案例式问题导向学习法应用于超声诊断实践课程中的问题及改进方案

摘要

Objective To discuss the problems and improve method of problem based learning (PBL) integrated with case based teaching (CBT) in teaching of ultrasound practice course. Methods Thirty-nine students were divided into 3 teams evenly. PBL integrated with CBT was scheduled and taken. After this course, the feedback was collected from students, instructors and supervisors. Results This study described some problems: ①Time devision in this instructional design was irrational. ②It looked like a common instructional design of clinical courses, not specific for ultrasonic students that this one in the content. ③There was no special emphasis on analysis of sonogram. ④The number of sonogram was not enough for learning, and there was no sonograms prepared for normal and differential diagnosis. ⑤The disease was rather difficult for theses students, only 5. 13% (2/39) of them gave the right answer. ⑥Asking question randomly during the discussion made some students uncomfortable. Some suggestions to improve teaching: ①The time of sonogram analysis needs to be increased to 40%. ②Put the part of sonogram analysis on the front of the discussion session. ③The instructors must guide students to focus their mind on sonogram. ④Increasing the sonogram about normal and differential diagnosis. ⑤Simple and typical sonogram needs to be selected. ⑥Let students have more time to prepare for the presentation and give them some guidance, the instructors should not call on student randomly during the discussion as possible. Conclusion The teaching method of improving CBT and PBL will be more appropriate for ultrasound practice course.%目的 探讨问题导向学习法(PBL)结合案例法教学设计(CBT)应用于超声诊断实践课程中出现的问题以及改进方案.方法 将超声诊断专业实践见习组中39名学生平均分为3组进行案例式PBL教学,教学后收集学生、授课教师及教学督导的反馈意见.结果 本次教学设计存在问题:①超声图像分析时间安排较少；②内容安排未特定针对超声诊断专业；③讨论内容未突出超声专业的侧重点；④选用的超声声像图数量少,缺乏正常对照图及疾病鉴别诊断图；⑤选题难度大,学生诊断正确率仅为5.13％(2/39);⑥部分学生对课堂随意抽问感到不安.改进对策:①阅读及分析超声图像的时间增加至讨论学时的40％；②将超声图像分析放在分组讨论的前两项；③带教老师应引导学生将讨论重点放在阅读超声声像图、识别异常表现上；④增加正常的以及相关鉴别诊断的声像图；⑤选择浅显易懂、易于掌握的典型病例；⑥课前给予学生更多准备时间并进行相应指导,课中尽可能减少抽问.结论 改进后的案例式PBL教学方案将更适合超声诊断专业的实践教学.