Kusukela umqedazwe we-COVID-19, izwe seliqale ukunaka kakhulu umsebenzi wokufundisa ezibhedlela zasenyuvesi.Ukuqinisa ukuhlanganiswa kwemithi nemfundo kanye nokwenza ngcono ikhwalithi nokusebenza ngempumelelo kokufundisa emtholampilo kuyizinselele ezinkulu ezibhekene nemfundo yezokwelapha.Ubunzima bokufundisa i-orthopaedics bulele ezinhlobonhlobo zezifo, ubuchwepheshe obuphezulu kanye nezici ezingabonakali, ezithonya isinyathelo, umdlandla kanye nempumelelo yokufundisa kwabafundi bezokwelapha.Lolu cwaningo luthuthukise uhlelo lokufundisa lwasekilasini oluphendukile olusekelwe kumqondo we-CDIO (Concept-Design-Implement-Operate) futhi lwawusebenzisa esifundweni sokuqeqeshwa kwabafundi bobuhlengikazi ukuze kuthuthukiswe umthelela wokufunda ongokoqobo nokusiza othisha babone ukushintshanisa ikusasa lemfundo yobuhlengikazi imfundo yezokwelapha.Ukufunda ekilasini kuzosebenza ngempumelelo futhi kugxile.
Abafundi abangu-50 bezobudokotela abaphothule i-internship emnyangweni wamathambo wesibhedlela semfundo ephakeme ngoJuni 2017 bafakwe eqenjini elilawulayo, kanti abafundi abahlengikazi abangama-50 abaphothule i-internship emnyangweni ngoJuni 2018 bafakwa eqenjini lokungenelela.Iqembu lokungenelela lamukele umqondo we-CDIO wemodeli yokufundisa yasekilasini ephendukile, kuyilapho iqembu elilawulayo lamukela imodeli yokufundisa evamile.Ngemva kokuphothula imisebenzi eyenziwayo yomnyango, amaqembu amabili abafundi ahlolwe ngethiyori, amakhono okusebenza, ikhono lokufunda elizimele kanye nekhono lokucabanga ngokujulile.Amaqembu amabili othisha aqede izilinganiso eziyisishiyagalombili zokuhlola amakhono okuzijwayeza emtholampilo, okuhlanganisa izinqubo ezine zobunesi, amakhono obuhlengikazi besintu, kanye nokuhlolwa kwekhwalithi yokufundisa emtholampilo.
Ngemuva kokuqeqeshwa, ikhono lokuzilolonga emtholampilo, ikhono lokucabanga elibucayi, ikhono lokufunda elizimele, ukusebenza kwethiyori nokusebenza, kanye nekhwalithi yokufundisa emtholampilo yeqembu lokungenelela kwakuphakeme kakhulu kuneqembu lokulawula (yonke i-P <0.05).
Imodeli yokufundisa esekelwe ku-CDIO ingashukumisa ukufunda okuzimele kwabafundela umsebenzi wobuhlengikazi kanye nekhono lokucabanga elijulile, ikhuthaze inhlanganisela yezinto eziphilayo zethiyori nokuzijwayeza, ithuthukise ikhono labo lokusebenzisa ngokugcwele ulwazi lwethiyori ukuze ihlaziye futhi ixazulule izinkinga ezingokoqobo, futhi ithuthukise umphumela wokufunda.
Imfundo yomtholampilo iyisigaba esibaluleke kakhulu semfundo yobuhlengikazi futhi ibandakanya ukuguquka kolwazi lwethiyori ukuya ekusebenzeni.Ukufunda umtholampilo okuphumelelayo kungasiza abafundi abahlengikazi babe ngamakhono ochwepheshe, kuqinise ulwazi lobungcweti, futhi kuthuthukise ikhono labo lokuprakthiza ubuhlengikazi.Futhi kuyisigaba sokugcina soshintsho lwendima yomsebenzi kubafundi bezokwelapha [1].Eminyakeni yakamuva, abacwaningi bokufundisa basemtholampilo abaningi benze ucwaningo ngezindlela zokufundisa ezifana nokufunda okusekelwe ezinkingeni (PBL), ukufunda okusekelwe esimweni (CBL), ukufunda okusekelwe eqenjini (TBL), nokufunda kwesimo kanye nokufunda kokulingisa isimo ekufundiseni komtholampilo. ..Kodwa-ke, izindlela zokufundisa ezehlukene zinezinzuzo zazo kanye nokubi ngokuphathelene nomphumela wokufunda wokuxhumana okusebenzayo, kodwa azifinyeleli ukuhlanganiswa kwethiyori nokwenza [2].
