Ukusukela oko kwaqhambuka ubhubhane we-COVID-19, ilizwe liqalise ukunikela ingqalelo ngakumbi kumsebenzi wokufundisa ngezonyango kwizibhedlele zaseyunivesithi. Ukuqinisa ukuhlanganiswa kwezonyango kunye nemfundo kunye nokuphucula umgangatho kunye nokusebenza kakuhle kokufundisa ngezonyango yimingeni emikhulu ejongene nemfundo yezonyango. Ubunzima bokufundisa nge-orthopedics buxhomekeke kwiintlobo ngeentlobo zezifo, ubuchule obuphezulu kunye neempawu ezingacacanga, ezichaphazela inyathelo, umdla kunye nokusebenza kakuhle kokufundisa kwabafundi bezonyango. Olu phononongo luphuhlise isicwangciso sokufundisa eklasini esiguqulweyo esisekelwe kwingcamango ye-CDIO (Concept-Design-Implement-Operate) kwaye sayisebenzisa kwikhosi yoqeqesho lwabafundi be-orthopedic nursing ukuphucula isiphumo sokufunda esisebenzayo kunye nokunceda ootitshala baqonde ukutshintsha ikamva lemfundo ye-nursing kwanemfundo yezonyango. Ukufunda eklasini kuya kusebenza ngakumbi kwaye kugxile.
Abafundi bezonyango abangamashumi amahlanu abagqibe uqeqesho kwisebe lamathambo kwisibhedlele semfundo ephakamileyo ngoJuni ka-2017 babandakanyiwe kwiqela lolawulo, kwaye abafundi bobuhlengikazi abangama-50 abagqibe uqeqesho kwisebe ngoJuni ka-2018 babandakanyiwe kwiqela longenelelo. Iqela longenelelo lamkele ingcamango ye-CDIO yemodeli yokufundisa eklasini eguqulweyo, ngelixa iqela lolawulo lamkela imodeli yokufundisa yendabuko. Emva kokugqiba imisebenzi esebenzayo yesebe, amaqela amabini abafundi avavanywa kwithiyori, izakhono zokusebenza, amandla okufunda ngokuzimeleyo kunye nobuchule bokucinga ngokunzulu. Amaqela amabini ootitshala agqibe amanyathelo asibhozo okuvavanya amandla okwenza iklinikhi, kubandakanya iinkqubo ezine zobuhlengikazi, amandla okwenza iklinikhi yobuntu, kunye novavanyo lomgangatho wokufundisa kweklinikhi.
Emva koqeqesho, ubuchule bokuziqhelanisa neklinikhi, ubuchule bokucinga ngokucokisekileyo, ubuchule bokufunda ngokuzimeleyo, ukusebenza kwethiyori kunye nokusebenza, kunye namanqaku omgangatho wokufundisa kweklinikhi kwiqela longenelelo ayephezulu kakhulu kunalawo eqela lolawulo (zonke ii-P < 0.05).
Imodeli yokufundisa esekelwe kwi-CDIO inokukhuthaza ukufunda okuzimeleyo kwabafundi abaqeqeshwayo njengabahlengikazi kunye nokukwazi ukucinga ngokucokisekileyo, ikhuthaze indibaniselwano yendalo yethiyori kunye nokusebenza, iphucule amandla abo okusebenzisa ngokupheleleyo ulwazi lwethiyori ukuhlalutya nokusombulula iingxaki ezisebenzayo, kunye nokuphucula isiphumo sokufunda.
Imfundo yeklinikhi yeyona nqanaba libalulekileyo lemfundo yobuhlengikazi kwaye ibandakanya utshintsho ukusuka kulwazi lwethiyori ukuya ekusebenzeni. Ukufunda kweklinikhi okusebenzayo kunokunceda abafundi bobuhlengikazi ukuba baphumelele kwizakhono zobungcali, baqinise ulwazi lobungcali, kwaye baphucule amandla abo okwenza ubunesi. Ikwalinqanaba lokugqibela lotshintsho lomsebenzi wabafundi bezonyango [1]. Kwiminyaka yakutshanje, abaphandi abaninzi bokufundisa ngeklinikhi benze uphando ngeendlela zokufundisa ezifana nokufunda okusekelwe kwingxaki (PBL), ukufunda okusekelwe kwiimeko (CBL), ukufunda okusekelwe kwiqela (TBL), kunye nokufunda ngokwemeko kunye nokufunda ukulinganisa imeko ekufundiseni ngeklinikhi. . Nangona kunjalo, iindlela ezahlukeneyo zokufundisa zinezibonelelo kunye neengxaki zazo ngokubhekiselele kwisiphumo sokufunda sonxibelelwano olusebenzayo, kodwa azifezekisi ukuhlanganiswa kwethiyori kunye nokusebenza [2].
"Iklasi eguqulweyo" ibhekisa kwimodeli entsha yokufunda apho abafundi basebenzisa iqonga lolwazi oluthile ukuze bafunde ngokuzimeleyo izixhobo ezahlukeneyo zemfundo ngaphambi kweklasi kwaye bagqibezele umsebenzi wesikolo ngohlobo "lokufunda ngokubambisana" kwigumbi lokufundela ngelixa ootitshala bekhokela abafundi. Phendula imibuzo kwaye unike uncedo lomntu ngamnye[3]. I-American New Media Alliance iqaphele ukuba igumbi lokufundela eliguqulweyo lilungisa ixesha ngaphakathi nangaphandle kweklasi kwaye lidlulisela izigqibo zokufunda zabafundi ukusuka kootitshala ukuya kubafundi [4]. Ixesha elixabisekileyo elichithwa kwigumbi lokufundela kule modeli yokufunda livumela abafundi ukuba bagxile ngakumbi ekufundeni okusebenzayo, okusekelwe kwiingxaki. UDeshpande [5] wenze uphando kwigumbi lokufundela eliguqulweyo kwimfundo yokufundisa kunye nokufundisa kwaye wagqiba kwelokuba igumbi lokufundela eliguqulweyo linokuphucula umdla wokufunda kwabafundi kunye nokusebenza kwezemfundo kwaye linciphise ixesha leklasi. UKhe Fung HEW kunye noChung Kwan LO [6] bahlolisise iziphumo zophando zamanqaku athelekisayo kwigumbi lokufundela eliguqulweyo kwaye bashwankathela isiphumo siphela sendlela yokufundisa igumbi lokufundela eliguqulweyo ngokusebenzisa uhlalutyo lwe-meta, nto leyo ebonisa ukuba xa kuthelekiswa neendlela zokufundisa zendabuko, indlela yokufundisa igumbi lokufundela eliguqulweyo kwimfundo yezempilo yobungcali ingcono kakhulu kwaye iphucula ukufunda kwabafundi. UZhong Jie [7] uthelekise iziphumo zokufunda nge-flipped virtual classroom kunye ne-flipped physical classroom hybrid learning ekufumaneni ulwazi lwabafundi, waza wafumanisa ukuba kwinkqubo yokufunda nge-hybrid kwiklasi ye-flipped histology, ukuphucula umgangatho wokufundisa kwi-intanethi kunokuphucula ulwaneliseko nolwazi lwabafundi. Ngokusekelwe kwiziphumo zophando ezingentla, kwicandelo lemfundo yobuhlengikazi, uninzi lwabaphengululi lufunda impembelelo ye-flipped classroom ekusebenzeni kakuhle kokufundisa eklasini kwaye bakholelwa ukuba ukufundisa nge-flipped classroom kunokuphucula ukusebenza kwabafundi bobuhlengikazi kwizifundo, amandla okufunda ngokuzimeleyo, kunye nolwaneliseko eklasini.
