educ, 2000, 31: 30-43. doi: 10.1080/00220480009596759 [2] Bouwmeester RAM, de Kleijn RAM, van den Berg IET, et al. Flipping the medical classroom: Effect on workload, interactivity, motivation and retention of knowledge[J]. Compu Educ, 2019, 139: 118-128. doi: 10.1016/j.compedu.2019.05.002 [3] 盛瑞, 王燕, 薛洁, 等. 基于PBL/CBL的微课翻转课堂在药理学教学中的应用[J]. 药学教育, 2018, 34: 37-40. https://www.cnki.com.cn/Article/CJFDTOTAL-YXJO201803010.htm [4] 郭春红, 薛志林, 常青, 等. 翻转课堂联合CBL在临床本科儿科教学中的探索[J]. 中国医学教育技术, 2016, 30: 702-725. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXJ201606023.htm [5] 朱壮彦, 郭春红, 富晓敏, 等. 翻转课堂联合CBL教学法在临床妇产科教学中的优势探讨[J]. 中国高等医学教育, 2017, 7: 115-116. https://www.cnki.com.cn/Article/CJFDTOTAL-ZOGU201707061.htm [6] Krupat E, Richards JB, Sullivan AM, et al. Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial[J]. Acad Med, 2016, 91: 723-729. doi: 10.1097/ACM.0000000000001004 -
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