Jiang Yang, Fu Xinghua, Wang Jing, Liu Qinling, Wang Xinyu, Liu Peijie, Fu Runchen, Shi Jiangpiao, Wu Yibo
Jitang College, North China University of Science and Technology, Tangshan, Hebei, China.
The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
BMC Med Educ. 2024 Dec 20;24(1):1511. doi: 10.1186/s12909-024-06530-8.
Combination of Standardized Patient (SP) and Case Based Learning (CBL) is a common method in medical education, but traditional SP (TSP) may not be conducive to students' mastery of basic medical knowledge and the cultivation of clinical thinking. Therefore, it is necessary to innovate SP to optimize SP combined with CBL teaching method.
This study aims to explore the effectiveness of a chatbot utilizing standardized patients based on CBL (CSP-CBL) for colorectal cancer education.
61 medical students who have studied the theoretical knowledge of colorectal cancer were selected as the study objects and randomly divided into experimental group and control group. The experimental group used CSP-CBL, and the control group used traditional SP based on CBL (TSP-CBL). Before the intervention, basic knowledge test and clinical thinking ability assessment scale were used to investigate basic ability. After the intervention, we compared the effectiveness of two teaching methods in training colorectal cancer diagnosis and treatment skills through basic knowledge test, clinical thinking ability assessment scale, course experience questionnaire and client satisfaction questionnaire.
The majority of participants were female (62.3%, 38/61), 67.2% (41/61) were in the top 60% of school grades, and only 13.1% (8/61) had a medical background. There were no significant differences between the two groups in terms of demographic and sociological characteristics. There was no difference in pre-test of basic knowledge scores between the two groups (P = 0.489), but the CSP-CBL group scored significantly higher at post-intervention compared to the TSP-CBL group (SMD = -0.629, P < 0.05, 95% CI = (-0.789,-0.468)) and the CSP-CBL group also scored significantly higher than their baseline scores (SMD = - 0.991, p < 0.05, 95% CI = (-1.241,-0.740)). In terms of clinical thinking skills, the CSP-CBL group significantly improved their total score from (79.6 ± 15.9) to (86.2 ± 17.3) after the intervention (SMD = - 0.398, p < 0.05, 95% CI = (-0.498,-0.297)), but there was no significant difference between the two groups.The CSP-CBL group had a significantly lower academic load and course stress than the TSP-CBL group (SMD = -0.941, p < 0.01, 95% CI = (-1.181,-0.701); SMD = -0.6, p < 0.05, 95% CI = (-0.753,-0.447)) and scored significantly higher on the evaluation of future knowledge value (SMD = 0.603, p < 0.05, 95% CI = (0.449,0.757)). There was no significant difference between the two groups in terms of overall satisfaction, but the CSP-CBL group was significantly more satisfied than the TSP-CBL group in terms of meeting learning needs (SMD = 0.532, P < 0.05, 95% CI=(0.396,0.668)). There was no significant difference between the two groups in willingness to reuse the learning model.
The results show that CSP-CBL teaching can significantly improve the basic knowledge and clinical thinking of clinical medical students learning colorectal cancer, better meet the learning needs of students and reduce the learning burden appropriately.
ChiCTR2300072017 (registered on 31/05/2023).
标准化病人（SP）与基于案例的学习（CBL）相结合是医学教育中的一种常用方法，但传统标准化病人（TSP）可能不利于学生掌握基础医学知识和临床思维的培养。因此，有必要对标准化病人进行创新，以优化标准化病人与CBL相结合的教学方法。
本研究旨在探讨基于CBL的标准化病人聊天机器人（CSP-CBL）用于结直肠癌教育的有效性。
选取61名已学习结直肠癌理论知识的医学生作为研究对象，随机分为实验组和对照组。实验组采用CSP-CBL，对照组采用基于CBL的传统标准化病人（TSP-CBL）。干预前，使用基础知识测试和临床思维能力评估量表调查基础能力。干预后，通过基础知识测试、临床思维能力评估量表、课程体验问卷和客户满意度问卷比较两种教学方法在培养结直肠癌诊疗技能方面的效果。
大多数参与者为女性（62.3%，38/61），67.2%（41/61）的学生成绩排名在班级前60%，只有13.1%（8/61）有医学背景。两组在人口统计学和社会学特征方面无显著差异。两组基础知识得分的预测试无差异（P = 0.489），但干预后CSP-CBL组得分显著高于TSP-CBL组（标准化均数差（SMD）=-0.629，P < 0.05，95%置信区间（CI）=（-0.789，-0.468）），且CSP-CBL组得分也显著高于其基线得分（SMD = -0.991，p < 0.05，95% CI =（-1.241，-0.740））。在临床思维技能方面，干预后CSP-CBL组总分从（79.6±15.9）显著提高到（86.2±17.3）（SMD = -0.398，p < 0.05，95% CI =（-0.498，-0.297）），但两组之间无显著差异。CSP-CBL组的学业负担和课程压力显著低于TSP-CBL组（SMD = -0.941，p < 0.01，95% CI =（-1.181，-0.701）；SMD = -0.6，p < 0.05，95% CI =（-0.753，-0.447）），且在未来知识价值评估中得分显著更高（SMD = 0.603，p < 0.05，95% CI =（0.449，0.757））。两组在总体满意度方面无显著差异，但CSP-CBL组在满足学习需求方面显著比TSP-CBL组更满意（SMD = 0.532，P < 0.05，95% CI =（0.396，0.668））。两组在重复使用学习模式的意愿方面无显著差异。
结果表明，CSP-CBL教学可显著提高临床医学生学习结直肠癌的基础知识和临床思维，更好地满足学生的学习需求，并适当减轻学习负担。
中国临床试验注册中心注册号：ChiCTR2300072017（于2023年5月31日注册）