Ngoko ke, kukho imfuneko engxamisekileyo yokuphonononga nokuphuhlisa indlela entsha yokufundisa eya kunceda abafundi bobuhlengikazi ukuba bathathe kwaye basebenzise ulwazi olucwangcisiweyo lobuchwephesha kwaye baphucule amandla abo okusebenza kwezonyango kunye nomgangatho opheleleyo. I-CDIO (Concept-Design-Implement-Operate) yimodeli yemfundo yobunjineli eyaphuhliswa ngo-2000 ziiyunivesithi ezine, kubandakanya iMassachusetts Institute of Technology kunye neRoyal Institute of Technology eSweden. Yimodeli ephucukileyo yemfundo yobunjineli evumela abafundi bobuhlengikazi ukuba bafunde kwaye bafumane izakhono ngendlela esebenzayo, esebenzayo, neyomzimba [8, 9]. Ngokuphathelele ukufunda okuphambili, le modeli igxininisa "ukugxininisa kwabafundi," evumela abafundi ukuba bathathe inxaxheba ekucingeni, ekuyileni, ekuphunyezweni, nasekusebenzeni kweeprojekthi, nasekuguquleni ulwazi olufunyenweyo lwethiyori lube zizixhobo zokusombulula iingxaki. Izifundo ezininzi zibonise ukuba imodeli yokufundisa ye-CDIO inegalelo ekuphuculeni izakhono zoqheliselo lweklinikhi kunye nomgangatho opheleleyo wabafundi bezonyango, ukuphucula ukusebenzisana kootitshala nabafundi, ukuphucula ukusebenza kakuhle kokufundisa, kwaye idlala indima ekukhuthazeni uhlengahlengiso lolwazi kunye nokwenza ngcono iindlela zokufundisa. Isetyenziswa kakhulu kuqeqesho lwetalente olusetyenzisiweyo [10].
Ngotshintsho lwemodeli yezonyango yehlabathi, iimfuno zabantu zempilo ziyanda, nto leyo ekhokelele ekwandeni koxanduva lwabasebenzi bezonyango. Amandla kunye nomgangatho wabahlengikazi kunxulumene ngokuthe ngqo nomgangatho wokhathalelo lwezonyango kunye nokhuseleko lwezigulane. Kwiminyaka yakutshanje, uphuhliso kunye novavanyo lwezakhono zonyango zabasebenzi bezonyango lube ngumxholo oshushu kwicandelo labahlengikazi [11]. Ke ngoko, indlela yovavanyo enenjongo, ebanzi, ethembekileyo, nesebenzayo ibalulekile kuphando lwemfundo yezonyango. Uvavanyo oluncinci lwezonyango (mini-CEX) yindlela yokuvavanya amandla ezonyango apheleleyo abafundi bezonyango kwaye isetyenziswa kakhulu kwicandelo lemfundo yezonyango eyahlukeneyo ekhaya nakwamanye amazwe. Yabonakala kancinci kancinci kwicandelo labahlengikazi [12, 13].
Izifundo ezininzi zenziwe malunga nokusetyenziswa kwemodeli ye-CDIO, igumbi lokufundela elijikiweyo, kunye ne-mini-CEX kwimfundo yobuhlengikazi. UWang Bei [14] uxoxe ngempembelelo yemodeli ye-CDIO ekuphuculeni uqeqesho olukhethekileyo lwabahlengikazi kwiimfuno zabahlengikazi be-COVID-19. Iziphumo zibonisa ukuba ukusebenzisa imodeli yoqeqesho lwe-CDIO ukubonelela ngoqeqesho olukhethekileyo lwabahlengikazi kwi-COVID-19 kuya kunceda abasebenzi bobuhlengikazi ukuba bafumane ngcono izakhono zoqeqesho lobuhlengikazi ezikhethekileyo kunye nolwazi oluhambelanayo, kwaye baphucule ngokupheleleyo izakhono zabo zobuhlengikazi. Iingcali ezifana noLiu Mei [15] zixoxe ngokusetyenziswa kwendlela yokufundisa yeqela kunye neklasi ejikiweyo ekuqeqesheni abahlengikazi be-orthopedic. Iziphumo zibonise ukuba le modeli yokufundisa inokuphucula ngempumelelo izakhono ezisisiseko zabahlengikazi be-orthopedic ezifana nokuqonda. kunye nokusetyenziswa kolwazi lwethiyori, ukusebenza njengeqela, ukucinga ngokucokisekileyo, kunye nophando lwesayensi. ULi Ruyue et al. [16] bafunde isiphumo sokusebenzisa i-Nursing Mini-CEX ephuculweyo kuqeqesho oluqhelekileyo lwabahlengikazi abatsha abatyandayo kwaye bafumanise ukuba ootitshala banokusebenzisa i-Nursing Mini-CEX ukuvavanya yonke inkqubo yovavanyo kunye nokusebenza ekufundiseni kweklinikhi okanye emsebenzini. Amakhonkco abuthathaka kuye. abahlengikazi kunye nokubonelela ngempendulo yexesha langempela. Ngenkqubo yokuzijonga nokuzihlolisisa, amanqaku asisiseko ovavanyo lokusebenza kwabahlengikazi ayafundwa, ikharityhulam iyalungiswa, umgangatho wokufundisa ngeklinikhi uphuculwa ngakumbi, amandla abafundi okunyanga abahlengikazi aphuculiweyo, kwaye indibaniselwano yeklasi eguqulweyo esekelwe kwingcamango ye-CDIO iyavavanywa, kodwa okwangoku akukho ngxelo yophando. Ukusetyenziswa kwemodeli yovavanyo lwe-mini-CEX kwimfundo yabahlengikazi kubafundi bamathambo. Umbhali usebenzise imodeli ye-CDIO kuphuhliso lweekhosi zoqeqesho zabafundi bamathambo abahlengikazi, wakha igumbi lokufundela eliguqulweyo ngokusekelwe kwingcamango ye-CDIO, waza wadibanisa nemodeli yovavanyo lwe-mini-CEX ukuphumeza ulwazi kunye nezakhono zokufunda ezintathu-kwinye, kwaye wanegalelo ekuphuculeni umgangatho wokufundisa. Uphuculo oluqhubekayo lubonelela ngesiseko sokufunda okusekelwe ekusebenzeni kwizibhedlele zokufundisa.
