Hofer M, Schiebel B, Hartwig H G, Garten A, Mödder U
Institut für Diagnostische Radiologie, Heinrich-Heine-Universität Düsseldorf.
Dtsch Med Wochenschr. 2000 Jun 9;125(23):717-23. doi: 10.1055/s-2007-1024468.
Medical students in Germany often criticize the anonymous and not practice-orientated way they are taught. It was the aim of this study to develop, try out and evaluate cost-effectiveness of practice-oriented interdisciplinary teaching in small groups.
The study was based on ca. 300 medical students/year, a practicable number in relation the average annual total intake by German medical schools. Between 1995 and 1998, 300 medical students annually, chosen by lot, were offered voluntary additional teaching of imaging methods (computed tomography, endoscopy and sonography), from a total of 2485 students (1276 females, 1209 males; mean age 25.8 years), the reminder serving as controls. After lecture-demonstration to all, the selected small groups were separately taught. They performed sonography on each other in small cohorts of 5 or they practised endoscopies on phantom models under supervision of a student tutor. In addition, lecturers circulated among the groups to answer additional questions and provide further help. All participants evaluated the course concept and the instructors on a questionnaire provided by the interdisciplinary centre for tertiary education. The effects of teaching on the participants were tested by a practical test in the form of an objective structured clinical examination (OSCE).
Ca. 80% of course participants reached the intended aim and passed the OSCE examination. They gave the instructions in the pilot project highest marks, in all its criteria nearly one mark higher than those of other evaluated teaching sessions. Pre-clinical students judged the programme even more favourably than those in their clinical years. The additional cost incurred was moderately low at ca. DM 67 per year per student.
Modern practice-oriented small group teaching will provide high quality results even with large numbers of students. The concept has already been taken over by other medical faculties.
德国医科学生常常批评他们所接受的教学方式既缺乏针对性又不注重实践。本研究旨在开发、试行并评估小组形式的注重实践的跨学科教学的成本效益。
本研究以每年约300名医科学生为基础，这一数量对于德国医学院校的年平均招生总数而言是可行的。1995年至1998年期间，每年从总共2485名学生（1276名女生，1209名男生；平均年龄25.8岁）中通过抽签选出300名医科学生，提供有关成像方法（计算机断层扫描、内窥镜检查和超声检查）的自愿额外教学，其余学生作为对照组。在对全体学生进行讲座演示之后，对选定的小组进行单独授课。他们以5人小组的形式互相进行超声检查，或者在学生导师的监督下在模拟模型上练习内窥镜检查。此外，讲师在各小组之间走动，回答额外问题并提供进一步帮助。所有参与者根据高等教育跨学科中心提供的问卷对课程概念和讲师进行评估。通过客观结构化临床考试（OSCE）形式的实践测试来检验教学对参与者的效果。
约80%的课程参与者达到预期目标并通过了OSCE考试。他们对试点项目的指导给予了最高分，在所有标准方面几乎比其他评估教学课程高出一分。临床前学生对该项目的评价甚至比对临床阶段学生的评价更高。每年每名学生产生的额外成本适度较低，约为67德国马克。
即使学生数量众多，现代注重实践的小组教学也能提供高质量的教学效果。该理念已被其他医学院系采用。