“Ikilasi eliphendukile” lisho imodeli entsha yokufunda lapho abafundi basebenzisa inkundla yolwazi oluthile ukuze bafunde ngokuzimela inhlobonhlobo yezinto zokufunda ngaphambi kwekilasi futhi baqedele umsebenzi wesikole wasekhaya ngendlela “yokufunda ngokubambisana” ekilasini kuyilapho othisha beqondisa abafundi.Phendula imibuzo futhi unikeze usizo lomuntu siqu[3].I-American New Media Alliance iphawule ukuthi ikilasi eliphendukile lilungisa isikhathi ngaphakathi nangaphandle kwekilasi futhi lidlulisela izinqumo zokufunda zabafundi zisuka kothisha ziye kubafundi [4].Isikhathi esibalulekile esichithwa ekilasini kule modeli yokufunda sivumela abafundi ukuthi bagxile kakhulu ekufundeni okusebenzayo, okusekelwe ezinkingeni.U-Deshpande [5] wenze ucwaningo ngekilasi eliphendukile emfundweni yabezimo eziphuthumayo kanye nokufundisa futhi waphetha ngokuthi ikilasi eliphendukile lingathuthukisa umdlandla wokufunda wabafundi kanye nokusebenza kahle kwezemfundo futhi kunciphise isikhathi sekilasi.U-Khe Fung HEW kanye no-Chung Kwan LO [6] bahlole imiphumela yocwaningo yezindatshana eziqhathanisayo ekilasini eliphendukile futhi bafingqa umphumela ophelele wendlela yokufundisa yasekilasini ephendukile ngokuhlaziywa kwe-meta, okubonisa ukuthi uma kuqhathaniswa nezindlela zokufundisa zendabuko, indlela yokufundisa yasekilasini ephendukile. emfundweni yezempilo yobungcweti ingcono kakhulu futhi ithuthukisa ukufunda kwabafundi.U-Zhong Jie [7] uqhathanise imiphumela yekilasi eliphendukile kanye nokufunda okuxubile kwekilasi elingokoqobo ekutholeni ulwazi lwabafundi, wathola ukuthi ohlelweni lokufunda okuxubile ekilasini le-histology eliphendukile, ukuthuthukisa ikhwalithi yokufundisa nge-inthanethi kungathuthukisa ukwaneliseka kwabafundi futhi ulwazi.bamba.Ngokusekelwe emiphumeleni yocwaningo engenhla, emkhakheni wezemfundo yabahlengikazi, izifundiswa eziningi zifunda umphumela wekilasi eliphendukile ekusebenzeni kahle kokufundisa ekilasini futhi zikholelwa ukuthi ukufundisa okuphendukile ekilasini kungathuthukisa ukusebenza kwezemfundo kwabafundi abahlengikazi, ikhono lokufunda ngokuzimela, nokwaneliseka kwekilasi.
Ngakho-ke, kunesidingo esiphuthumayo sokuhlola nokuthuthukisa indlela entsha yokufundisa ezosiza abafundi abahlengikazi ukuba bamunce futhi basebenzise ulwazi oluhlelekile lwezobuchwepheshe futhi bathuthukise ikhono labo lokuzijwayeza emtholampilo kanye nekhwalithi ephelele.I-CDIO (Concept-Design-Implement-Operate) iyimodeli yemfundo yobunjiniyela eyasungulwa ngo-2000 amanyuvesi amane, okuhlanganisa iMassachusetts Institute of Technology kanye neRoyal Institute of Technology eSweden.Kuyimodeli ethuthukisiwe yemfundo yobunjiniyela evumela abafundi abahlengikazi ukuthi bafunde futhi bathole amakhono ngendlela esebenzayo, esebenzayo, nangendlela ephilayo [8, 9].Mayelana nokufunda okuwumongo, le modeli igcizelela “ukugxila komfundi,” okuvumela abafundi ukuthi babambe iqhaza ekuqanjweni, ekuklameni, ekusetshenzisweni nasekusebenzeni kwamaphrojekthi, kanye nokuguqula ulwazi lwethiyori oluzuziwe lube amathuluzi okuxazulula izinkinga.Ucwaningo oluningi lubonise ukuthi imodeli yokufundisa ye-CDIO inikela ekuthuthukiseni amakhono okuzijwayeza emtholampilo kanye nekhwalithi ephelele yabafundi bezokwelapha, ukuthuthukisa ukusebenzisana kothisha nomfundi, ukuthuthukisa ukusebenza kahle kokufundisa, futhi idlala indima ekuthuthukiseni ukuguqulwa kolwazi kanye nokwenza kahle izindlela zokufundisa.Isetshenziswa kabanzi ekuqeqesheni ithalente elisetshenziswayo [10].
Ngokushintshwa kwemodeli yezokwelapha emhlabeni wonke, izidingo zabantu zempilo ziyanda, okuye kwaholela ekwandeni kwesibopho sabasebenzi bezokwelapha.Ikhono kanye nekhwalithi yabahlengikazi kuhlobene ngokuqondile nekhwalithi yokunakekelwa komtholampilo nokuphepha kwesiguli.Eminyakeni yamuva nje, ukuthuthukiswa nokuhlolwa kwamakhono omtholampilo wabahlengikazi sekuphenduke isihloko esishisayo emkhakheni wobuhlengikazi [11].Ngakho-ke, indlela yokuhlola eyimpokophelo, ebanzi, ethembekile, nesemthethweni ibalulekile ocwaningweni lwemfundo yezokwelapha.I-mini-clinical evaluation exercise (mini-CEX) iyindlela yokuhlola amakhono omtholampilo aphelele abafundi bezokwelapha futhi isetshenziswa kakhulu emkhakheni wemfundo yezokwelapha yemikhakha eminingi ekhaya naphesheya.Kwavela kancane kancane emkhakheni wobuhlengikazi [12, 13].