Ukuze kube lula ukuphunyezwa kwale khosi, indlela yokunika iisampulu elula isetyenzisiwe njengezifundo zokufunda ukukhetha abafundi bobuhlengikazi ukususela ngo-2017 nango-2018 ababesebenza kwicandelo lamathambo esibhedlele semfundo ephakamileyo. Ekubeni kukho abafundi abangama-52 kwinqanaba ngalinye, ubungakanani besampulu buya kuba yi-104. Abafundi abane abazange bathathe inxaxheba kuqheliselo olupheleleyo lweklinikhi. Iqela lolawulo laliquka abafundi bobuhlengikazi abangama-50 abagqibe uqeqesho kwisebe lamathambo esibhedlele semfundo ephakamileyo ngoJuni 2017, apho amadoda ama-6 kunye nabafazi abangama-44 abaneminyaka engama-20 ukuya kuma-22 (21.30 ± 0.60), abagqibe uqeqesho kwisebe elifanayo ngoJuni 2018. Iqela longenelelo laliquka abafundi bezonyango abangama-50, kuquka amadoda asi-8 kunye nabafazi abangama-42 abaneminyaka engama-21 ukuya kuma-22 (21.45 ± 0.37). Zonke izifundo zinike imvume enolwazi. Iikhrayitheriya zokubandakanywa: (1) Abafundi boqeqesho lwezonyango lwamathambo abanesidanga se-bachelor. (2) Imvume enolwazi kunye nokuthatha inxaxheba ngokuzithandela kolu phononongo. Iikhrayitheriya zokukhutshwa: Abantu abangakwaziyo ukuthatha inxaxheba ngokupheleleyo kuqheliselo lwezonyango. Akukho mahluko ubalulekileyo ngokwezibalo kulwazi oluqhelekileyo lwamaqela amabini abafundi bezonyango (p>0.05) kwaye bayalingana.
Omabini amaqela agqibe uqeqesho lweklinikhi lweeveki ezi-4, zonke izifundo zigqityiwe kwiSebe leeOrthopedics. Ngexesha lokujonga, bekukho amaqela ali-10 abafundi bezonyango, abafundi aba-5 kwiqela ngalinye. Uqeqesho lwenziwa ngokuhambelana nenkqubo yoqeqesho lwabafundi bobuhlengikazi, kuquka amacandelo ethiyori kunye nezobugcisa. Ootitshala kumaqela omabini baneziqinisekiso ezifanayo, kwaye utitshala womongikazi unoxanduva lokujonga umgangatho wokufundisa.
Iqela lolawulo lisebenzise iindlela zokufundisa zemveli. Kwiveki yokuqala yesikolo, iiklasi ziqala ngoMvulo. Ootitshala bafundisa ithiyori ngoLwesibini nangoLwesithathu, kwaye bagxila kuqeqesho lokusebenza ngoLwesine nangoLwesihlanu. Ukususela kwiveki yesibini ukuya kweyesine, ilungu ngalinye le-faculty linoxanduva lomfundi wezonyango onika iintetho ngamanye amaxesha kwicandelo. Kwiveki yesine, uvavanyo luya kugqitywa kwiintsuku ezintathu ngaphambi kokuphela kwekhosi.
Njengoko bekutshiwo ngaphambili, umbhali usebenzisa indlela yokufundisa eguqulweyo esekwe kwingcamango ye-CDIO, njengoko kuchaziwe ngezantsi.
Iveki yokuqala yoqeqesho iyafana neyakwiqela lolawulo; Iveki yesibini ukuya kweyesine yoqeqesho lwamathambo oluqhutywa ngexesha lotyando lusebenzisa isicwangciso sokufundisa esiguqulweyo esisekelwe kwingcamango ye-CDIO iiyure ezingama-36 zizonke. Inxalenye yengcinga kunye noyilo igqitywa kwiveki yesibini kwaye inxalenye yokuphunyezwa igqitywa kwiveki yesithathu. Utyando lugqitywe kwiveki yesine, kwaye uvavanyo kunye novavanyo lugqitywe kwiintsuku ezintathu ngaphambi kokukhululwa. Jonga iTheyibhile 1 ukuze ufumane ulwabiwo oluthile lwexesha leklasi.
Kwasekwa iqela lokufundisa eliquka umongikazi oyintloko omnye, i-faculty ye-orthopedic esi-8 kunye nengcali yomongikazi ye-CDIO engeyiyo i-orthopedic. Umongikazi oyiNtloko unika amalungu eqela lokufundisa isifundo kunye nokuqonda ikharityhulam kunye nemigangatho ye-CDIO, incwadi yesikhokelo ye-CDIO kunye nezinye iingcamango ezinxulumene noko kunye neendlela ezithile zokuphumeza (ubuncinane iiyure ezingama-20), kwaye ubonisana neengcali ngamaxesha onke ngemiba enzima yokufundisa ithiyori. I-faculty ibeka iinjongo zokufunda, ilawula ikharityhulam, kwaye ilungiselela izifundo ngendlela ehambelana neemfuno zomongikazi wabantu abadala kunye nenkqubo yokuhlala.
