Ukusukela oko kwabakho ubhubhani we-COVID-19, ilizwe seliqalisile ukunikela ingqalelo ngakumbi kumsebenzi wokufundisa wezonyango kwizibhedlele zaseyunivesithi.Ukomeleza ukudityaniswa kweyeza kunye nemfundo kunye nokuphucula umgangatho kunye nokusebenza kakuhle kokufundiswa kweklinikhi yimingeni emikhulu ejongene nemfundo yezonyango.Ubunzima bokufundisa i-orthopedics buxhomekeke kwiintlobo ngeentlobo zezifo, ubungcali obuphezulu kunye neempawu ezingabonakaliyo, ezichaphazela inyathelo lokuqala, ihlombe kunye nokusebenza kakuhle kokufundisa kwabafundi bezonyango.Olu phononongo luphuhlise isicwangciso sokufundisa eklasini esijijekileyo esisekelwe kwingqikelelo yeCDIO (Concept-Design-Implement-Operate) saza sasiphumeza kwikhosi yoqeqesho lwabafundi bomongikazi wamathambo ukuze kuphuculwe isiphumo sokufunda ngokubonakalayo nokunceda ootitshala baqonde ukuguqula ikamva lemfundo yokonga kwaye imfundo yezonyango.Ukufunda eklasini kuya kusebenza ngakumbi kwaye kugxininiswe.
Abafundi bezonyango abangamashumi amahlanu abagqibe i-internship kwisebe lamathambo kwisibhedlele semfundo ephakamileyo ngoJuni 2017 bafakwe kwiqela lolawulo, kwaye abafundi abangama-50 abongikazi abagqibe i-internship kwisebe ngoJuni 2018 babandakanywa kwiqela lokungenelela.Iqela longenelelo lamkele ingqikelelo yeCDIO yemodeli yokufundisa ejingiwe eklasini, ngelixa iqela lolawulo lamkela imodeli yokufundisa yemveli.Emva kokugqiba imisebenzi yepraktikhali yesebe, amaqela amabini abafundi avavanywa kwithiyori, izakhono zokusebenza, isakhono sokufunda ngokuzimeleyo namandla okucinga nzulu.Amaqela amabini ootitshala agqibe imilinganiselo esibhozo yokuvavanya ubuchule bokukwazi ukuziqhelanisa nonyango, kubandakanywa neenkqubo ezine zokonga, izakhono zokonga ngobuntu, kunye novavanyo lomgangatho wokufundisa kwezonyango.
Emva koqeqesho, ikhono lokuziqhelanisa neklinikhi, ukukwazi ukucinga okubalulekileyo, ukukwazi ukufunda ngokuzimeleyo, ukusebenza kwethiyori kunye nokusebenza, kunye namanqaku omgangatho wokufundisa kweklinikhi weqela lokungenelela laliphezulu kakhulu kuneqela lokulawula (yonke i-P <0.05).
Imodeli yokufundisa esekelwe kwi-CDIO inokukhuthaza abafundi abaqeqeshwayo ukuba bafunde ngokuzimeleyo kunye nobuchule bokucinga nzulu, ikhuthaze indibaniselwano ye-organic yethiyori kunye nokuziqhelanisa, iphucule isakhono sabo sokusebenzisa ngokunzulu ulwazi lwethiyori ukuhlalutya nokusombulula iingxaki zepraktikhali, nokuphucula ifuthe lokufunda.
Imfundo yeklinikhi lelona nqanaba libaluleke kakhulu kwimfundo yobuhlengikazi kwaye ibandakanya inguqu kulwazi lwethiyori ukuya kwiprakthiza.Ukufunda okusebenzayo kweklinikhi kunokunceda abafundi abongikazi bagqwese kwizakhono zobuchwephesha, bomeleze ulwazi lobuchwephesha, kunye nokuphucula isakhono sabo sokuziqhelanisa nobunesi.Ikwalinqanaba lokugqibela lenguqu yendima yomsebenzi kubafundi bezonyango [1].Kwiminyaka yakutshanje, abaphandi abaninzi bokufundisa kwezonyango baye baqhuba uphando kwiindlela zokufundisa ezifana nokufunda okusekwe kwingxaki (PBL), ukufunda okusekwe kwimeko (CBL), ukufunda okusekwe kwiqela (TBL), kunye nokufunda ngokwemeko kunye nokufunda kwemeko ekufundiseni kweklinikhi. ..Nangona kunjalo, iindlela ezahlukeneyo zokufundisa zineengenelo kunye nezingeloncedo zazo ngokubhekiselele kwisiphumo sokufunda sonxibelelwano olusebenzayo, kodwa aziphumeleli ukuhlanganiswa kwethiyori kunye nokusebenza [2].
“Igumbi lokufundela elijingiweyo” libhekisa kumzekelo omtsha wokufunda apho abafundi basebenzisa iqonga lolwazi oluthile ukuze bafunde ngokuzimeleyo iindidi ngeendidi zemathiriyeli zemfundo phambi kweklasi baze bagqibezele umsebenzi wesikolo wasekhaya ngendlela “yokufunda ngokubambisana” kwigumbi lokufundela ngelixa ootitshala bekhokela abafundi.Phendula imibuzo kwaye unike uncedo olulolwakho[3].I-American New Media Alliance yaqaphela ukuba igumbi lokufundela elijikelezisiweyo lihlengahlengisa ixesha ngaphakathi nangaphandle kwegumbi lokufundela kwaye lidlulisela izigqibo zokufunda zabafundi ukusuka kootitshala ukuya kubafundi [4].Ixesha elixabisekileyo elichithwa kwigumbi lokufundela kule modeli yokufunda livumela abafundi ukuba bagxininise ngakumbi ekufundeni okusebenzayo, okusekelwe kwiingxaki.UDeshpande [5] uqhube uphononongo kwiklasi ejikeleziswayo kwimfundo ye-paramedic kunye nokufundisa kwaye wagqiba kwelokuba igumbi lokufundela eliguqulweyo linokuphucula umdlandla wokufunda wabafundi kunye nokusebenza kwizifundo kunye nokunciphisa ixesha leklasi.UKhe Fung HEW kunye noChung Kwan LO [6] baphonononge iziphumo zophando lwamanqaku athelekisekayo kwigumbi lokufundela elijingisiweyo kwaye bashwankathela isiphumo esipheleleyo sendlela yokufundisa eguqukileyo eklasini ngohlalutyo lwemeta, ebonisa ukuba xa kuthelekiswa neendlela zokufundisa zemveli, indlela yokufundisa ejiyiweyo eklasini. kwimfundo yezempilo yobungcali ingcono kakhulu kwaye iphucula ukufunda kwabafundi.UZhong Jie [7] uthelekise iziphumo zegumbi lokufundela elijingisiweyo kunye nesifundo somdibaniselwano wokufunda eklasini ekufumaneni ulwazi lwabafundi, waze wafumanisa ukuba kwinkqubo yokufunda exutyiweyo kwiklasi ye-histology ephothiweyo, ukuphucula umgangatho wokufundisa nge-intanethi kunokuphucula ukwaneliseka kwabafundi ulwazi.bamba.Ngokusekwe kwezi ziphumo zophando zingasentla, kwinkalo yemfundo yobuhlengikazi, uninzi lwabafundi lufunda ifuthe legumbi lokufundela elijikelezisiweyo ekufundiseni kakuhle eklasini kwaye bakholelwa ukuba ukufundisa eklasini okuphekiweyo kunokuphucula indlela abaqhuba ngayo kwizifundo zabongikazi, ukukwazi ukufunda ngokuzimeleyo, kunye nokwaneliseka eklasini.