Izifundo eziningi zenziwe ngokusetshenziswa kwemodeli ye-CDIO, ikilasi eliphendukile, kanye ne-mini-CEX emfundweni yobunesi.U-Wang Bei [14] uxoxe ngomthelela wemodeli ye-CDIO ekuthuthukiseni ukuqeqeshwa okuqondene nabahlengikazi ngezidingo zabahlengikazi be-COVID-19.Imiphumela iphakamisa ukuthi ukusebenzisa imodeli yokuqeqeshwa kwe-CDIO ukuhlinzeka ngokuqeqeshwa okukhethekile kwezobuhlengikazi ku-COVID-19 kuzosiza abasebenzi abahlengikazi bathole kangcono amakhono akhethekile okuqeqesha abahlengikazi nolwazi oluhlobene, futhi kuthuthukise ngokuphelele amakhono abo obuhlengikazi.Izazi ezinjengo-Liu Mei [15] zaxoxa ngokusetshenziswa kwendlela yokufundisa yeqembu ehlanganiswe nekilasi eliphendukile ekuqeqesheni abahlengikazi bezifo zamathambo.Imiphumela yabonisa ukuthi le modeli yokufundisa ingathuthukisa ngempumelelo amakhono ayisisekelo abahlengikazi bamathambo njengokuqonda.kanye nokusetshenziswa kolwazi lwethiyori, ukusebenzisana, ukucabanga okujulile, kanye nocwaningo lwesayensi.U-Li Ruyue et al.[16] itadishe umphumela wokusebenzisa iNursing Mini-CEX ethuthukisiwe ekuqeqesheni okujwayelekile kwabahlengikazi abasha futhi yathola ukuthi othisha bangasebenzisa iNursing Mini-CEX ukuze bahlole yonke inqubo yokuhlola nokusebenza ekufundiseni komtholampilo noma izixhumanisi ze-work.weak ku- wakhe.abahlengikazi futhi banikeze impendulo yesikhathi sangempela.Ngenqubo yokuzibheka kanye nokuzindla ngokwakho, amaphuzu ayisisekelo okuhlolwa kokusebenza kobuhlengikazi ayafundwa, ikharikhulamu iyalungiswa, izinga lokufundisa emtholampilo liyathuthukiswa, ikhono eliphelele lokuhlinzwa lokuhlengikaza labafundi liyathuthukiswa, futhi kuyaphendukizwa. inhlanganisela yekilasi ngokusekelwe kumqondo we-CDIO iyahlolwa, kodwa okwamanje awukho umbiko wocwaningo.Ukusetshenziswa kwemodeli yokuhlola ye-mini-CEX emfundweni yobuhlengikazi yabafundi bamathambo.Umbhali usebenzise imodeli ye-CDIO ekuthuthukisweni kwezifundo zokuqeqesha zabafundi abahlengikazi bamathambo, wakha ikilasi eliphendukile elisuselwa kumqondo we-CDIO, futhi lahlanganiswa nemodeli yokuhlola ye-mini-CEX ukuze kusetshenziswe imodeli yokufunda kathathu kokukodwa nekhwalithi.ulwazi namakhono, futhi libe nesandla ekuthuthukiseni izinga lokufundisa.Ukuthuthukiswa okuqhubekayo kunikeza isisekelo sokufunda okusekelwe ekusebenzeni ezibhedlela zokufundisa.
Ukuze kube lula ukuqaliswa kwalesi sifundo, kusetshenziswe indlela yokwenza isampula elula njengezifundo ukuze kukhethwe abafundi abahlengikazi kusukela ngo-2017 nango-2018 abebesebenza emnyangweni wezifo zamathambo esibhedlela semfundo ephakeme.Njengoba kunabafundi abaqeqeshwayo abangama-52 ezingeni ngalinye, usayizi wesampula uzoba ngu-104. Abafundi abane abazange babambe iqhaza ekuqeqesheni okugcwele komtholampilo.Iqembu elilawulayo lalihlanganisa abafundi abahlengikazi abangama-50 abaphothule i-internship emnyangweni wamathambo wesibhedlela semfundo ephakeme ngoJuni 2017, lapho amadoda ayi-6 nabesifazane abangama-44 abaneminyaka engama-20 kuya kwengama-22 (21.30 ± 0.60), abaphothule i-internship kulowo mnyango ofanayo. ngoJuni 2018. Iqembu lokungenelela lalihlanganisa abafundi bezokwelapha abangu-50, kuhlanganise namadoda angu-8 nabesifazane abangu-42 abaneminyaka engu-21 kuya ku-22 (21.45±0.37) iminyaka.Zonke izifundo zinikeze imvume enolwazi.Imibandela Yokufaka: (1) Abafundi be-Orthopedic medical internship abaneziqu ze-bachelor.(2) Imvume enolwazi nokubamba iqhaza ngokuzithandela kulolu cwaningo.Imibandela yokukhishwa: Abantu abangakwazi ukubamba iqhaza ngokugcwele emisebenzini yomtholampilo.Awukho umehluko obalulekile ngokwezibalo olwazini olujwayelekile lwamaqembu amabili abafundi abafundela ubudokotela (p>0.05) futhi ayaqhathaniswa.
Womabili amaqembu aqede i-internship yomtholampilo yamasonto ama-4, nazo zonke izifundo eziqediwe eMnyangweni Wezamathambo.Ngesikhathi sokubhekwa, bekukhona isamba samaqembu ayi-10 abafundi bezokwelapha, abafundi aba-5 eqenjini ngalinye.Ukuqeqeshwa kwenziwa ngokuhambisana nohlelo lwe-internship lwabafundi abahlengikazi, okubandakanya izingxenye zethiyori nezobuchwepheshe.Othisha bawo womabili la maqembu baneziqu ezifanayo, kanti uthisha ongumhlengikazi unomthwalo wemfanelo wokuqapha izinga lokufundisa.