Ngokwenkqubo yoqeqesho, ngokubhekiselele kwinkqubo yoqeqesho lweetalente ze-CDIO kunye nemigangatho [17] kunye neempawu zokufundisa zomongikazi wamathambo, iinjongo zokufunda zabaqeqeshwa abaqeqeshwayo abangongikazi zibekwe ngokwamanqanaba amathathu, oko kukuthi: iinjongo zolwazi (ukuqonda ulwazi olusisiseko), ulwazi lobuchwephesha kunye neenkqubo zenkqubo ezinxulumene noko, njl.njl.), iinjongo zobuchule (ukuphucula izakhono zobungcali ezisisiseko, izakhono zokucinga ngokucokisekileyo kunye nezakhono zokufunda ezizimeleyo, njl.njl.) kunye neenjongo ezisemgangathweni (ukwakha amaxabiso obuchwephesha afanelekileyo kunye nomoya wokukhathalela abantu njl.njl.). .). Iinjongo zolwazi zihambelana nolwazi lobuchwephesha kunye nokuqiqa kwekharityhulam ye-CDIO, izakhono zomntu, izakhono zobungcali kunye nobudlelwane bekharityhulam ye-CDIO, kwaye iinjongo ezisemgangathweni zihambelana nezakhono ezithambileyo zekharityhulam ye-CDIO: ukusebenza kunye nonxibelelwano.
Emva kweentlanganiso ezimbini, iqela lokufundisa lixoxe ngesicwangciso sokufundisa umsebenzi wobuhlengikazi kwigumbi lokufundela eliguqulweyo elisekelwe kwingcamango ye-CDIO, lahlulahlula uqeqesho lwaba ngamanqanaba amane, laza lamisela iinjongo kunye noyilo, njengoko kubonisiwe kwiTheyibhile 1.
Emva kokuhlalutya umsebenzi wokonga ngezifo zamathambo, utitshala uchonge amatyala ezifo zamathambo eziqhelekileyo neziqhelekileyo. Masithathe isicwangciso sonyango lwezigulane ezine-lumbar disc herniation njengomzekelo: Isigulana uZhang Moumou (oyindoda, oneminyaka engama-73 ubudala, ubude obuyi-177 cm, ubunzima obuyi-80 kg) ukhale "ngentlungu esezantsi yomqolo ehamba nokungaziva kunye nentlungu kwilungu elisezantsi lasekhohlo kangangeenyanga ezi-2" kwaye wangeniswa esibhedlele kwikliniki yezigulane ezingalaliyo. Njengesigulana Umongikazi onoxanduva: (1) Nceda ubuze imbali yesigulana ngokusekwe kulwazi olufumeneyo kwaye umisele ukuba kwenzeka ntoni kwisigulana; (2) Khetha uphando olucwangcisiweyo kunye neendlela zovavanyo lobuchwephesha ngokusekelwe kwimeko kwaye ucebise imibuzo yophando efuna uvavanyo olongezelelweyo; (3) Yenza ukuxilongwa komongikazi. Kule meko, kuyimfuneko ukudibanisa isiseko sedatha sokukhangela ityala; bhala phantsi iindlela zokungenelela zomongikazi ezijolise kwisigulana; (4) Xoxa ngeengxaki ezikhoyo ekuzilawuleni kwesigulana, kunye neendlela zangoku kunye nomxholo wokulandelela isigulana xa siphuma. Thumela amabali abafundi kunye noluhlu lwemisebenzi kwiintsuku ezimbini ngaphambi kweklasi. Uluhlu lwemisebenzi yale meko lulandelayo: (1) Ukuphonononga nokuqinisa ulwazi lwethiyori malunga ne-etiology kunye neempawu zeklinikhi ze-lumbar intervertebral disc herniation; (2) Ukuphuhlisa isicwangciso sokhathalelo esijolise kuko; (3) Ukuphuhlisa le meko ngokusekelwe kumsebenzi weklinikhi kwaye usebenzise unyango lwangaphambi kotyando kunye nonyango lwasemva kotyando zezona meko zimbini ziphambili zokulinganisa iprojekthi yokufundisa. Abafundi bobuhlengikazi baphonononga ngokuzimeleyo umxholo wekhosi ngemibuzo yokuziqhelanisa, bajonge uncwadi olufanelekileyo kunye needathabheyisi, kwaye bagqibezele imisebenzi yokuzifundela ngokungena kwiqela le-WeChat.
Abafundi bakha amaqela ngokukhululekileyo, kwaye iqela likhetha inkokeli yeqela enoxanduva lokwahlula-hlula abasebenzi kunye nokulungelelanisa iprojekthi. Inkokeli yangaphambi kweqela inoxanduva lokusasaza umxholo one: intshayelelo yetyala, ukuphunyezwa kwenkqubo yobuhlengikazi, imfundo yezempilo, kunye nolwazi olunxulumene nezifo kwilungu ngalinye leqela. Ngexesha loqeqesho, abafundi basebenzisa ixesha labo lasimahla ukuphanda imvelaphi yethiyori okanye izixhobo ukusombulula iingxaki zetyala, ukuqhuba iingxoxo zeqela, kunye nokuphucula izicwangciso ezithile zeprojekthi. Ekuphuhlisweni kweprojekthi, utitshala unceda inkokeli yeqela ekwabeleni amalungu eqela ukuba ahlele ulwazi olufanelekileyo, aphuhlise kwaye avelise iiprojekthi, abonise kwaye atshintshe uyilo, kwaye ancede abafundi bobuhlengikazi ekudibaniseni ulwazi olunxulumene nomsebenzi kuyilo kunye nemveliso. Fumana ulwazi lwemodyuli nganye. Imingeni kunye namanqaku aphambili eli qela lophando ahlalutywe kwaye aphuhliswa, kwaye isicwangciso sokuphunyezwa kwemodeli yemeko yeli qela lophando saphunyezwa. Ngeli nqanaba, ootitshala baququzelele nemiboniso yemijikelo yobuhlengikazi.