Ke ngoko, kukho imfuneko engxamisekileyo yokuphonononga kunye nokuphuhlisa indlela entsha yokufundisa eya kunceda abafundi abongikazi bafunxe kwaye baphumeze ulwazi olucwangcisiweyo lobuchwephesha kunye nokuphucula isakhono sabo sokuziqhelanisa nonyango kunye nomgangatho obanzi.I-CDIO (Concept-Design-Implement-Operate) yimodeli yemfundo yobunjineli ephuhliswe ngo-2000 ziiyunivesithi ezine, kuquka iMassachusetts Institute of Technology kunye neRoyal Institute of Technology eSweden.Yimodeli ephucukileyo yemfundo yobunjineli evumela abafundi abongikazi ukuba bafunde kwaye bafumane izakhono ngendlela esebenzayo, ngezandla, nangendlela ephilayo [8, 9].Ngokubhekiselele kwimfundo engundoqo, le modeli igxininisa "ukugxila komfundi," ivumela abafundi ukuba bathathe inxaxheba ekuqulunqweni, ukuyila, ukuphunyezwa, nokusebenza kweeprojekthi, kunye nokuguqula ulwazi olufunyenweyo lwethiyori kwizixhobo zokusombulula iingxaki.Izifundo ezininzi zibonise ukuba imodeli yokufundisa ye-CDIO inegalelo ekuphuculeni izakhono zokuziqhelanisa nonyango kunye nomgangatho obanzi wabafundi bezonyango, ukuphucula intsebenziswano phakathi kootitshala nabafundi, ukuphucula impumelelo yokufundisa, kwaye idlala indima ekukhuthazeni uhlaziyo lolwazi kunye nokuphucula iindlela zokufundisa.Isetyenziswa ngokubanzi kuqeqesho lwetalente esetyenziswayo [10].
Ngokuguqulwa kwemodeli yonyango yehlabathi, iimfuno zabantu zempilo ziyanda, eziye zakhokelela ekunyuseni uxanduva lwabasebenzi bezonyango.Ikhono kunye nomgangatho wabahlengikazi uhambelana ngokuthe ngqo nomgangatho wokunakekelwa kwekliniki kunye nokhuseleko lwesigulane.Kwiminyaka yakutshanje, uphuhliso kunye novavanyo lwezakhono zeklinikhi zabahlengikazi baye baba ngumxholo oshushu kwinkalo yobuhlengikazi [11].Ke ngoko, injongo, ebanzi, ethembekileyo, kunye nendlela yokuhlola esebenzayo ibalulekile kuphando lwemfundo yezonyango.Uvavanyo lovavanyo lweklinikhi encinci (mini-CEX) yindlela yokuvavanya izakhono zeklinikhi ezibanzi zabafundi bezonyango kwaye isetyenziswa ngokubanzi kwinkalo yemfundo yezonyango yezonyango ekhaya nakwamanye amazwe.Yabonakala ngokuthe ngcembe kwintsimi yokonga [12, 13].
Uphononongo oluninzi luye lwaqhutywa ngokusetyenziswa kwemodeli ye-CDIO, igumbi lokufundela elijingisiweyo, kunye ne-mini-CEX kwimfundo yobuhlengikazi.U-Wang Bei [14] uxoxe ngempembelelo yemodeli ye-CDIO ekuphuculeni uqeqesho olungqamene nomongikazi kwiimfuno zabongikazi be-COVID-19.Iziphumo zicebisa ukuba ukusebenzisa imodeli yoqeqesho ye-CDIO ukubonelela ngoqeqesho lobunesi obukhethekileyo kwi-COVID-19 kuya kunceda abongikazi ukuba bafumane izakhono ezikhethekileyo zoqeqesho lwabongikazi nolwazi olunxulumeneyo, kwaye baphucule ngokupheleleyo izakhono zabo zokonga.Abaphengululi abafana no-Liu Mei [15] baxoxe ngokusetyenziswa kwendlela yokufundisa yeqela kudityaniswe negumbi lokufundela elijikeleziswayo ekuqeqesheni abongikazi bamathambo.Iziphumo zibonise ukuba lo mzekelo wokufundisa unokuphucula ngokufanelekileyo izakhono ezisisiseko zabahlengikazi bamathambo njengokuqonda.kunye nokusetyenziswa kolwazi lwethiyori, ukusebenzisana, ukucinga nzulu, kunye nophando lwezenzululwazi.U-Li Ruyue et al.[16] wafunda umphumo wokusetyenziswa kweNursing Mini-CEX ephuculweyo kuqeqesho olusemgangathweni lwabahlengikazi abatsha botyando kwaye wafumanisa ukuba ootitshala banokusebenzisa iNursing Mini-CEX ukuvavanya lonke uvavanyo kunye nenkqubo yokusebenza ekufundiseni kweklinikhi okanye kwi-work.weak links in yena.abongikazi kwaye banike ingxelo ngexesha lokwenyani.Ngenkqubo yokuzijonga kunye nokuzihlaziya, amanqaku asisiseko ovavanyo lomsebenzi wokonga ayafundwa, ikharityhulam iyahlengahlengiswa, umgangatho wokufundisa kwezonyango uphuculwa ngakumbi, isakhono esibanzi sotyando lokonga lwabafundi siyaphuculwa, kwaye ukuguqulwa indibaniselwano yeklasi esekelwe kwingqikelelo ye-CDIO iyavavanywa, kodwa okwangoku akukho ngxelo yophando.Ukusetyenziswa kwemodeli yovavanyo lwe-mini-CEX kwimfundo yokonga kubafundi be-orthopedic.Umbhali usebenzise imodeli ye-CDIO ekuphuhliseni izifundo zoqeqesho lwabafundi bobuhlengikazi bamathambo, wakha igumbi lokufundela elijijekileyo elisekelwe kwingqikelelo ye-CDIO, kwaye lidityaniswe nemodeli yovavanyo lwe-mini-CEX ukuphumeza imodeli yokufunda emithathu-enye kunye nomgangatho.ulwazi nezakhono, kwaye kwakhona libe negalelo ekuphuculeni umgangatho wokufundisa.Uphuculo oluthe gqolo lubonelela ngesiseko sokufunda okusekwe kwizibhedlele zokufundisa.
