Objective To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective To evaluate the feasibility and significance of problem-based learning (PBL) in orthopedic internship. Methods A total of 315 students in grade 2002 were involved in PBL during their internship in the Department of Orthopedics at the First Affiliated Hospital of China Medical University, Shenyang, China. Teaching effectiveness was evaluated with a questionnaire and an ability examination. The results of PBL teaching during different semesters were compared, and the feasibil ity and significance of PBL were analyzed. Results Students who participated in PBL were in a dominant position and were more active in the learning process. The PBL pattern could improve students’ ability to identify, analyze and solve problems, and also contribute to fostering and enhancing their clinical thinking. This could help them solve the problems that emerged from the theory curriculum.Conclusions The PBL pattern used in the orthopedics internship has advantages and practical significance, which are applicable in modern medical teaching practice.
ObjectiveTo improve the quality of clinical teaching by restructuring the clinical teaching process with Six Sigma management theory. MethodsBased on the Six Sigma management theory, this paper explored the key causes of the quality of clinical teaching in the respiratory department by using scientific tools including Brainstorming, Fishbone Diagram and Pareto Principle. The problem of teaching of professional clinical skills was the key factor that affected the quality of department's clinical teaching. This paper improved the quality of clinical teaching by restructuring the clinical teaching process including drawing up and carrying out The Manual of Clinical Skills Teaching in respiratory department and introducing the scientific teaching method. ResultsAbout the survey on the satisfaction of clinical teaching process, the score of the control group was much higher than that of the experimental group (P < 0.05). And the score of the skill test of the control group was much higher than that of the experimental group (P < 0.05). ConclusionThe application of Six Sigma management and process restructuration to improve the clinical teaching is significantly effective.
Lumbar puncture for children is a difficult technique and is an important aspect of clinical teaching for residents and interns in the neurological department of pediatrics. In this article, we summarized techniques and experiences of clinical teaching in pediatric lumbar puncture, and discussed difficulty, variability and remedial strategy for lumbar puncture in children. Narrow intervertebral space, poor compliance and resistance of children are the main difficulty for pediatric lumbar puncture. The causes of failure for medical students include different sensations of breakthrough when using different needles, choice of un-preferable intervertebral space, excessive vertical angle for needling performance, deviation from the longitudinal midline of the body, incorrect anesthesia, and exceeding resistance of children patients. Corresponding remedial strategy for failure of puncture includes informing students of the technique and variability of puncture, training experienced staff for second- and third-line substitutes, and reinforcing nursing after surgery. This summary of techniques for pediatric lumbar puncture and experiences of clinical teaching will benefit pediatricians and their clinical training.
Objective To investigate the evaluation of nursing students on nurse teachers’ teaching quality between lessons ofBasic Nursing, in order to provide references for the improvement of teaching methods and promotion of teaching quality. Methods Questionnaire survey was used to investigate nurse students on the evaluation of nurse teachers’ teaching quality in three different clinical practice stages between lessons ofBasic Nursing. SPSS 19.0 statistical package was used to analyze the data. Results In the 5-point scale, the average score of all items was (4.72±0.38) points, and the average scores of three dimensions including timely project completion and gains in the practice, nurse teachers’ teaching, and teaching environment and resources were respectively (4.71±0.44), (4.76±0.35), and (4.66±0.52) points. The three items with the highest scores were teachers’ theoretical knowledge, teachers’ professional quality, and helping nurse students analyze existing problems; while the three with the lowest scores were teaching methods, timely completion of the practice, and participation by other nurses during the teaching. There were significant differences among the three stages in practice gains, reasonability of practice arrangement, instructing the students to solve problems, proficiency and standardization of the operation demonstration, basic theoretical knowledge, flexibility and enlightenment of the teaching methods, attitudes of the nurse teachers, participation by other nurses during the teaching, and head nurse’s support (P<0.05). Conclusions To improve the quality of clinical practice teaching, nurse teachers, other nurses in the ward, head nurse and the whole department should make collective effort. Nurse teachers should pay more attention to the improvement of teaching methods and reasonable planning of clinical practice.
Prosthetics and orthotics is an applied discipline which require students to have a good ability of clinical application. However, the present doctor-patient tension poses great difficulties in students’ clinical practice and study, and thus proposes higher requirements in the talent cultivation. Standardized patients (SP), as a newly established teaching mode, has been applied well in such areas as internal medicine, diagnostics and clinical care for about 20 years in this country. However, in prosthetics and orthotics, we hardly have any SP teaching experience in China. According to the experience of using SP in clinical medicine, this article discusses the necessity of SP in the teaching of prosthetics and orthotics, explains the advantages and disadvantages of SP teaching, and analyzes the feasibility of SP application in the teaching of prosthetics and orthotics under the present situation. Finally, this article concludes that using SP can improve students’ motivation, interest in learning and communication skills with patients. Therefore, it will become a research direction and development trend of prosthetics and orthotics.
ObjectiveTo explore the feasibility of lumbar puncture models based on 3D printing technology for training junior orthopaedic surgeons to find the optimal pedicle screw insertion points.MethodsMimics software was used to design 3D models of lumbar spine with the optimal channels and alternative channels. Then, the printed lumbar spine models, plasticine, and cloth were used to build lumbar puncture models. From January 2018 to June 2019, 43 orthopedic trainees performed simulated operations to search for the insertion points of pedicle screws base on the models. The operations were performed once a day for 10 consecutive days, and the differences in operation scores and operation durations of the trainees among the 10 days were compared.ResultsAll the trainees completed the surgical training operations successfully, and there were significant differences in the operation scores (13.05±2.45, 14.02±3.96, 17.58±3.46, 21.02±2.04, 23.40±4.08, 25.14±3.72, 27.26±6.09, 33.37±4.23, 35.00±4.15, 38.49±1.70; F=340.604, P<0.001) and operation durations [(22.51±4.28), (19.93±4.28), (18.05±2.89), (17.05±1.76), (16.98±1.97), (15.47±1.74), (13.51±1.42), (12.60±2.17), (12.44±1.71), (11.91±1.87) minutes; F=102.359, P<0.001] among the 10 days.ConclusionThe 3D models of lumbar puncture are feasible and repeatable, which can contribute to surgical training.
ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.