Abafundi basebenza ngamaqela amancinci ukuze babonise iiprojekthi. Emva kwengxelo, amanye amalungu eqela kunye namalungu e-faculty baxoxe baza baphawula ngeqela elinika ingxelo ukuze baphucule ngakumbi isicwangciso sokhathalelo lwabahlengikazi. Inkokeli yeqela ikhuthaza amalungu eqela ukuba alingise yonke inkqubo yokhathalelo, kwaye utitshala unceda abafundi ukuba bahlole utshintsho oluguquguqukayo lwesifo ngokusebenzisa uqheliselo olulinganisiweyo, bandise ukuqonda kwabo kunye nokwakhiwa kolwazi lwethiyori, kwaye baphuhlise izakhono zokucinga nzulu. Yonke into ekufuneka igqitywe kuphuhliso lwezifo ezizodwa igqitywa phantsi kolwalathiso lootitshala. Ootitshala bathetha kwaye bakhokela abafundi bobuhlengikazi ukuba benze uqheliselo olusecaleni kwebhedi ukuze bafezekise indibaniselwano yolwazi kunye noqheliselo lweklinikhi.
Emva kokuvavanya iqela ngalinye, utitshala wenze izimvo waza waphawula amandla kunye nobuthathaka belungu ngalinye leqela ekucwangcisweni komxholo kunye nenkqubo yezakhono ukuze kuphuculwe rhoqo ukuqonda kwabafundi bobuhlengikazi ngomxholo wokufunda. Ootitshala bahlalutya umgangatho wokufundisa kwaye baphucule izifundo ngokusekelwe kuvavanyo lwabafundi bobuhlengikazi kunye novavanyo lokufundisa.
Abafundi bobuhlengikazi babhala iimviwo zethiyori kunye nezokusebenza emva koqeqesho olusebenzayo. Imibuzo yethiyori yongenelelo ibuzwa ngutitshala. Amaphepha ongenelelo ahlulwe ngamaqela amabini (A kunye no-B), kwaye iqela elinye likhethwa ngokungacwangciswanga longenelelo. Imibuzo yongenelelo yahlulwe yangamacandelo amabini: ulwazi lobuchwephesha lwethiyori kunye nohlalutyo lwetyala, ngalinye lixabisa amanqaku angama-50 ngamanqaku apheleleyo angama-100. Abafundi, xa bevavanya izakhono zobuhlengikazi, baya kukhetha ngokungacwangciswanga enye yezi zilandelayo, kubandakanya indlela yokuguqula i-axial, indlela elungileyo yokubeka amalungu kwizigulana ezenzakeleyo kumqolo, ukusetyenziswa kwendlela yonyango lwe-pneumatic, indlela yokusebenzisa umatshini wokuvuselela amalungu e-CPM, njl. Amanqaku apheleleyo ngamanqaku ali-100.
Kwiveki yesine, iSikali soVavanyo lokuFunda esiZimeleyo siya kuvavanywa kwiintsuku ezintathu ngaphambi kokuphela kwekhosi. Isikali sovavanyo esizimeleyo sesakhono sokufunda esaphuhliswa nguZhang Xiyan [18] sasetyenziswa, kubandakanya inkuthazo yokufunda (izinto ezi-8), ukuzibamba (izinto ezili-11), ukukwazi ukusebenzisana ekufundeni (izinto ezi-5), kunye nolwazi lokufunda (izinto ezi-6). Into nganye ilinganiswa kwisikali se-Likert samanqaku ama-5 ukusuka ku-"not at all stain" ukuya ku-"compatible ngokupheleleyo," ngamanqaku aqala ku-1 ukuya ku-5. Amanqaku ewonke ayi-150. Okukhona amanqaku ephezulu, kokukhona amandla okufunda ngokuzimeleyo esomelela. I-alpha coefficient ye-Cronbach yesikali yi-0.822.
Kwiveki yesine, isikali sokulinganisa amandla okucinga abalulekileyo savavanywa kwiintsuku ezintathu ngaphambi kokuba siphume. Inguqulelo yesiTshayina yeSikali soVavanyo loBuchule bokuCinga obuCritical eguqulelwe yiMercy Corps [19] yasetyenziswa. Inemilinganiselo esixhenxe: ukufumanisa inyaniso, ukucinga okuvulekileyo, amandla okuhlalutya kunye nokukwazi ukuhlela, kunye nezinto ezili-10 kumlinganiselo ngamnye. Isikali samanqaku ama-6 sisetyenziswa ukusuka ku-"andivumelani ngokupheleleyo" ukuya ku-"ndiyavuma kakhulu" ukusuka ku-1 ukuya ku-6, ngokulandelanayo. Iingxelo ezingalunganga zijongwa ngokuphambeneyo, kunye namanqaku apheleleyo aqala ku-70 ukuya ku-420. Amanqaku apheleleyo angama-≤210 abonisa ukusebenza okungalunganga, ama-211–279 abonisa ukusebenza okungathathi cala, ama-280–349 abonisa ukusebenza okuhle, kwaye ama-≥350 abonisa amandla okucinga aqinileyo. I-alpha coefficient ye-Cronbach yesikali yi-0.90.
Kwiveki yesine, uvavanyo lobuchule beklinikhi luza kwenzeka kwiintsuku ezintathu ngaphambi kokukhululwa. Isikali se-mini-CEX esisetyenzisiweyo kolu phononongo siguqulwe kwiMedical Classic [20] ngokusekelwe kwi-mini-CEX, kwaye ukungaphumeleli kufunyenwe ukusuka kumanqaku ali-1 ukuya kwama-3. Ihlangabezana neemfuno, amanqaku ama-4-6 ukuhlangabezana neemfuno, amanqaku asi-7-9 unaphakade. Abafundi bezonyango bagqiba uqeqesho lwabo emva kokugqiba uqeqesho olukhethekileyo. I-alpha coefficient yeCronbach yale sikali yi-0.780 kwaye i-split-half reliability coefficient yi-0.842, ebonisa ukuthembeka okuhle.