Iqembu elilawulayo lasebenzisa izindlela zokufundisa zendabuko.Ngesonto lokuqala lesikole, amakilasi aqala ngoMsombuluko.Othisha bafundisa ithiyori ngoLwesibili nangoLwesithathu, futhi bagxile ekuqeqesheni ukusebenza ngoLwesine nangoLwesihlanu.Kusukela ngesonto lesibili kuya kwelesine, ilungu ngalinye le-faculty linesibopho somfundi wezokwelapha onikeza izinkulumo ngezikhathi ezithile emnyangweni.Ngesonto lesine, ukuhlolwa kuzoqedwa ezinsukwini ezintathu ngaphambi kokuphela kwesifundo.
Njengoba kushiwo ngaphambili, umbhali usebenzisa indlela yokufundisa yasekilasini ephendukile esekelwe kumqondo we-CDIO, njengoba kuchazwe ngezansi.
Isonto lokuqala lokuqeqeshwa lifana neqembu lokulawula;Amaviki amabili kuya kwamane okuqeqeshwa kwe-orthopaedic perioperative asebenzisa uhlelo lokufundisa lwasekilasini oluphendukile olusekelwe kumqondo we-CDIO amahora angu-36 esewonke.Ingxenye yombono nokuklama iqedwa ngesonto lesibili futhi ingxenye yokuqaliswa kwayo iphothulwa ngesonto lesithathu.Ukuhlinzwa kwaqedwa ngesonto lesine, futhi ukuhlolwa nokuhlolwa kwaqedwa ezinsukwini ezintathu ngaphambi kokukhishwa.Bheka Ithebula 1 ukuze uthole ukusabalalisa kwesikhathi sekilasi elithile.
Ithimba lothisha elihlanganisa umhlengikazi oyedwa ongu-1, uphiko lwamathambo oluyisi-8 kanye nochwepheshe ongu-1 ongewona wamathambo we-CDIO wasungulwa.Umhlengikazi Omkhulu uhlinzeka amalungu ethimba lothisha ngesifundo kanye nekhono lekharikhulamu namazinga e-CDIO, ibhukwana le-CDIO workshop kanye neminye imibono ehlobene nezindlela ezithile zokuyisebenzisa (okungenani amahora angama-20), futhi uthintana nochwepheshe ngaso sonke isikhathi ngezindaba eziyinkimbinkimbi zokufundisa. .I-Faculty isetha izinhloso zokufunda, iphathe ikharikhulamu, futhi ilungiselele izifundo ngendlela engaguquki ehambisana nezidingo zobuhlengikazi abadala kanye nohlelo lokuhlala.
Ngokohlelo lwe-internship, kubhekiselwa kuhlelo lokuqeqeshwa kwethalente le-CDIO kanye namazinga [17] futhi kuhlanganiswe nezici zokufundisa zomhlengikazi wamathambo, izinhloso zokufunda zabahlengikazi abaqeqeshelwa umsebenzi zibekwe ngezigaba ezintathu, okungukuthi: izinhloso zolwazi (ukuphatha kahle okuyisisekelo ulwazi), ulwazi lobungcweti kanye nezinqubo zesistimu ezihlobene, njll.), izinjongo zobuchule (ukuthuthukisa amakhono ayisisekelo ochwepheshe, amakhono okucabanga abucayi namakhono okufunda azimele, njll.) kanye nezinhloso zekhwalithi (ukwakha amanani ochwepheshe anengqondo nomoya wokunakekela kobuntu kanye njll.)..).Imigomo yolwazi ihambisana nolwazi lobuchwepheshe nokucabanga kwekharikhulamu ye-CDIO, amakhono omuntu siqu, amakhono ochwepheshe kanye nobudlelwano bekharikhulamu ye-CDIO, kanye nezinjongo zekhwalithi zihambisana namakhono athambile ekharikhulamu ye-CDIO: ukusebenzisana ngokubambisana nokuxhumana.
Ngemva kwemizuliswano emibili yemihlangano, ithimba lothisha laxoxisana ngohlelo lokufundisa umkhuba wobuhlengikazi ekilasini eliphendukile elisekelwe kumqondo we-CDIO, lahlukanisa ukuqeqeshwa kwaba izigaba ezine, futhi lanquma imigomo nokuklama, njengoba kukhonjisiwe kuThebula loku-1.
