Bridgemohan Carolyn Frazer, Levy Sharon, Veluz Anna K, Knight John R
Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
Med Educ. 2005 Aug;39(8):797-806. doi: 10.1111/j.1365-2929.2005.02232.x.
We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines.
To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT).
Quasi-randomised comparison of two educational interventions.
Preclinic teaching conferences at a large urban children's hospital.
A total of 46 paediatric residents years 1-3 assigned to either FCD (n = 21) or CT (n = 25).
FCD residents met in groups of 8-12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2-3 at a computer station linked to an interactive website.
Participant responses during semistructured focus group interviews.
Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology.
Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis.
FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings.
作为一项基于“光明未来”指南的国家课程项目的一部分，我们针对儿童学习障碍这一主题开发了标准化的基于案例的教育活动以及该活动的多媒体计算机化改编版本。
探讨住院医师对引导式案例讨论（FCD）和计算机化教程（CT）的看法。
两种教育干预措施的准随机比较。
一家大型城市儿童医院的临床前教学会议。
共有46名1 - 3年级的儿科住院医师，分为FCD组（n = 21）或CT组（n = 25）。
FCD组的住院医师以8 - 12人一组的形式与一名经过培训的引导者进行结构化案例讨论，而CT组的住院医师则以2 - 3人一组的形式在与交互式网站相连的计算机站进行学习。
半结构化焦点小组访谈中的参与者反馈。
使用定性扎根理论方法同时分析焦点小组记录、现场笔记和计算机日志。
住院医师认为CT有趣，具有灵活性、更强的视听吸引力以及更多主动学习的机会。FCD则使他们有更多机会接触专家教员，并使学习材料与临床实践更相关。FCD参与者强调了所学到的临床技能，并表示这种学习经历将改变他们未来对患者的管理方式。两组均报告称案例讨论比计算机学习更具互动性。CT组的学习时间中位数略短。所有学习组都得出了正确的最终诊断结果。
FCD和CT在儿科住院医师中激发了不同类型的学习。未来需要进行研究以确定如何整合这两种技术，以满足不同环境下住院医师的学习需求。