Kwiveki yesine, ngosuku olungaphambi kokushiya isebe, kwabanjwa intlanganiso yootitshala nabafundi kunye novavanyo lomgangatho wokufundisa. Ifomu yovavanyo lomgangatho wokufundisa yaphuhliswa nguZhou Tong [21] kwaye ibandakanya iinkalo ezintlanu: isimo sengqondo sokufundisa, umxholo wokufundisa, kunye nokufundisa. Iindlela, iziphumo zoqeqesho kunye neempawu zoqeqesho. Kusetyenziswe isikali se-Likert esinama-5-point. Okukhona amanqaku ephezulu, kokukhona umgangatho wokufundisa ungcono. Igqityiwe emva kokugqiba uqeqesho olukhethekileyo. Iphepha lemibuzo linokuthembeka okuhle, kunye ne-alpha kaCronbach yesikali ingu-0.85.
Idatha ihlalutywe kusetyenziswa isoftware yezibalo ye-SPSS 21.0. Idatha yokulinganisa ichazwa njenge-mean ± standard deviation (\(\strike X \pm S\)) kwaye iqela longenelelo t lisetyenziselwa ukuthelekisa amaqela. Idatha yokubala ichazwe njengenani lamatyala (%) kwaye ithelekiswa kusetyenziswa i-chi-square okanye i-Fisher's exact intervention. Ixabiso le-p <0.05 libonisa umahluko obalulekileyo ngokwezibalo.
Uthelekiso lwamanqaku ongenelelo lwethiyori kunye nokusebenza kwamaqela amabini abafundi abaqeqeshwayo abahlengikazi luboniswe kwiTheyibhile 2.
Uthelekiso lwezakhono zokufunda ngokuzimeleyo kunye nokucinga ngokunzulu kwamaqela amabini abafundi abaqeqeshwayo abangongikazi luboniswe kwiTheyibhile 3.
Uthelekiso lovavanyo lwezakhono zokwenza umsebenzi weklinikhi phakathi kwamaqela amabini abafundi abaqeqeshwayo njengabahlengikazi. Amandla okwenza umsebenzi wezonyango kubafundi kwiqela longenelelo ayengcono kakhulu kunalawo akwiqela lolawulo, kwaye umahluko wawubalulekile ngokwezibalo (p < 0.05) njengoko kubonisiwe kwiTheyibhile 4.
Iziphumo zokuvavanya umgangatho wokufundisa wamaqela amabini zibonise ukuba amanqaku omgangatho wokufundisa ewonke eqela lolawulo yayingama-90.08 ± 2.34 amanqaku, kwaye amanqaku omgangatho wokufundisa ewonke eqela longenelelo yayingama-96.34 ± 2.16 amanqaku. Umahluko wawubalulekile ngokwezibalo. (t = – 13.900, p < 0.001).
Uphuhliso kunye nenkqubela phambili kwezonyango kufuna ukuqokelelwa okwaneleyo kwetalente yezonyango. Nangona kukho iindlela ezininzi zoqeqesho lokulinganisa kunye nokulinganisa, azinakuthatha indawo yendlela yokusebenza kwezonyango, enxulumene ngokuthe ngqo nokukwazi kwetalente yezonyango yexesha elizayo ukunyanga izifo nokusindisa ubomi. Ukusukela kubhubhane we-COVID-19, ilizwe liye lanikela ingqalelo engakumbi kumsebenzi wokufundisa kwezonyango kwizibhedlele zaseyunivesithi [22]. Ukuqinisa ukuhlanganiswa kwezonyango kunye nemfundo kunye nokuphucula umgangatho kunye nokusebenza kakuhle kokufundisa kwezonyango yimingeni emikhulu ejongene nemfundo yezonyango. Ubunzima bokufundisa i-orthopedics bukwiintlobo ngeentlobo zezifo, ubungcali obuphezulu kunye neempawu ezingacacanga, ezichaphazela inyathelo, umdla kunye nokukwazi ukufunda kwabafundi bezonyango [23].
Indlela yokufundisa eklasini eguqulweyo ngaphakathi kwengcamango yokufundisa ye-CDIO idibanisa umxholo wokufunda nenkqubo yokufundisa, ukufunda kunye nokuziqhelanisa. Oku kutshintsha ulwakhiwo lwamagumbi okufundela kwaye kubeka abafundi bobuhlengikazi kwindawo ephambili yokufundisa. Ngexesha lenkqubo yemfundo, ootitshala banceda abafundi bobuhlengikazi ukuba bafumane ulwazi olufanelekileyo kwimiba enzima yobuhlengikazi kwiimeko eziqhelekileyo [24]. Uphando lubonisa ukuba i-CDIO ibandakanya uphuhliso lomsebenzi kunye nemisebenzi yokufundisa yeklinikhi. Le projekthi inika isikhokelo esineenkcukacha, idibanisa ngokusondeleyo ukuhlanganiswa kolwazi lobungcali kunye nophuhliso lwezakhono zomsebenzi ezisebenzayo, kwaye ichonga iingxaki ngexesha lokulinganisa, okuluncedo kubafundi bobuhlengikazi ekuphuculeni ubuchule babo bokufunda ngokuzimeleyo kunye nobuchule bokucinga ngokunzulu, kunye nolwalathiso ngexesha lokufunda ngokuzimeleyo. -study. Iziphumo zolu phononongo zibonisa ukuba emva kweeveki ezi-4 zoqeqesho, amanqaku abafundi bobuhlengikazi abazimeleyo kunye nobuchule bokucinga ngokunzulu kwiqela longenelelo ayephezulu kakhulu kunalawo akwiqela lolawulo (zombini p < 0.001). Oku kuhambelana neziphumo zophando lukaFan Xiaoying kwisiphumo se-CDIO edityaniswe nendlela yokufundisa ye-CBL kwimfundo yobuhlengikazi [25]. Le ndlela yoqeqesho inokuphucula kakhulu ubuchule bokucinga ngokunzulu kunye nobuchule bokufunda ngokuzimeleyo babaqeqeshwayo. Ngexesha lesigaba sokucinga, utitshala uqala ngokwabelana ngamanqaku anzima nabafundi bobuhlengikazi kwigumbi lokufundela. Abafundi bobuhlengikazi emva koko bafunda ngokuzimeleyo ulwazi olufanelekileyo ngeevidiyo zeentetho ezincinci baze bafune ngenkuthalo izixhobo ezifanelekileyo ukuze baphucule ukuqonda kwabo umsebenzi wobuhlengikazi bamathambo. Ngexesha lenkqubo yoyilo, abafundi bobuhlengikazi baqhelise ukusebenza kunye nezakhono zokucinga ngokunzulu ngeengxoxo zamaqela, bekhokelwa ngabafundisi kunye nokusebenzisa izifundo zetyala. Ngexesha lesigaba sokuphunyezwa, ootitshala babona unyango