“大带小”教学模式在肌电图临床教学中的探索及效果评价

Near Peer Learning in Neurology Residency Training on Electromyography

  • 摘要:
    目的 探索“大带小”教学(near peer learning,NPL)模式在神经科住院医师一阶段规范化培养(下文简称“规培”)“肌电图”学习模块中的实施效果。
    方法 北京协和医院神经科于2020年11月至2024年3月期间在北京市一阶段规培生神经系统辅助检查教学中探索实施NPL教学模式。具体教学方法:每年1次,主要以第三年规培生作为“主讲”,第一、二年规培生作为“学员”进行肌电图学习,客观评价方式为随机抽取试卷进行入口和出口理论测试,对比规培生培训前后成绩变化;主观评价方式为规培生通过问卷对课后学习感受进行多维度评分,以了解该模式对其专业知识、自信程度等方面的作用。
    结果 研究期间共开展4次NPL教学,累计83人次规培生参加了该教学项目。其中,临床医学博士后24人次,专业型研究生52人次,基地规培生7人次。结果显示,规培生出口平均成绩显著高于入口成绩(74.33±2.43)分比(70.11±2.49)分,P=0.005。亚组分析显示,作为“学员”的规培生(73.84±20.53)分比(70.29±21.46)分,P=0.020、专业型研究生(74.04±22.51)分比(68.97±21.40)分,P=0.009、第一年规培生(70.19±4.02)分比(63.59±3.59)分,P=0.040、第一次参加该课程的规培生(65.23±3.24)分比(60.97±3.21)分,P=0.030其出口成绩较入口成绩提高显著。问卷调查结果显示,96.69%的“学员”规培生对课程内容、形式及效果表示满意或很满意,100%的规培生感觉“能力有实质性提高”。
    结论 NPL模式有助于神经科住院医师一阶段规培学员夯实神经系统辅助检查相关基础知识,提高解决临床实际问题的能力,值得在其他教学项目和教学基地中推广应用。

     

    Abstract:
    Objective To explore the effectiveness of "near peer learning" (NPL) in the electromyography(EMG)teaching module for neurology residents.
    Methods The Department of Neurology, Peking Union Medical College Hospital implemented an NPL instructional design for a course on EMG for residents from November 2020 to March 2024. This teaching session was held annually, in which senior residents instructed juniors who were 1 or 2 years earlier in their training. The residents participated in the pre-course/post-course tests and completed a feedback survey at the end of the session. This evaluation method was used to understand the effectiveness of the NPL intervention in EMG teaching.
    Results Over four years, a total of 83 residents participated. Among them, there were 24 postdoctoral students, 52 postgraduates and 7 junior residents. The results showed that the post-course test scores were significantly improved compared with pre-course test scores (74.33±2.43 vs. 70.11±2.49, P=0.005), with the most remarkable improvements seen for "tutees" (73.84±20.53 vs. 70.29±21.46, P=0.020), postgraduates (74.04±22.51 vs. 68.97±21.40, P=0.009), first-year residents (70.19±4.02 vs. 63.59±3.59, P=0.040) and first-time participating residents (65.23±3.24 vs. 60.97±3.21, P=0.030). The post-program feedback showed that both tutors and tutees thought highly of NPL, believing that it enabled them to gain knowledge and helped them to improve teaching skills.
    Conclusions The NPL intervention is suitable for the teaching of EMG, because of its contribution to knowledge acquisition and basic clinical skills improvement. The NPL is worth replicating in other teaching and learning programs.

     

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