Ukuququzelela ukuphunyezwa kwekhosi, indlela yokufumana isampuli elula isetyenziswe njengezifundo zokufunda ukuze kukhethwe abafundi abongikazi ukususela ngo-2017 no-2018 ababesebenza kwisebe lamathambo kwisibhedlele senqanaba eliphezulu.Ekubeni kukho abaqeqeshwayo abangama-52 kwinqanaba ngalinye, ubungakanani besampulu buya kuba yi-104. Abafundi abane abazange bathathe inxaxheba ekusebenzeni ngokupheleleyo kwekliniki.Iqela lolawulo libandakanya abafundi abangabongikazi abangama-50 abagqibe i-internship kwisebe lamathambo kwisibhedlele senqanaba eliphezulu ngoJuni 2017, apho amadoda angama-6 kunye nabasetyhini abangama-44 abaneminyaka engama-20 ukuya kwengama-22 (21.30 ± 0.60) iminyaka, abagqibe i-internship kwakwelo sebe linye. ngoJuni 2018. Iqela longenelelo libandakanya abafundi bezonyango abangama-50, kubandakanywa amadoda angama-8 kunye nabasetyhini abangama-42 abaneminyaka eyi-21 ukuya kwi-22 (21.45±0.37) iminyaka.Zonke izifundo zinike imvume enolwazi.Iinqobo zokuBandakanywa: (1) Abafundi be-Orthopedic medical internship abanesidanga se-bachelor.(2) Imvume enolwazi kunye nokuthatha inxaxheba ngokuzithandela kwesi sifundo.Iikhrayitheriya zokungabandakanywa: Abantu abangakwaziyo ukuthatha inxaxheba ngokupheleleyo ekusebenzeni kweklinikhi.Akukho mahluko ubalulekileyo ngokweenkcukacha-manani kulwazi ngokubanzi lwamaqela amabini abafundi bezonyango abaqeqeshwayo (p>0.05) kwaye bayathelekiseka.
Omabini amaqela agqibe i-4-iveki ye-internship yeklinikhi, kunye nazo zonke izifundo ezigqityiweyo kwiSebe le-Orthopedics.Ngethuba lexesha lokujonga, kwakukho amaqela angama-10 abafundi bezonyango, abafundi be-5 kwiqela ngalinye.Uqeqesho lwenziwa ngokuhambelana neprogram ye-internship yabafundi abangabongikazi, kubandakanywa nethiyori kunye nezobugcisa.Ootitshala kuwo omabini la maqela baneziqinisekiso ezifanayo, kwaye utitshala ongumongikazi unoxanduva lokubeka esweni umgangatho wokufundisa.
Iqela lolawulo lasebenzisa iindlela zokufundisa eziqhelekileyo.Kwiveki yokuqala yesikolo, iiklasi ziqala ngoMvulo.Ootitshala bafundisa ithiyori ngooLwesibini nangooLwezithathu, baze bagxininise kuqeqesho lomsebenzi ngooLwezine nangooLwezihlanu.Ukususela kwiveki yesibini ukuya kweyesine, ilungu ngalinye lefakhalthi linoxanduva lomfundi wezonyango onika iintetho ngamaxesha athile kwisebe.Kwiveki yesine, iimvavanyo ziya kugqitywa kwiintsuku ezintathu ngaphambi kokuphela kwekhosi.
Njengoko bekutshiwo ngaphambili, umbhali wamkela indlela yokufundisa ejiyiweyo yaseklasini esekwe kwingqikelelo yeCDIO, njengoko kucacisiwe ngezantsi.
Iveki yokuqala yoqeqesho iyafana neqela lolawulo;Iiveki ezimbini ukuya kwezine zoqeqesho lwamathambo eprayopedikhi zisebenzisa isicwangciso sokufundisa eklasini esijingisiweyo esisekelwe kwingqikelelo yeCDIO iiyure ezingama-36 zizonke.Ingcinga kunye nenxalenye yoyilo iqukunjelwa kwiveki yesibini kwaye inxalenye yokuphunyezwa igqitywe kwiveki yesithathu.Utyando lwagqitywa kwiveki yesine, kwaye uvavanyo kunye novavanyo lwagqitywa kwiintsuku ezintathu ngaphambi kokukhutshwa.Jonga iThebhile 1 malunga nolwabiwo lwexesha leklasi elithile.
Iqela lootitshala elibandakanya umongikazi o-1 ophezulu, i-8 faculty ye-orthopedic kunye ne-1 non-orthopedic CDIO ingcali yokonga yasekwa.UMongikazi oyiNtloko ubonelela amalungu eqela lootitshala ngezifundo kunye nobuchule bekharityhulam nemigangatho yeCDIO, incwadi ye-CDIO workshop manual kunye nezinye iithiyori ezinxulumeneyo kunye neendlela ezithile zokuphumeza (ubuncinane iiyure ezingama-20), kwaye ubonisana neengcali ngamaxesha onke kwimiba yokufundisa entsonkothileyo. .I-Faculty ibeka iinjongo zokufunda, ilawule ikharityhulam, kwaye ilungiselele izifundo ngendlela ehambelanayo ehambelana neemfuno zabongikazi abadala kunye neprogram yokuhlala.