lwezifo zobomi bokwenyani ngexesha lotyando njengethuba kwaye basebenzise iindlela zokufundisa zokulinganisa imeko ukufundisa abafundi bobuhlengikazi ukuba benze imithambo yetyala ngokubambisana kwamaqela ukuze baziqhelanise kwaye bafumane iingxaki kumsebenzi wobuhlengikazi. Kwangaxeshanye, ngokufundisa iimeko zokwenyani, abafundi bobuhlengikazi banokufunda amanqaku aphambili okhathalelo lwangaphambi kotyando kunye nolwemva kotyando ukuze baqonde ngokucacileyo ukuba zonke iinkalo zokhathalelo lwangaphambi kotyando zizinto ezibalulekileyo ekubuyiseleni kwesigulana emva kotyando. Kwinqanaba lokusebenza, ootitshala banceda abafundi bezonyango ukuba baqonde iingcamango kunye nezakhono ekusebenzeni. Ngokwenza njalo, bafunda ukujonga utshintsho kwiimeko zokwenyani, ukucinga ngeengxaki ezinokubakho, kwaye bangakhumbuli iinkqubo ezahlukeneyo zobuhlengikazi ukunceda abafundi bezonyango. Inkqubo yokwakha kunye nokusetyenziswa idibanisa umxholo woqeqesho ngokwasemzimbeni. Kule nkqubo yokufunda esebenzisanayo, esebenzisanayo neyamava, ubuchule bokufunda bokufundisa abafundi abangongayo kunye nomdla wokufunda busebenza kakuhle kwaye izakhono zabo zokucinga ngokucokisekileyo ziyaphuculwa. Abaphandi basebenzise i-Design Thinking (DT)-Conceive-Design-Implement-Operate (CDIO)) ukwazisa isakhelo soyilo lobunjineli kwiikhosi zeenkqubo zewebhu ezibonelelwayo ukuphucula ukusebenza kwabafundi kwezemfundo kunye nobuchule bokucinga ngokubala (CT), kwaye iziphumo zibonisa ukuba ukusebenza kwabafundi kwezemfundo kunye nobuchule bokucinga ngokubala buphuculwe kakhulu [26].
Olu phononongo lunceda abafundi abangongikazi ukuba bathathe inxaxheba kuyo yonke inkqubo ngokwenkqubo yokubuza imibuzo-yokuyila-ukusetyenziswa-kokusebenza-ukuhlalutya. Iimeko zonyango ziye zaphuhliswa. Ingqwalasela ke ngoko ikukusebenzisana kweqela kunye nokucinga ngokuzimeleyo, kongezelelwa ngutitshala ophendula imibuzo, abafundi becebisa izisombululo kwiingxaki, ukuqokelelwa kwedatha, imisebenzi yeemeko, kwaye ekugqibeleni imisebenzi esecaleni kwebhedi. Iziphumo zophononongo zibonise ukuba amanqaku abafundi bezonyango kwiqela longenelelo ekuvavanyweni kolwazi lwethiyori kunye nezakhono zokusebenza ayengcono kunalawo abafundi kwiqela lolawulo, kwaye umahluko wawubalulekile ngokwezibalo (p < 0.001). Oku kuhambelana nenyaniso yokuba abafundi bezonyango kwiqela longenelelo babeneziphumo ezingcono ekuvavanyweni kolwazi 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 okwenzeka, kwaye okwesibini, ubunzima bezicwangciso zeprojekthi buhambelana nesiseko. Kule modeli, emva kokuba abafundi begqibile umxholo osebenzayo, bagqibezela incwadi yomsebenzi weprojekthi njengoko kufuneka, bahlaziye umxholo ofanelekileyo, baze baxoxe ngezabelo namalungu eqela ukuze baqonde kwaye bafake umxholo wokufunda ngaphakathi kwaye badibanise ulwazi olutsha nokufunda. Ulwazi oludala ngendlela entsha. Ukuhlanganiswa kolwazi kuyaphucuka.
Olu phononongo lubonisa ukuba ngokusebenzisa imodeli yokufunda yeklinikhi ye-CDIO, abafundi bobuhlengikazi kwiqela longenelelo babengcono kunabafundi bobuhlengikazi kwiqela lolawulo ekwenzeni iingcebiso zobuhlengikazi, uviwo lomzimba, ukumisela ukuxilongwa kobuhlengikazi, ukuphumeza ukungenelela kobuhlengikazi, kunye nemiphumo yokhathalelo lobuhlengikazi. Ukongeza, bekukho umahluko obalulekileyo ngokwezibalo kwipharamitha nganye phakathi kwamaqela amabini (p < 0.05), eyayifana neziphumo zikaHongyun [29]. UZhou Tong [21] wafunda isiphumo sokusebenzisa imodeli yokufundisa yeConcept-Design-Implement-Operate (CDIO) kwindlela yokufundisa yobuhlengikazi bentliziyo, waza wafumanisa ukuba abafundi kwiqela lovavanyo basebenzisa indlela yokufundisa yeklinikhi ye-CDIO. Indlela yokufundisa kwinkqubo yobuhlengikazi, ubuntu. Iiparameter ezisibhozo, ezifana nokukwazi ukonga kunye nokuzinikela, zingcono kakhulu kunezo zabafundi bobuhlengikazi abasebenzisa iindlela zokufundisa zendabuko. Oku kungenxa yokuba kwinkqubo yokufunda, abafundi bobuhlengikazi abasamkeli ulwazi ngaphandle kokwenza, kodwa basebenzisa izakhono zabo. bafumana ulwazi ngeendlela ezahlukeneyo. Amalungu eqela akhulula ngokupheleleyo umoya weqela labo, adibanise izixhobo zokufunda, kwaye aphinde axele, aqhelise, ahlalutye, kwaye axoxe ngemiba yangoku yobuhlengikazi beklinikhi. Ulwazi lwabo lukhula ukusuka kokungacacanga ukuya kokunzulu, benika ingqalelo ngakumbi kumxholo othile wohlalutyo lwesizathu. iingxaki zempilo, ukwakhiwa kweenjongo zobuhlengikazi kunye nokwenzeka kokungenelela kobuhlengikazi. Abafundisi babonelela ngesikhokelo kunye nomboniso ngexesha leengxoxo ukuze benze ukhuthazo olujikelezayo lwempendulo yokuqonda-yokwenza, bancede abafundi bobuhlengikazi bagqibezele inkqubo yokufunda enentsingiselo, baphucule izakhono zobuchule bokwenza ubugcisa beklinikhi zabafundi bobuhlengikazi, baphucule umdla wokufunda kunye nokusebenza kakuhle, kwaye baphucule rhoqo ubugcisa bokwenza ubugcisa beklinikhi babafundi - abahlengikazi. ...
