实施本科医学教育改革以提高解决问题的能力和实践技能。
Implementing Undergraduate Medical Education Reform to Enhance Problem-Solving and Practical Skills.
作者信息
Tang Xiaolong, Li Amin, Xu Lifa, Cai Ru, Zhou Shuping
机构信息
Medical College, Anhui University of Science and Technology, Huainan, 232001, People's Republic of China.
The First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, 232003, People's Republic of China.
出版信息
Adv Med Educ Pract. 2025 Aug 20;16:1469-1480. doi: 10.2147/AMEP.S535339. eCollection 2025.
BACKGROUND
Undergraduate medical education in China faces significant gaps in integrating theory with practice, with 32.7% of graduates requiring remedial procedural training.
OBJECTIVE
To implement and evaluate a competency-based reform targeting problem-solving and practical skills.
METHODS
In a single-center RCT (Anhui, China; 2023-2024), 180 medical undergraduates were randomized to control (traditional pedagogy, n = 90) or intervention groups (reformed curriculum: 40% practice-oriented content, integrated PBL/TBL/CBT). Assessments used OSCE-aligned tools (clinical checklists: Cronbach's α = 0.89; case analysis rubrics: κ = 0.85).
RESULTS
Intervention group showed significant improvements: theoretical scores (78.7 ± 3.9 vs 68.3 ± 4.8; t = -17.78, < 0.01, d = 2.39); clinical skill excellence (80.4% vs 60.2%; χ² = 25.93, < 0.001, OR = 2.67); PBL adaptability (70.1% vs 42.3%; χ² = 9.0, < 0.05).
CONCLUSION
This reform bridges theory-practice gaps and enhances clinical decision-making, requiring institutional support for scalability.
背景
中国本科医学教育在理论与实践结合方面存在显著差距，32.7%的毕业生需要补救性操作培训。
目的
实施并评估一项针对解决问题能力和实践技能的基于胜任力的改革。
方法
在一项单中心随机对照试验（中国安徽；2023 - 2024年）中，180名医科本科生被随机分为对照组（传统教学法，n = 90）和干预组（改革后的课程：40%以实践为导向的内容，整合了基于问题的学习/基于团队的学习/基于案例的学习）。评估使用与客观结构化临床考试（OSCE）一致的工具（临床检查表：Cronbach's α = 0.89；病例分析评分标准：κ = 0.85）。
结果
干预组表现出显著改善：理论成绩（78.7 ± 3.9对68.3 ± 4.8；t = -17.78，< 0.01，d = 2.39）；临床技能优秀率（80.4%对60.2%；χ² = 25.93，< 0.001，OR = 2.67）；基于问题的学习适应性（70.1%对42.3%；χ² = 9.0，< 0.05）。
结论
这项改革弥合了理论与实践的差距，增强了临床决策能力，需要机构支持以实现推广。
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