Ngokwenkqubo ye-internship, ngokubhekiselele kwinkqubo yoqeqesho lwetalente yeCDIO kunye nemigangatho [17] kunye neempawu zokufundisa zomongikazi wamathambo, iinjongo zokufunda zabongikazi abaqeqeshwayo zibekwe ngamacandelo amathathu, angala: iinjongo zolwazi (ukuphatha isiseko esisisiseko. ulwazi), ulwazi lobuchwephesha kunye neenkqubo ezinxulumene nenkqubo, njl.njl.), iinjongo zobuchule (ukuphucula izakhono zobungcali ezisisiseko, izakhono zokucinga ezibalulekileyo kunye nezakhono zokufunda ezizimeleyo, njl. njl.)..).Iinjongo zolwazi zihambelana nolwazi lobugcisa kunye nokuqiqa kwekharityhulam ye-CDIO, izakhono zomntu, izakhono zobungcali kunye nobudlelwane bekharityhulam ye-CDIO, kunye neenjongo ezisemgangathweni zihambelana nezakhono ezithambileyo zekharityhulam ye-CDIO: ukusebenzisana kunye nonxibelelwano.
Emva kwemijikelo emibini yeentlanganiso, igqiza lootitshala laxoxa ngesicwangciso sokufundisa ukonga kwigumbi lokufundela elijikelezisiweyo elisekelwe kwingqikelelo yeCDIO, lahlulahlula uqeqesho lwaba ngamanqanaba amane, laza lamisela iinjongo kunye noyilo, njengoko kubonisiwe kwiThebhile 1.
Emva kokuhlalutya umsebenzi wobuhlengikazi kwizifo ze-orthopedic, utitshala wachonga iimeko zezifo eziqhelekileyo kunye nezifo eziqhelekileyo zamathambo.Makhe sithathe isicwangciso sonyango lwezigulane ezine-lumbar disc herniation njengomzekelo: Isigulana uZhang Moumou (indoda, iminyaka eyi-73 ubudala, ubude be-177 cm, ubunzima be-80 kg) wakhalaza "ngeentlungu ezisezantsi ezikhatshwa yintlungu kunye nentlungu kwilungu elisezantsi lasekhohlo Iinyanga ezi-2” kwaye walaliswa esibhedlele kwikliniki yezigulane ezingalaliswanga.Njengomongikazi onesigulana: (1) Nceda ubuze ngokucwangcisiweyo imbali yesigulana ngokusekelwe kulwazi olufumeneyo kwaye ubone ukuba kwenzeka ntoni kumguli;(2) Khetha uphando olucwangcisiweyo kunye neendlela zokuhlola zobungcali ezisekelwe kwimeko kwaye ucebise ngemibuzo yophando efuna uphononongo olongezelelweyo;(3) Yenza ukuxilongwa kobunesi.Kule meko, kuyimfuneko ukudibanisa i-database yokukhangela imeko;irekhodi yongenelelo olujoliswe kukonga olunxulumene nesigulane;(4) Xoxa ngeengxaki ezikhoyo kwi-self-management management, kunye neendlela zangoku kunye nomxholo wokulandelwa kwesigulane ekuphumeni.Thumela amabali abafundi kunye noluhlu lwemisebenzi kwiintsuku ezimbini ngaphambi kweklasi.Uluhlu lomsebenzi wale meko lulandelayo: (1) Ukuphonononga kunye nokuqinisa ulwazi lwethiyori malunga ne-etiology kunye nokubonakaliswa kwekliniki ye-lumbar intervertebral disc herniation;(2) Ukuphuhlisa isicwangciso sokhathalelo ekujoliswe kuso;(3) Ukuphuhlisa eli tyala ngokusekelwe kumsebenzi weklinikhi kunye nokuphumeza ukunakekelwa kwangaphambili kunye nasemva kokusebenza zizinto ezimbini eziphambili zokufundisa ukulinganisa iprojekthi.Abafundi abongikazi baphonononge ngokuzimeleyo umxholo wekhosi kunye nemibuzo yokuziqhelanisa, jongana noncwadi olufanelekileyo kunye noovimba bedatha, kwaye ugqibezele imisebenzi yokuzifundela ngokungena kwiqela le-WeChat.
Abafundi benza amaqela ngokukhululekileyo, kwaye iqela likhetha inkokeli yeqela enoxanduva lokwahlula abasebenzi kunye nokulungelelanisa iprojekthi.Inkokeli yangaphambi kweqela inoxanduva lokusasaza iziqulatho ezine: isingeniso secala, ukuphunyezwa kwenkqubo yokonga, imfundo yezempilo, kunye nolwazi olunxulumene nesifo kwilungu ngalinye leqela.Ngexesha le-internship, abafundi basebenzisa ixesha labo lokukhulula ukuphanda imvelaphi yethiyori okanye izixhobo zokusombulula iingxaki zamatyala, ukuqhuba iingxoxo zeqela, kunye nokuphucula izicwangciso zeprojekthi ezithile.Kuphuhliso lweprojekthi, utitshala uncedisa inkokeli yeqela ekwabeleni amalungu eqela ukuba alungelelanise ulwazi olufanelekileyo, aphuhlise kwaye avelise iiprojekthi, abonise kwaye aguqule uyilo, kwaye ancedise abafundi abangabongikazi ekuhlanganiseni ulwazi olunxulumene nomsebenzi kuyilo kunye nemveliso.Fumana ulwazi lwemodyuli nganye.Imingeni kunye neengongoma eziphambili zeli qela lophando zahlaziywa kwaye zaphuhliswa, kwaye isicwangciso sokuphunyezwa komzekelo wemeko yeli qela lophando lwaphunyezwa.Ngesi sigaba, ootitshala baphinde baququzelela imiboniso yomjikelo wokonga.