Ukuphunyezwa kweenkqubo zemfundo yeklinikhi ezisekelwe kwi-CDIO kuphucula umgangatho wemfundo yeklinikhi. Iziphumo zophando zikaDing Jinxia [30] kunye nabanye zibonisa ukuba kukho unxibelelwano phakathi kweempawu ezahlukeneyo ezifana nenkuthazo yokufunda, amandla okufunda ngokuzimeleyo, kunye nokuziphatha okusebenzayo kokufundisa kootitshala beklinikhi. Kolu phononongo, ngokuphuhliswa kokufundisa kweklinikhi kwe-CDIO, ootitshala beklinikhi bafumana uqeqesho oluphuculweyo lobuchwephesha, iingcamango zokufundisa ezihlaziyiweyo, kunye nezakhono zokufundisa eziphuculweyo. Okwesibini, ityebisa imizekelo yokufundisa yeklinikhi kunye nomxholo wemfundo yobuhlengikazi bentliziyo, ibonisa ulungelelwano kunye nokusebenza kwemodeli yokufundisa ngokwembono enkulu, kwaye ikhuthaza ukuqonda kwabafundi kunye nokugcina umxholo wekhosi. Ingxelo emva kwentetho nganye inokukhuthaza ukuzazi kootitshala beklinikhi, ikhuthaze ootitshala beklinikhi ukuba bacinge ngezakhono zabo, inqanaba lobungcali kunye neempawu zobuntu, baqonde ngokwenene ukufunda kontanga, kwaye baphucule umgangatho wokufundisa kweklinikhi. Iziphumo zibonise ukuba umgangatho wokufundisa wootitshala beklinikhi kwiqela longenelelo wawungcono kunowokwiqela lolawulo, owawufana neziphumo zophando lukaXiong Haiyang [31].
Nangona iziphumo zolu phononongo zibalulekile ekufundiseni ngeklinikhi, uphando lwethu lusenemida eliqela. Okokuqala, ukusetyenziswa kwesampulu elula kunokunciphisa ukwenzeka kwezi ziphumo, kwaye isampulu yethu yayilinganiselwe kwisibhedlele esinye sokhathalelo lwezonyango oluphezulu. Okwesibini, ixesha loqeqesho ziiveki ezi-4 kuphela, kwaye abafundi abaqeqeshwayo abangongikazi bafuna ixesha elingakumbi lokuphuhlisa izakhono zokucinga nzulu. Okwesithathu, kolu phononongo, izigulane ezisetyenzisiweyo kwiMini-CEX zazizizigulane zokwenyani ezingenalo uqeqesho, kwaye umgangatho wokusebenza kwekhosi yabahlengikazi abaqeqeshwayo unokwahluka ukusuka kwisigulana ukuya kwisigulana. Le yimiba ephambili ethintela iziphumo zolu phononongo. Uphando lwexesha elizayo kufuneka lwandise ubungakanani besampulu, lwandise uqeqesho lwabafundisi bezonyango, kwaye luhlanganise imigangatho yokuphuhlisa izifundo zetyala. Uphononongo olude lukwafuneka ukuphanda ukuba iklasi eguqulweyo esekelwe kwingcamango ye-CDIO inokuphuhlisa izakhono ezibanzi zabafundi bezonyango kwixesha elide.
Olu phononongo luphuhlise imodeli ye-CDIO kuyilo lwezifundo zabafundi abangongikazi bamathambo, lwakha igumbi lokufundela elijikiweyo elisekelwe kwingcamango ye-CDIO, lwaza lwayidibanisa nemodeli yovavanyo lwe-mini-CEX. Iziphumo zibonisa ukuba igumbi lokufundela elijikiweyo elisekelwe kwingcamango ye-CDIO aliphuculi nje kuphela umgangatho wokufundisa ngeklinikhi, kodwa likwaphucula nokukwazi kwabafundi ukufunda ngokuzimeleyo, ukucinga ngokucokisekileyo, kunye nokukwazi ukwenza imisebenzi yeklinikhi. Le ndlela yokufundisa inokuthenjwa kwaye isebenza ngakumbi kuneentetho zemveli. Kungagqitywa kwelokuba iziphumo zinokuba nefuthe kwimfundo yezonyango. Igumbi lokufundela elijikiweyo, elisekelwe kwingcamango ye-CDIO, ligxile ekufundiseni, ekufundeni nakwimisebenzi esebenzayo kwaye lidibanisa ngokusondeleyo ukuqiniswa kolwazi lobungcali kunye nophuhliso lwezakhono ezisebenzayo ukulungiselela abafundi umsebenzi weklinikhi. Ngenxa yokubaluleka kokubonelela abafundi ithuba lokuthatha inxaxheba ekufundeni nasekuziqhelaniseni, kwaye kuqwalaselwa zonke iinkalo, kucetyiswa ukuba imodeli yokufunda yeklinikhi esekelwe kwi-CDIO isetyenziswe kwimfundo yezonyango. Le ndlela inokucetyiswa njengendlela entsha, egxile kubafundi ekufundiseni ngeklinikhi. Ukongeza, iziphumo ziya kuba luncedo kakhulu kubenzi bomgaqo-nkqubo kunye nososayensi xa bephuhlisa amaqhinga okuphucula imfundo yezonyango.
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Ixesha leposi: Februwari-24-2024