Objective To explore the short term and long term effectiveness of the problem-based learning (PBL) in clinical skill training. Methods A total of 162 clinical medicine undergraduates in Grade 2003 (7-years study) and 2004 (5-year study) who were supposed to intern in the internal medicine departments were randomly divided into the PBL group (n=75) and the control group with traditional training (n=87) for having their clinical skills training. Then t test was applied to compare the two groups about the scores of intern rotation examination and graduate OSCE as well. Results About the baseline: the students in the two groups got similar scores in their internal medicine exam before clinical intern rotation (84.04±7.40 vs. 82.63±8.77, P=0.287). About the short term effectiveness: compared to the control group, the students in the PBL group got higher subjective evaluation from their supervised clinicians (P=0.006). In writing examination, the students of those two group got similar scores in knowledge part (54.17±9.26 vs. 51.67±9.56, P=0.92), while the PBL group won in case reasoning question (20.39±5.27 vs. 16.51±4.90, Plt;0.001). About the long term effectiveness: in the graduate OSCE, the two groups got similar scores in skills operation such as punctures and lab results analyses (P=0.567 and P=0.741), while the students in the PBL group had better performance at the case reasoning and standard patients treating (75.59±9.85 vs. 71.11±12.01, P=0.027). Conclusion With the great short term and long term effectiveness, the PBL applied in the clinical skill training improves the students’ ability of both synthesized analyses and the integrated clinical skills such as clinical thinking and interpersonal communication, but doesn’t aim at the basic knowledge and operation skills.
ObjectiveTo explore a standardized model for cardiothoracic surgery resident training program based on a combined clinical and research oriented team approach. Methods We conducted this study in a nationally ranked Class AAA hospital among the eleven residents who were accepted into the program. Throughout their training periods, clinical surgical skills were taught by one-on-one mentoring by individually assigned doctoral degree advisors, other attending surgeons and doctoral degree candidates in the program. To foster their scientific curiosity and research skills, regular didactic lectures in basic science and statistical skills by the doctoral thesis advisors, supplemented by monthly journal clubs during which trainees were required to present and discuss a previously assigned topics based on recent clinical cases within the department, thus combining acquisition of clinical skills and theory/research at the same setting. ResultsEleven physicians were selected for this training path. With respect to clinical surgical skills, 4 residents were judged to be sufficient at the end of the first cycle. The other seven residents at the end of the second cycle. One trainee won the third prize in the Medical Skill Competition in the hospital. As for scientific research skills, the team produced 11 scientific articles, one of which was accepted by the annual national conference in cardiothoracic surgery and the first author was invited to present the article. The team submitted four research projects, one won funding at the provincial competition and three within the medical school. ConclusionOur proposed standardized model of cardiothoracic surgery resident training based on a combined clinical and research oriented approach appears to be practical with moderate success. Adaptation of this model by other cardiothoracic surgery training programs in the nation will further attest to its value and functionality.
Evidence-based psychotherapy is an idea and performance reform in the clinical practice of psychology which is influenced by evidence-based medicine. It proposes to integrate the best available evidence provided by researchers, the clinical expertise of practitioners, and the patient’s characteristics, cultures and preferences, so as to achieve the best treatment. The development of evidence-based psychotherapy can be divided into two stages: empirically supported treatments and evidence-based practice. This paper reviews existing problems as well as developing tendencies.
Objective To evaluate the effect and significance of PBL in clinical skills experiment teaching center (CSETC). Methods A total of 60 undergraduates in major of clinical medicine were divided into two groups according to their student ID. The control group (n=30) was set in an ordinary small classroom, while the experimental group (n=30) was in CSETC for fully using the teaching resources there. Both groups were taught with PBL method by same teachers, and the integrated final examination and questionnaire were adopted to evaluate the teaching effect. SPSS was used for statistical analysis. Results All 8 participated teachers believed that carrying out PBL in CSETC could promote teachers’ professional development, alleviate the shortage of teachers and classroom, increase the utilization ratio of CSETC, and improve the teaching quality. The results of survey on students showed that, compared with the control group, information management ability and clinical skills of students were improved obviously (Plt;0.01). Although there was no difference in total score of final exam, the experimental group was markedly higher than the control group in the score of clinical skill subject (Plt;0.01). Conclusion Carrying out PBL in CSETC can improve teaching quality, and clinical skills and information management ability of students. It is helpful to alleviate the shortage of teachers and classroom, and promote the teaching standards of CSETC.