Abafundi basebenza ngokwamaqela amancinci ukubonisa iiprojekthi.Ukulandela ingxelo, amanye amalungu eqela kunye namalungu e-faculty axoxile kwaye abeka izimvo kwiqela lengxelo ukuze kuphuculwe ngakumbi isicwangciso sokhathalelo lokonga.Inkokeli yeqela ikhuthaza amalungu eqela ukuba afanise yonke inkqubo yokunyamekela, kwaye utitshala unceda abafundi ukuba bahlolisise utshintsho oluguquguqukayo lwesifo ngokusebenzisa ukulinganisa, ukuqinisa ukuqonda kwabo kunye nokwakhiwa kolwazi lwethiyori, kunye nokuphuhlisa izakhono zokucinga ezibalulekileyo.Wonke umxholo ekufuneka ugqitywe kuphuhliso lwezifo ezizodwa ugqitywe phantsi kweliso lootitshala.Ootitshala baphawula kwaye bakhokele abafundi abongikazi ukuba benze uqheliselo olusecaleni kwebhedi ukuze bafikelele indibaniselwano yolwazi kunye nokuziqhelanisa nonyango.
Emva kokuvavanya iqela ngalinye, umhlohli wenze amagqabantshintshi kwaye waqaphela amandla kunye nobuthathaka belungu ngalinye kwintlangano yomxholo kunye nenkqubo yezakhono ukuqhubeka nokuphucula ukuqonda kwabafundi abongikazi kumxholo wokufunda.Ootitshala bahlalutya umgangatho wokufundisa kwaye bandise izifundo ezisekelwe kuvavanyo lwabafundi bokonga kunye novavanyo lokufundisa.
Abafundi abongikazi bathatha iimviwo zethiyori nezeprakhtikhali emva koqeqesho lwepraktikhali.Imibuzo yethiyori yongenelelo ngoncedo ibuzwa ngutitshala.Amaphepha ongenelelo ahlulwe abe ngamaqela amabini (A kunye no-B), kwaye elinye iqela likhethwe ngokungenamkhethe kungenelelo ngoncedo.Imibuzo yongenelelo yahlulwe yangamacandelo amabini: ulwazi lwethiyori yobuchwephesha kunye nohlalutyo lwemeko, ngalinye lixabisa amanqaku angama-50 kumanqaku ewonke amanqaku angama-100.Abafundi, xa bevavanya izakhono zobuhlengikazi, baya kukhetha ngokungakhethiyo enye yezi zilandelayo, kubandakanywa ubuchule be-axial inversion, ubuchule obuhle bokubeka imilenze kwizigulane ezinokulimala kwentambo yomgogodla, ukusetyenziswa kobuchule bonyango lwe-pneumatic, ubuchule bokusebenzisa umatshini wokuvuselela ngokubambisana kwe-CPM, njl. amanqaku ngamanqaku ali-100.
Kwiveki yesine, isiGaba soVavanyo lokuFunda esiZimeleyo siya kuvavanywa kwiintsuku ezintathu phambi kokuphela kwekhosi.Isikali sokuhlola esizimeleyo sobuchule bokufunda obuphuhliswe nguZhang Xiyan [18] sisetyenzisiwe, kubandakanywa nokukhuthaza ukufunda (izinto eziyi-8), ukuzithiba (izinto eziyi-11), ukukwazi ukusebenzisana ekufundeni (izinto ezi-5), kunye nolwazi lokufunda nokubhala (izinto ezi-6) .Into nganye ilinganiswe kwisikali se-5-point Likert ukusuka "ukungahambelani konke konke" ukuya "ngokuhambelana ngokupheleleyo," kunye namanqaku avela kwi-1 ukuya kwi-5. Amanqaku apheleleyo yi-150. Amanqaku aphezulu, amandla okufunda ngokuzimeleyo .I-alpha coefficient ye-Cronbach yesikali yi-0.822.
Kwiveki yesine, isikali sokucinga esinzulu sokucinga savavanywa kwiintsuku ezintathu ngaphambi kokukhutshwa.Uguqulelo lwesiTshayina lweSikali soVavanyo lokuCwangcisa ukuCwangcisa ukuCwangcisa oluguqulelwe nguMercy Corps [19] lusetyenzisiwe.Inamacala asixhenxe: ukufunyanwa kwenyaniso, ukucinga okuvulekileyo, ukukwazi ukuhlalutya kunye nokukwazi ukulungelelanisa, kunye nezinto ezili-10 kumyinge ngamnye.I-6-point scale isetyenziswe ukusuka "ukungavumelani kakhulu" ukuya "kuvuma ngokuqinileyo" ukusuka kwi-1 ukuya kwi-6, ngokulandelanayo.Iingxelo ezingezizo zibuyele umva, kunye namanqaku apheleleyo ukusuka kwi-70 ukuya kwi-420. Amanqaku apheleleyo ≤210 abonisa ukusebenza kakubi, i-211-279 ibonisa ukusebenza okungathathi hlangothi, i-280-349 ibonisa ukusebenza kakuhle, kwaye ≥350 ibonisa amandla anamandla okucinga.I-alpha coefficient ye-Cronbach yesikali yi-0.90.
Kwiveki yesine, uvavanyo lobuchule beklinikhi luya kwenzeka kwiintsuku ezintathu ngaphambi kokukhutshwa.I-mini-CEX isikali esetyenzisiweyo kolu phononongo yatshintshwa ukusuka kwi-Medical Classic [20] ngokusekelwe kwi-mini-CEX, kwaye ukungaphumeleli kwamanqaku kwi-1 ukuya kwi-3 amanqaku.Ihlangabezana neemfuno, amanqaku angama-4-6 okuhlangabezana neemfuno, amanqaku angama-7-9 ngokulungileyo.Abafundi bezonyango bagqiba uqeqesho lwabo emva kokugqiba i-internship ekhethekileyo.I-alpha ye-alpha ye-Cronbach yesi sikali yi-0.780 kwaye i-coefficient yokuthembeka kwesiqingatha-isiqingatha yi-0.842, ebonisa ukuthembeka okulungileyo.