Ngemva kokuhlaziya umsebenzi wobuhlengikazi ngezifo zamathambo, uthisha wakhomba amacala ezifo ezivamile nezivamile zamathambo.Ake sithathe uhlelo lokwelapha iziguli ezine-lumbar disc herniation njengesibonelo: Isiguli uZhang Moumou (owesilisa, oneminyaka engu-73 ubudala, ubude obungu-177 cm, isisindo esingu-80 kg) wakhalaza “ngobuhlungu obuphansi beqolo obuhambisana nokuba ndikindiki nobuhlungu esithweni esingezansi kwesokunxele 2 izinyanga” futhi walaliswa esibhedlela emtholampilo wangaphandle.Njengomhlengikazi onesibophezelo: (1) Sicela ubuze ngokuhlelekile umlando wesiguli ngokusekelwe olwazini olutholile futhi unqume ukuthi kwenzekani esigulini;(2) Khetha inhlolovo ehlelekile kanye nezindlela zokuhlola zobungcweti ezisekelwe esimweni bese uphakamisa imibuzo yocwaningo edinga ukuhlolwa okwengeziwe;(3) Yenza ukuxilongwa komhlengikazi.Kulokhu, kuyadingeka ukuhlanganisa imininingwane yokusesha yamacala;qopha ukungenelela okuhlosiwe kobuhlengikazi okuhlobene nesiguli;(4) Xoxa ngezinkinga ezikhona ekuzilawuleni kwesiguli, kanye nezindlela zamanje kanye nokuqukethwe kokulandelela isiguli lapho kukhishwa.Thumela izindaba zabafundi nohlu lwemisebenzi ezinsukwini ezimbili ngaphambi kwekilasi.Uhlu lwemisebenzi yaleli cala lumi kanje: (1) Buyekeza futhi uqinise ulwazi lwethiyori mayelana ne-etiology kanye nokubonakaliswa kwemitholampilo ye-lumbar intervertebral disc herniation;(2) Yenza uhlelo lokunakekela oluhlosiwe;(3) Ukuthuthukisa leli cala ngokusekelwe emsebenzini womtholampilo futhi usebenzise ukunakekelwa kwangaphambi kokuhlinzwa kanye nangemuva kokuhlinzwa yizimo ezimbili eziyinhloko zokufundisa ukulingisa iphrojekthi.Abafundi abahlengikazi babuyekeza ngokuzimela okuqukethwe kwesifundo ngemibuzo yokuzilolonga, bathintane nezincwadi ezifanele kanye nesizindalwazi, futhi baqedele imisebenzi yokuzifundela ngokungena eqenjini le-WeChat.
Abafundi bakha amaqembu ngokukhululekile, futhi iqembu likhetha umholi weqembu onesibopho sokuhlukanisa abasebenzi kanye nokuxhumanisa iphrojekthi.Umholi wangaphambi kweqembu unomthwalo wemfanelo wokusabalalisa okuqukethwe okune: isingeniso samacala, ukuqaliswa kwenqubo yobuhlengikazi, imfundo yezempilo, nolwazi oluhlobene nezifo kulungu leqembu ngalinye.Ngesikhathi sokuqeqeshwa, abafundi basebenzisa isikhathi sabo samahhala ukucwaninga isizinda sethiyori noma izinto zokwakha ukuxazulula izinkinga zamacala, ukuqhuba izingxoxo zeqembu, nokuthuthukisa izinhlelo ezithile zephrojekthi.Ekuthuthukisweni kwephrojekthi, uthisha usiza umholi weqembu ekwabeleni amalungu eqembu ukuthi ahlele ulwazi olufanele, athuthukise futhi akhiqize amaphrojekthi, abonise futhi aguqule imiklamo, futhi asize abafundi abahlengikazi ekuhlanganiseni ulwazi oluhlobene nomsebenzi ekuklameni nasekukhiqizeni.Thola ulwazi lwemojuli ngayinye.Izinselelo namaphuzu abalulekile aleli qembu locwaningo ahlaziywa futhi athuthukiswa, futhi kwaqaliswa uhlelo lokuqalisa lokumodela isimo saleli qembu locwaningo.Ngalesi sigaba, othisha baphinde bahlela imibukiso yobuhlengikazi.
Abafundi basebenza ngamaqembu amancane ukwethula amaphrojekthi.Ngemuva kwalo mbiko, amanye amalungu eqembu kanye namalungu obuhlakani axoxile futhi aphawula ngeqembu elibikayo ukuze athuthukise uhlelo lokunakekela abahlengikazi.Umholi weqembu ukhuthaza amalungu eqembu ukuthi alingise yonke inqubo yokunakekela, futhi uthisha usiza abafundi ukuthi bahlole izinguquko eziguquguqukayo zesifo ngokwenza okulingisayo, bajulise ukuqonda kwabo nokwakhiwa kolwazi lwethiyori, futhi bathuthukise amakhono okucabanga okujulile.Konke okuqukethwe okufanele kuqedwe ekuthuthukisweni kwezifo ezikhethekile kuqedwa ngaphansi kokuqondisa kothisha.Othisha baphawula futhi baqondise abafundi abahlengikazi ukuthi benze umkhuba wokuzijwayeza eceleni kombhede ukuze bathole inhlanganisela yolwazi nokusebenza komtholampilo.
Ngemva kokuhlola iqembu ngalinye, ofundisayo wenze imibono futhi waphawula amandla kanye nobuthakathaka belungu leqembu ngalinye enhlanganweni yokuqukethwe kanye nenqubo yamakhono ukuze kuthuthukiswe ngokuqhubekayo ukuqonda kwabafundi abahlengikazi kokuqukethwe okufundwayo.Othisha bahlaziya ikhwalithi yokufundisa futhi balungise izifundo ezisekelwe ekuhlolweni kwabafundi bobuhlengikazi kanye nokuhlolwa kokufundisa.
