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引用次数: 0
摘要
背景：中国本科医学教育在理论与实践结合方面存在明显差距，32.7%的毕业生需要补习程序性培训。目的：实施和评价以解决问题和实践技能为目标的能力本位改革。方法：采用单中心随机对照试验（中国安徽；2023-2024），将180名医学本科生随机分为对照组（传统教学法，n = 90）和干预组（改革课程：40%实践导向内容，PBL/TBL/CBT整合）。评估使用与欧安组织一致的工具（临床检查表：Cronbach’s α = 0.89；病例分析标准：κ = 0.85）。结果：干预组理论评分有显著提高（78.7±3.9 vs 68.3±4.8,t = -17.78, P < 0.01, d = 2.39）；临床技能优秀（80.4% vs 60.2%; χ 2 = 25.93, P < 0.001, OR = 2.67）；PBL适应性（70.1% vs 42.3%; χ²= 9.0,P < 0.05）。结论：这一改革弥补了理论与实践的差距，提高了临床决策能力，需要机构的支持才能实现可扩展性。
Implementing Undergraduate Medical Education Reform to Enhance Problem-Solving and Practical Skills.
Background: Undergraduate medical education in China faces significant gaps in integrating theory with practice, with 32.7% of graduates requiring remedial procedural training.
Objective: To implement and evaluate a competency-based reform targeting problem-solving and practical skills.
Methods: In a single-center RCT (Anhui, China; 2023-2024), 180 medical undergraduates were randomized to control (traditional pedagogy, n = 90) or intervention groups (reformed curriculum: 40% practice-oriented content, integrated PBL/TBL/CBT). Assessments used OSCE-aligned tools (clinical checklists: Cronbach's α = 0.89; case analysis rubrics: κ = 0.85).
Results: Intervention group showed significant improvements: theoretical scores (78.7 ± 3.9 vs 68.3 ± 4.8; t = -17.78, P < 0.01, d = 2.39); clinical skill excellence (80.4% vs 60.2%; χ² = 25.93, P < 0.001, OR = 2.67); PBL adaptability (70.1% vs 42.3%; χ² = 9.0, P < 0.05).
Conclusion: This reform bridges theory-practice gaps and enhances clinical decision-making, requiring institutional support for scalability.
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