Kwiveki yesine, kusuku oluphambi kokulishiya isebe, kwabanjwa i-symposium yootitshala nabafundi kunye novavanyo lomgangatho wokufundisa.Ifomu yokuvavanya umgangatho wokufundisa yaphuhliswa nguZhou Tong [21] kwaye ibandakanya imiba emihlanu: isimo sengqondo sokufundisa, umxholo wokufundisa, kunye nokufundisa.Iindlela, iziphumo zoqeqesho kunye neempawu zoqeqesho.Kusetyenziswe isikali se-5-point Likert.Okukhona amanqaku aphezulu, kokukhona uphucuka umgangatho wokufundisa.Igqitywe emva kokugqiba i-internship ekhethekileyo.Uluhlu lwemibuzo lunokuthembeka okulungileyo, kunye nealpha yeCronbach yesikali ngu-0.85.
Idatha yahlalutywa kusetyenziswa isoftwe yezibalo ze-SPSS 21.0.Idatha yokulinganisa ichazwa njengentsingiselo ± ukutenxa okusemgangathweni (\(\ukubetha X \pm S\)) kwaye iqela longenelelo t lisetyenziselwa ukuthelekisa phakathi kwamaqela.Idatha yokubala ibonakaliswe njengenani leemeko (%) kwaye kuthelekiswa kusetyenziswa i-chi-square okanye ungenelelo oluchanekileyo lukaFisher.Ixabiso le-p <0.05 libonisa umahluko obalulekileyo ngokweenkcukacha-manani.
Ukuthelekiswa kwamanqaku okungenelela kwethiyori kunye nokusebenza kwamaqela amabini abongikazi abaqeqeshwayo kuboniswe kwiThebhile 2.
Uthelekiso lokufunda ngokuzimeleyo namandla okucinga nzulu kwamaqela amabini abongikazi abaqeqeshwayo kubonisiwe kwiThebhile yesi-3.
Uthelekiso lovavanyo lwesakhono seklinikhi phakathi kwamaqela amabini abongikazi abaqeqeshwayo.Ikhono lokuziqhelanisa nobuhlengikazi bekliniki yabafundi kwiqela lokungenelela lalingcono kakhulu kunelo qela lokulawula, kwaye umehluko wawubaluleke kakhulu (p <0.05) njengoko kuboniswe kwiThebhile 4.
Iziphumo zokuvavanya umgangatho wokufundisa wamaqela amabini zibonise ukuba umgangatho wokufundisa uwonke weqela lolawulo wawuyi-90.08 ± 2.34 amanqaku, kwaye itotali yamanqaku omgangatho wokufundisa weqela longenelelo ngama-96.34 ± 2.16 amanqaku.Umahluko wawubalulekile ngokwezibalo.(t = - 13.900, p <0.001).
Uphuhliso kunye nenkqubela phambili yeyeza kufuna ukuqokelela okwaneleyo kwetalente yonyango.Nangona iindlela ezininzi zokulinganisa kunye neendlela zoqeqesho zokulinganisa zikhona, azikwazi ukuthatha indawo yokusebenza kweklinikhi, ehambelana ngokuthe ngqo nekhono letalente yezonyango elizayo ukunyanga izifo kunye nokusindisa ubomi.Ukusukela oko kwabakho ubhubhani we-COVID-19, ilizwe linike ingqwalasela engakumbi kumsebenzi wokufundisa wezonyango kwizibhedlele zaseyunivesithi [22].Ukomeleza ukudityaniswa kweyeza kunye nemfundo kunye nokuphucula umgangatho kunye nokusebenza kakuhle kokufundiswa kweklinikhi yimingeni emikhulu ejongene nemfundo yezonyango.Ubunzima bokufundisa i-orthopedics buxhomekeke kuluhlu olubanzi lwezifo, ubungcali obuphezulu kunye neempawu ezingabonakaliyo, ezichaphazela inyathelo lokuqala, ihlombe kunye nokukwazi ukufunda kwabafundi bezonyango [23].
Indlela yokufundisa ejikelezisiweyo eklasini ngaphakathi kwengqikelelo yokufundisa yeCDIO idibanisa umxholo wokufunda kunye nenkqubo yokufundisa, yokufunda nokwenza.Oku kutshintsha ubume bamagumbi okufundela kwaye kubeka abafundi abongikazi kumbindi wokufundisa.Ngexesha lenkqubo yemfundo, ootitshala bancedisa abafundi abongikazi ngokuzimeleyo ukuba bafikelele kulwazi olufanelekileyo kwimiba enzima yokonga kwiimeko eziqhelekileyo [24].Uphando lubonisa ukuba iCDIO ibandakanya uphuhliso lomsebenzi kunye nemisebenzi yokufundisa kweklinikhi.Le projekthi ibonelela ngesikhokelo esineenkcukacha, idibanisa ngokusondeleyo ukudityaniswa kolwazi lobuchwephesha kunye nophuhliso lwezakhono zomsebenzi owenziwayo, kwaye ichonge iingxaki ngexesha lokulinganisa, eliluncedo kubafundi abongikazi ekuphuculeni ukufunda kwabo ngokuzimeleyo kunye nobuchule bokucinga obunzulu, kunye nesikhokelo ngexesha lokuzimela. ukufunda.-ukufunda.Iziphumo zolu pho nonongo zibonisa ukuba emva kweeveki ze-4 zoqeqesho, ukufunda ngokuzimeleyo kunye nobuchule bokucinga obubalulekileyo amanqaku abafundi abahlengikazi kwiqela lokungenelela babephezulu kakhulu kuneqela lokulawula (zombini p <0.001).Oku kuhambelana neziphumo zophononongo lukaFan Xiaoying ngesiphumo seCDIO kudityaniswe nendlela yokufundisa ye-CBL kwimfundo yobuhlengikazi [25].Le ndlela yoqeqesho inokuphucula ngokubonakalayo ukucinga okunzulu kwabafundi kunye nokukwazi ukufunda ngokuzimeleyo.Ngexesha lesigaba sokucinga, utitshala uqala abelane ngamanqaku anzima nabafundi abangoonga eklasini.Abafundi abongikazi emva koko bafunda ngokuzimeleyo ulwazi olufanelekileyo ngeevidiyo zesifundo esincinci kwaye bafuna izixhobo ezifanelekileyo ukuqhubela phambili ukuqonda kwabo ubunesi bamathambo.Ngexesha lenkqubo yoyilo, abafundi abongikazi baziqhelanise neqela kunye nezakhono zokucinga ezinzulu ngeengxoxo zeqela, zikhokelwa yi-faculty kunye nokusetyenziswa kwezifundo.Ngethuba lesigaba sokuphunyezwa, ootitshala bajonga ukunakekelwa kwe-perioperative yezifo zobomi bokwenyani njengethuba kwaye basebenzise iindlela zokufundisa ze-case simulation ukufundisa abafundi abahlengikazi ukuba baqhube ii-case