Abafundi abahlengikazi bathatha izivivinyo zethiyori kanye nezokusebenza ngemuva kokuqeqeshwa okusebenzayo.Imibuzo yetiyetha yokungenelela ibuzwa nguthisha.Amaphepha okungenelela ahlukaniswe ngamaqembu amabili (A no-B), futhi iqembu elilodwa likhethwa ngokungahleliwe ukuze kungenelele.Imibuzo yokungenelela ihlukaniswe yaba izingxenye ezimbili: ulwazi lwethiyori yobungcweti nokuhlaziywa kwecala, ngayinye ibiza amaphuzu angama-50 ngenani eliphelele lamaphuzu ayi-100.Abafundi, lapho behlola amakhono obuhlengikazi, bazokhetha ngokungahleliwe okukodwa kwalokhu okulandelayo, okuhlanganisa inqubo ye-axial inversion, indlela enhle yokumisa imilenze yeziguli ezinokulimala komgogodla, ukusetshenziswa kwenqubo yokwelapha i-pneumatic, inqubo yokusebenzisa umshini wokuvuselela ngokuhlanganyela we-CPM, njll. amaphuzu angu-100.
Esontweni lesine, Isikali Sokuhlola UkuFunda Okuzimele sizohlolwa ezinsukwini ezintathu ngaphambi kokuphela kwesifundo.Isikali sokuhlola esizimele sekhono lokufunda esathuthukiswa uZhang Xiyan [18] sasetshenziswa, okuhlanganisa ugqozi lokufunda (izinto eziyi-8), ukuzithiba (izinto eziyi-11), ikhono lokuhlanganyela ekufundeni (izinto ezi-5), nolwazi lokufunda nokubhala (izinto eziyi-6) .Into ngayinye ilinganiselwe esikalini se-Likert samaphoyinti angu-5 ukusuka kokuthi “akuhambisani nhlobo” kuya “kungaguquki ngokuphelele,” okunamaphuzu asuka ku-1 kuye ku-5. Isamba esiphelele singu-150. Uma amaphuzu aphezulu, aqina amandla okufunda ngokuzimela. .I-alpha coefficient ye-Cronbach ingu-0.822.
Ngesonto lesine, isikali sokulinganisa ikhono lokucabanga elibucayi sahlolwa izinsuku ezintathu ngaphambi kokukhishwa.Inguqulo yesiShayina ye-Critical Thinking Ability Assessment Scale ehunyushwe yi-Mercy Corps [19] yasetshenziswa.Inezinhlangothi eziyisikhombisa: ukutholakala kweqiniso, ukucabanga okuvulekile, ikhono lokuhlaziya kanye nekhono lokuhlela, nezinto ezingu-10 kuhlangothi ngalunye.Isikali samaphuzu angu-6 sisetshenziswa kusukela “kungavumelani kakhulu” kuya “kuvuma ngokuqinile” ukusuka ku-1 kuye ku-6, ngokulandelana.Izitatimende ezingezinhle zinemiphumela ehlehliswayo, nenani eliphelele elisukela ku-70 kuya ku-420. Isamba esiphelele sika-≤210 sibonisa ukusebenza okungalungile, i-211-279 ibonisa ukusebenza okungathathi hlangothi, i-280-349 ibonisa ukusebenza okuhle, futhi ≥350 ibonisa ikhono lokucabanga elibucayi eliqinile.I-alpha coefficient ye-Cronbach ingu-0.90.
Esontweni lesine, ukuhlolwa kwekhono lomtholampilo kuzokwenzeka ezinsukwini ezintathu ngaphambi kokukhishwa.Isilinganiso esincane se-CEX esisetshenziswe kulolu cwaningo sithathwe ku-Medical Classic [20] ngokusekelwe ku-mini-CEX, futhi ukwehluleka kwamaphuzu kusuka ku-1 kuya ku-3 amaphuzu.Ihlangabezana nezimfuneko, amaphuzu angu-4-6 ezidingo zomhlangano, amaphuzu angu-7-9 ngokuhle.Abafundi bezokwelapha baqeda ukuqeqeshwa kwabo ngemuva kokuphothula i-internship ekhethekile.I-alpha coefficient ye-Cronbach yalesi sikali ingu-0.780 futhi i-coefficient yokuthembeka kwe-split-half ngu-0.842, okubonisa ukwethembeka okuhle.
Esontweni lesine okuwusuku olwandulela ukuphuma kulo mnyango, kube nengqungquthela yothisha nabafundi kanye nokuhlolwa kwezinga lokufundisa.Ifomu lokuhlola izinga lokufundisa lakhiwe nguZhou Tong [21] futhi lihlanganisa izici ezinhlanu: isimo sengqondo sokufundisa, okuqukethwe kokufundisa, nokufundisa.Izindlela, imiphumela yokuqeqeshwa kanye nezici zokuqeqeshwa.Kusetshenziswe isikali se-Likert esingamaphuzu angu-5.Uma amaphuzu aphezulu, izinga lokufundisa lingcono.Kuqedwe ngemuva kokuphothula i-internship ekhethekile.Uhlu lwemibuzo lunokwethenjelwa okuhle, ne-alpha yesikali sika-Cronbach ingu-0.85.
