Li Xiangyu, Zhang Longsheng, Sun Wenjun, Lei Min, Li Ying, Zhang Jiacheng, Huang Xing
Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
Department of Neurology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China.
BMC Med Educ. 2024 Dec 30;24(1):1560. doi: 10.1186/s12909-024-06397-9.
In China, investigations into the efficacy of neurological clinical teaching try to ascertain the impacts of various teaching methods on intervention outcomes. However, these studies often suffer from limited sample sizes, single-center studies and low quality, compounded by the lack of direct comparative analyses between teaching methods, thereby leaving the identification of the most effective method unresolved. This study aims to compare the effectiveness of various teaching methods in the standardized training of Chinese neurology clinicians to inform an optimal teaching model utilizing a Bayesian network meta-analysis (NMA) approach.
A comprehensive computer search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of 7 teaching methods: problem-based learning (PBL), case-based learning (CBL), flipped classroom model (FCM), evidence-based medicine (EBM), clinical practice (CP), team-based learning (TBL), and lecture-based learning (LBL). The search, which spanned databases including the China National Knowledge Infrastructure (CNKI), Chinese Citation Database (CDD), China Science Periodical Database (CSPD), Chinese BioMedical Literature Database (CBM), PubMed, Web of Science, and the Cochrane Library, covered the period from the inception of these databases to April 1, 2023. The quality of the included studies was evaluated, and the data were analyzed in R 4.3.2 and Stata 17.0 software.
From the 31 studies included, comprising 2124 subjects, significant findings emerged. In theoretical examinations, a statistically significant difference was noted among the teaching methods, with CBL, PBL, TBL, FCM, and EBM showing superior performance over the LBL method. The effectiveness ranking of these methods was as follows: CBL > PBL > TBL > FCM > EBM > CP > LBL. In terms of practical skills examinations, a similar pattern of effectiveness was observed. Here, the order of effectiveness was CBL > EBM > PBL > TBL > FCM > CP > LBL.
This NMA indicated that the modern teaching pedagogies, particularly CBL, could be effective in neurology education, and might help improve the theoretical examinations and practical skills of neurology clinicians. Fully tapping into the strengths of modern teaching methods in neurology teaching will require additional work and advancing research.
在中国,对神经科临床教学效果的调查旨在确定各种教学方法对干预结果的影响。然而,这些研究往往样本量有限、多为单中心研究且质量较低,再加上缺乏教学方法之间的直接比较分析,因此尚未确定最有效的教学方法。本研究旨在比较各种教学方法在中国神经科临床医生规范化培训中的有效性,以利用贝叶斯网络荟萃分析(NMA)方法得出最佳教学模式。
进行了全面的计算机检索,以识别评估7种教学方法有效性的随机对照试验(RCT):基于问题的学习(PBL)、基于案例的学习(CBL)、翻转课堂模式(FCM)、循证医学(EBM)、临床实践(CP)、基于团队的学习(TBL)和基于讲座的学习(LBL)。检索范围涵盖中国知网(CNKI)、中国引文数据库(CDD)、中国科学期刊数据库(CSPD)、中国生物医学文献数据库(CBM)、PubMed、Web of Science和Cochrane图书馆等数据库,涵盖这些数据库创建至2023年4月1日的时间段。对纳入研究的质量进行评估,并使用R 4.3.2和Stata 17.0软件进行数据分析。
在纳入的31项研究(共2124名受试者)中得出了显著结果。在理论考试中,教学方法之间存在统计学显著差异,CBL、PBL、TBL、FCM和EBM的表现优于LBL方法。这些方法的有效性排名如下:CBL>PBL>TBL>FCM>EBM>CP>LBL。在实践技能考试方面,观察到了类似的有效性模式。这里的有效性顺序为CBL>EBM>PBL>TBL>FCM>CP>LBL。
这项NMA表明,现代教学法,尤其是CBL,在神经科教育中可能有效,并可能有助于提高神经科临床医生的理论考试成绩和实践技能。要充分发挥现代教学方法在神经科教学中的优势,还需要更多工作和进一步的研究。