exercises ngokubambisana kweqela ukuze baziqhelanise kunye nokufumanisa iingxaki kumsebenzi wobuhlengikazi.Kwangaxeshanye, ngokufundisa iimeko zokwenyani, abafundi abongikazi banokufunda iingongoma eziziintloko zokhathalelo lwangaphambi kotyando kunye nasemva kotyando ukuze baqonde ngokucacileyo ukuba zonke iinkalo zokunyamekela utyando zibalulekile ekuchacheni komguli emva kotyando.Kwinqanaba lokusebenza, ootitshala bancedisa abafundi bezonyango ukuba bafunde iithiyori kunye nezakhono ekusebenzeni.Ngokwenza njalo, bafunda ukujonga utshintsho kwiimeko zangempela, ukucinga malunga neengxaki ezinokwenzeka, kunye nokungazikhumbuli ngentloko iinkqubo ezahlukeneyo zobuhlengikazi ukunceda abafundi bezonyango.Inkqubo yokwakha kunye nokuphunyezwa kwezinto eziphilayo idibanisa umxholo woqeqesho.Kule nkqubo yokufunda isebenzisanayo, isebenzisanayo kunye namava, isakhono sokufunda sabafundi bomongikazi esizilawulayo kunye nolangazelelo lokufunda luhlanganiswe kakuhle kwaye nezakhono zabo zokucinga ezibukhali ziyaphuculwa.Abaphandi basebenzise i-Design Thinking (DT)-Conceive-Design-Implement-Operate (CDIO)) ukwazisa isakhelo soyilo lobunjineli kwizifundo zeprogram yewebhu ezinikezelwayo zokuphucula ukusebenza kwabafundi kwizifundo kunye nobuchule bokucinga (CT), kwaye iziphumo zibonisa, ukuba indlela abafundi abaqhuba ngayo ezifundweni kunye nezakhono zokucinga zokubala ziphuculwe kakhulu [26].
Olu phononongo lunceda abafundi abongikazi ukuba bathathe inxaxheba kuyo yonke inkqubo ngokwenkqubo ye-Questioning-Concept-Design-Implementation-Operation-Debriefing.Iimeko zonyango ziye zaphuhliswa.Ugqaliselo ke lukwintsebenziswano yeqela kunye nokucinga okuzimeleyo, okuncediswa ngutitshala ophendula imibuzo, abafundi bacebise izisombululo kwiingxaki, ukuqokelelwa kwedatha, uqheliselo lwemeko, kwaye ekugqibeleni imithambo ecaleni kwebhedi.Iziphumo zophando zibonise ukuba amanqaku abafundi bezonyango kwiqela longenelelo kuvavanyo lolwazi lwethiyori kunye nezakhono zokusebenza babengcono kunabo babafundi kwiqela lolawulo, kwaye umahluko wawubaluleke kakhulu (p <0.001).Oku kuhambelana nenyaniso yokuba abafundi bezonyango kwiqela longenelelo babe neziphumo ezingcono kuvavanyo lolwazi lwethiyori kunye nezakhono zokusebenza.Xa kuthelekiswa neqela lolawulo, umahluko wawubalulekile ngokwezibalo (p <0.001).Idityaniswe neziphumo zophando ezifanelekileyo [27, 28].Isizathu sohlalutyo kukuba imodeli ye-CDIO kuqala ikhetha amanqaku olwazi lwesifo kunye namazinga aphezulu eziganeko, kwaye okwesibini, ubunzima bezicwangciso zeprojekthi buhambelana nesiseko.Kulo mzekelo, emva kokuba abafundi begqibe umxholo osebenzayo, bagqibezela incwadi yomsebenzi weprojekthi njengoko kufuneka, bahlaziye umxholo ofanelekileyo, baze baxoxe ngezabelo kunye namalungu eqela ukuba betyise kwaye bafake umxholo wokufunda kunye nokudibanisa ulwazi olutsha kunye nokufunda.Ulwazi oludala ngendlela entsha.Ulungelelwaniso lolwazi luyaphucuka.
Olu pho nonongo lubonisa ukuba ngokusetyenziswa kwemodeli yokufunda yeklinikhi ye-CDIO, abafundi abahlengikazi kwiqela lokungenelela babengcono kunabafundi bobuhlengikazi kwiqela lolawulo ekwenzeni ukubonisana nobuhlengikazi, iimviwo zomzimba, ukufumanisa ukuxilongwa koongikazi, ukuphumeza ukungenelela koongikazi, kunye nokunyamekela.iziphumo.kunye nenkathalo yoluntu.Ukongezelela, kukho ukungafani okuphawulekayo kwiparameter nganye phakathi kwamaqela amabini (p <0.05), eyayifana neziphumo zeHongyun [29].UZhou Tong [21] wafunda umphumo wokusetyenziswa kwemodeli yokufundisa ye-Concept-Design-Implement-Operate (CDIO) kwindlela yokufundisa yokufundisa ngobuhlengikazi bentliziyo, kwaye wafumanisa ukuba abafundi kwiqela lovavanyo basebenzisa i-CDIO yonyango lwekliniki .Indlela yokufundisa kwinkqubo yokonga, ubuntu Iiparamitha ezisibhozo, ezifana nobuchule bokonga nokuba nesazela, zibhetele kakhulu kunezo zabafundi bomongikazi abasebenzisa iindlela zokufundisa zemveli.Oku kusenokuba kungenxa yokuba kwinkqubo yokufunda, abafundi abongikazi abasalwamkeli nje ulwazi, kodwa basebenzisa izakhono zabo.ukufumana ulwazi ngeendlela ezahlukeneyo.Amalungu eqela akhulula ngokupheleleyo umoya weqela lawo, adibanise izixhobo zokufunda, kwaye anike ingxelo ngokuphindaphindiweyo, aziqhelanise, ahlalutye kwaye axoxe ngemiba yangoku yokonga kweklinikhi.Ulwazi lwabo lukhula ukusuka phezulu ukuya kubunzulu, lunikela ingqalelo ngakumbi kumxholo othile wohlalutyo lwesizathu.iingxaki zempilo, ukuqulunqwa kweenjongo zabongikazi kunye nokuba nokwenzeka kongenelelo lokonga.I-Faculty ibonelela ngesikhokelo kunye nomboniso ngexesha leengxoxo ukwenza umjikelo wokuvuselela umbono-ukuziqhelanisa-impendulo, ukunceda abafundi abongikazi ukuba bagqibe inkqubo yokufunda enentsingiselo, baphucule izakhono zokuziqhelanisa nezonyango zabafundi bobunesi, ukomeleza umdla wokufunda kunye nokusebenza, kunye nokuphucula rhoqo umsebenzi weklinikhi wabafundi - abongikazi ..isakhono.Isakhono sokufunda kwithiyori ukuziqhelanisa, ukugqiba ukulinganisa ulwazi.