Idatha yahlaziywa kusetshenziswa isofthiwe yezibalo ye-SPSS 21.0.Idatha yokulinganisa ichazwa njengesho ± ukuchezuka okujwayelekile (\(\strike X \pm S\)) futhi iqembu lokungenela elithi t lisetshenziselwa ukuqhathanisa phakathi kwamaqembu.Idatha yokubala iboniswe njengenombolo yezigameko (%) futhi yaqhathaniswa kusetshenziswa i-chi-square noma ukungenelela okuqondile kukaFisher.Inani elingu-p <0.05 libonisa umehluko obalulekile ngokwezibalo.
Ukuqhathaniswa kwamaphuzu okungenelela kwethiyori kanye nokusebenza kwamaqembu amabili abahlengikazi abafundela umsebenzi kuboniswa kuThebula lesi-2.
Ukuqhathaniswa kokufunda okuzimele kanye namakhono okucabanga okujulile amaqembu amabili abahlengikazi abafundela umsebenzi kuboniswa kuThebula lesi-3.
Ukuqhathaniswa kokuhlolwa kwekhono lokuzijwayeza emtholampilo phakathi kwamaqembu amabili abahlengikazi abafundela umsebenzi.Ikhono lomkhuba wokuhlengikaza emtholampilo labafundi eqenjini lokungenelela lalingcono kakhulu kunalelo eqenjini lokulawula, futhi umehluko wawubalulekile ngokwezibalo (p <0.05) njengoba kuboniswe kuThebula lesi-4.
Imiphumela yokuhlola ikhwalithi yokufundisa yamaqembu amabili ibonise ukuthi inani eliphelele lekhwalithi yokufundisa yeqembu elilawulayo lalingamaphoyinti angu-90.08 ± 2.34, futhi inani eliphelele lekhwalithi yokufundisa yeqembu lokungenelela lalingamaphoyinti angu-96.34 ± 2.16.Umehluko ububalulekile ngokwezibalo.(t = – 13.900, p <0.001).
Ukuthuthukiswa kanye nenqubekelaphambili yomuthi kudinga ukuqoqwa okwanele kwethalente lezokwelapha.Nakuba izindlela eziningi zokulingisa nezindlela zokuqeqesha zokulingisa zikhona, azikwazi ukuthatha indawo yokusebenza komtholampilo, okuhlobene ngokuqondile nekhono lethalente lezokwelapha lesikhathi esizayo ukwelapha izifo nokusindisa izimpilo.Kusukela ubhubhane lwe-COVID-19, izwe liye lanaka kakhulu umsebenzi wokufundisa emtholampilo wezibhedlela zasenyuvesi [22].Ukuqinisa ukuhlanganiswa kwemithi nemfundo kanye nokwenza ngcono ikhwalithi nokusebenza ngempumelelo kokufundisa emtholampilo kuyizinselele ezinkulu ezibhekene nemfundo yezokwelapha.Ubunzima bokufundisa i-orthopaedics bulele ezinhlobonhlobo zezifo, ubuchwepheshe obuphezulu kanye nezici ezingabonakali, ezithinta isinyathelo, umdlandla kanye nekhono lokufunda labafundi bezokwelapha [23].
Indlela yokufundisa yasekilasini ephendukile ngaphakathi komqondo wokufundisa we-CDIO ihlanganisa okuqukethwe kokufunda nenqubo yokufundisa, yokufunda nokwenza.Lokhu kushintsha ukwakheka kwamakilasi futhi kubeka abafundi abahlengikazi emnyombweni wokufundisa.Ngesikhathi senqubo yemfundo, othisha basiza abafundi abahlengikazi ukuthi bafinyelele ulwazi olufanele mayelana nezinkinga eziyinkimbinkimbi zobuhlengikazi ezimweni ezijwayelekile [24].Ucwaningo lubonisa ukuthi i-CDIO ihlanganisa ukuthuthukiswa komsebenzi kanye nemisebenzi yokufundisa emtholampilo.Le phrojekthi inikeza isiqondiso esinemininingwane, ihlanganisa eduze ukuhlanganiswa kolwazi lochwepheshe nokuthuthukiswa kwamakhono okusebenza okungokoqobo, futhi ihlonza izinkinga ngesikhathi sokulingisa, okuwusizo kubafundi abahlengikazi ekuthuthukiseni ukufunda kwabo ngokuzimela kanye namakhono okucabanga okujulile, kanye nesiqondiso ngesikhathi sokuzimela. ukufunda.-isifundo.Imiphumela yalolu cwaningo ibonisa ukuthi ngemva kwamasonto e-4 okuqeqeshwa, ukufunda okuzimele kanye namakhono okucabanga okubucayi abafundi abahlengikazi eqenjini lokungenelela kwakuphakeme kakhulu kunalabo abaseqenjini lokulawula (kokubili p <0.001).Lokhu kuhambisana nemiphumela yocwaningo luka-Fan Xiaoying ngomphumela we-CDIO ehlanganiswe nendlela yokufundisa ye-CBL emfundweni yobunesi [25].Le ndlela yokuqeqesha ingathuthukisa kakhulu ukucabanga okujulile kwabaqeqeshwayo kanye namakhono okufunda azimele.Phakathi nesigaba sokucabanga, uthisha uqala abelane ngamaphuzu anzima nabafundi abahlengikazi ekilasini.Abafundi abahlengikazi babe sebefunda ngokuzimela ulwazi olufanele ngama-video ezinkulumo ezincane futhi bafune