Ukuphunyezwa kweenkqubo zemfundo yeklinikhi esekwe kwiCDIO kuphucula umgangatho wemfundo yezonyango.Iziphumo zophando zikaDing Jinxia [30] kunye nabanye zibonisa ukuba kukho unxibelelwano phakathi kwemiba eyahlukeneyo efana nenkuthazo yokufunda, isakhono sokufunda ngokuzimeleyo, kunye nokuziphatha okusebenzayo kokufundisa kootitshala bezonyango.Kolu phononongo, ngophuhliso lweCDIO yokufundisa kwezonyango, ootitshala bezonyango bafumana uqeqesho oluphuculweyo lobuchwephesha, iikhonsepthi zokufundisa ezihlaziyiweyo, kunye nezakhono zokufundisa eziphuculweyo.Okwesibini, iphucula imizekelo yokufundisa kwezonyango kunye nomxholo wemfundo yobuhlengikazi bentliziyo, ibonakalisa ucwangco kunye nokusebenza kwemodeli yokufundisa ngokwembono enkulu, kwaye ikhuthaza ukuqonda kwabafundi kunye nokugcinwa komxholo wekhosi.Ingxelo emva kwesifundo ngasinye inokukhuthaza ukuzazi kootitshala beklinikhi, ikhuthaze ootitshala bezonyango ukuba bacinge ngezakhono zabo, inqanaba lobuchwephesha kunye neempawu zobuntu, ukuqonda ngokwenene ukufunda koontanga, kwaye baphucule umgangatho wokufundisa kwezonyango.Iziphumo zibonise ukuba umgangatho wokufundisa wootitshala beklinikhi kwiqela lokungenelela lalingcono kunokuba kwiqela lolawulo, elifana neziphumo zophando ngu-Xionng Haiyang [31].
Nangona iziphumo zolu phononongo zibalulekile ekufundiseni kwezonyango, uphononongo lwethu lusenemida eliqela.Okokuqala, ukusetyenziswa kwesampulu elula kunokunciphisa ukwenzeka ngokubanzi kwezi ziphumo, kwaye isampuli yethu yayilinganiselwe kwisibhedlele sokhathalelo lwenqanaba eliphezulu.Okwesibini, ixesha loqeqesho ziiveki ezi-4 kuphela, kwaye abongikazi abaqeqeshwayo bafuna ixesha elingakumbi lokuphuhlisa izakhono zokucinga ezibalulekileyo.Okwesithathu, kolu phononongo, izigulane ezisetyenziswe kwi-Mini-CEX yayizigulana zokwenyani ngaphandle koqeqesho, kwaye umgangatho womsebenzi wekhosi yabahlengikazi abaqeqeshwayo unokwahluka kwisigulane ukuya kwisigulane.Le yimiba ephambili ethintela iziphumo zolu phononongo.Uphando lwexesha elizayo kufuneka lwandise ubungakanani besampulu, lwandise uqeqesho lwabafundisi-ntsapho bezonyango, kwaye ludibanise imigangatho yokuphuhlisa izifundo ezingumzekelo.Uphononongo olude nalo luyafuneka ukuphanda ukuba ingaba igumbi lokufundela elijingisiweyo elisekelwe kwingqikelelo yeCDIO lingaphuhlisa izakhono ezibanzi zabafundi bezonyango kwixesha elide.
Olu phononongo luphuhlise imodeli yeCDIO kuyilo lwesifundo kubafundi abongikazi bamathambo, lwakha igumbi lokufundela elijingisiweyo ngokusekwe kwingqikelelo yeCDIO, laze ladibanisa nemodeli yovavanyo ye-mini-CEX.Iziphumo zibonisa ukuba igumbi lokufundela elijingisiweyo elisekelwe kwingqikelelo yeCDIO ayiphuculi nje kuphela umgangatho wokufundisa kwezonyango, kodwa ikwaphucula isakhono sabafundi sokufunda ngokuzimeleyo, ukucinga nzulu, kunye nokukwazi ukuziqhelanisa nonyango.Le ndlela yokufundisa ithembekile kwaye iyasebenza kuneentetho zemveli.Kunokugqitywa ukuba iziphumo zinokuba nefuthe kwimfundo yezonyango.Igumbi lokufundela elijingisiweyo, elisekelwe kwingqikelelo yeCDIO, ligxile ekufundiseni, ekufundeni nakwimisebenzi eyenziwayo kwaye lidibanisa ngokusondeleyo ukuhlanganiswa kolwazi lobuchwephesha kunye nophuhliso lwezakhono ezisebenzayo ukulungiselela abafundi umsebenzi wezonyango.Ngenxa yokubaluleka kokubonelela abafundi ngethuba lokuthatha inxaxheba ngokukhutheleyo ekufundeni nasekuziqhelaniseni, kunye nokuqwalasela yonke imiba, kucetywayo ukuba imodeli yokufunda yeklinikhi esekelwe kwi-CDIO isetyenziswe kwimfundo yezonyango.Le ndlela inokucetyiswa kwakhona njengendlela entsha, egxile kumfundi ekufundiseni kwezonyango.Ukongezelela, iziphumo ziya kuba luncedo kakhulu kubenzi bomgaqo-nkqubo kunye nososayensi xa bequlunqa izicwangciso zokuphucula imfundo yezonyango.
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Ixesha lokuposa: Feb-24-2024