ngenkuthalo izinto ezidingekayo ukuze bathuthukise ukuqonda kwabo umsebenzi wobuhlengikazi bamathambo.Phakathi nenqubo yokuklama, abafundi abahlengikazi bazilolonge ukusebenzisana kanye namakhono okucabanga okujulile ngezingxoxo zamaqembu, eziqondiswa ubuhlakani kanye nokusebenzisa izifundo eziyisibonelo.Phakathi nesigaba sokuqaliswa, othisha babheka ukunakekelwa kwe-perioperative yezifo zangempela njengethuba futhi basebenzise izindlela zokufundisa zokulingisa amacala ukuze bafundise abafundi abahlengikazi ukwenza izivivinyo zecala ngokubambisana kweqembu ukuze bazijwayeze futhi bathole izinkinga emsebenzini wobuhlengikazi.Ngesikhathi esifanayo, ngokufundisa izimo zangempela, abafundi abahlengikazi bangafunda amaphuzu ayinhloko okunakekelwa kwangaphambi kokuhlinzwa kanye nangemuva kokuhlinzwa ukuze baqonde ngokucacile ukuthi zonke izici zokunakekelwa kwe-perioperative ziyizici ezibalulekile ekululameni kwesiguli ngemva kokuhlinzwa.Ezingeni lokusebenza, othisha basiza abafundi bezokwelapha ukuthi babe ngamathiyori namakhono ekusebenzeni.Ngokwenza kanjalo, bafunda ukubona izinguquko ezimweni ezimweni zangempela, ukucabanga ngezinkinga ezingase zibe khona, futhi bangakhumbuli ngekhanda izinqubo ezihlukahlukene zobuhlengikazi ukusiza abafundi bezokwelapha.Inqubo yokwakha kanye nokuqaliswa organically ihlanganisa okuqukethwe ukuqeqeshwa.Kule nqubo yokufunda ngokubambisana, esebenzisanayo nenolwazi, ikhono lokufunda labafundi abahlengikazi nomdlandla wokufunda kuhlanganiswe kahle futhi amakhono abo okucabanga athuthukisiwe.Abacwaningi basebenzise i-Design Thinking (DT)-Conceive-Design-Implement-Operate (CDIO)) ukwethula uhlaka lokuklama lobunjiniyela ezifundweni ezinikezwayo zokuhlela izinhlelo zewebhu ukuthuthukisa ukusebenza kwabafundi ezifundweni kanye namakhono okucabanga okuhlanganisa (CT), futhi imiphumela ikhombisa, lokho. Ukusebenza kwezemfundo kwabafundi kanye namakhono okucabanga okubaliwe athuthukiswa kakhulu [26].
Lolu cwaningo lusiza abafundi abahlengikazi ukuthi babambe iqhaza kuyo yonke inqubo ngokuya ngenqubo ye-Questioning-Concept-Design-Implementation-Operation-Debriefing.Izimo zomtholampilo zenziwe.Kugxilwa ekusebenzisaneni kweqembu kanye nokucabanga okuzimele, kulekelelwa uthisha ophendula imibuzo, abafundi baphakamise izixazululo zezinkinga, ukuqoqwa kwedatha, ukuvivinya umzimba kwesimo, futhi ekugcineni izivivinyo eziseceleni kombhede.Imiphumela yocwaningo ibonise ukuthi izikolo zabafundi bezokwelapha eqenjini lokungenelela ekuhlolweni kolwazi lwethiyori kanye namakhono okusebenza kwakungcono kunabafundi beqembu lokulawula, futhi umehluko wawubalulekile ngokwezibalo (p <0.001).Lokhu kuhambisana neqiniso lokuthi abafundi bezokwelapha eqenjini lokungenelela babe nemiphumela engcono ekuhlolweni kolwazi lwethiyori kanye namakhono okusebenza.Uma kuqhathaniswa neqembu lokulawula, umehluko ububalulekile ngokwezibalo (p<0.001).Kuhlanganiswe nemiphumela yocwaningo efanele [27, 28].Isizathu sokuhlaziywa ukuthi imodeli ye-CDIO iqala ngokukhetha amaphuzu olwazi lwezifo ngezinga eliphezulu lezigameko, futhi okwesibili, inkimbinkimbi yezilungiselelo zephrojekthi ifana nesisekelo.Kulo modeli, ngemva kokuba abafundi sebeqedele okuqukethwe okungokoqobo, baqedela incwadi yemisebenzi yephrojekthi njengoba kudingeka, babuyekeze okuqukethwe okufanele, futhi baxoxisane namalungu eqembu ngama-asayinimenti ukuze bagaye futhi bafake ngaphakathi okuqukethwe okufundwayo futhi bahlanganise ulwazi olusha nokufunda.Ulwazi oludala ngendlela entsha.Ukwenziwa kolwazi kuyathuthuka.
Lolu cwaningo lubonisa ukuthi ngokusetshenziswa kwemodeli yokufunda yomtholampilo ye-CDIO, abafundi abahlengikazi eqenjini lokungenelela babengcono kunabafundi abahlengikazi eqenjini lokulawula ekwenzeni ukubonisana kwabahlengikazi, ukuhlolwa ngokomzimba, ukunquma ukuxilongwa kwabahlengikazi, ukusebenzisa ukungenelela kwabahlengikazi, nokunakekelwa kwabahlengikazi.imiphumela.kanye nokunakekelwa kobuntu.Ngaphezu kwalokho, kwakukhona umehluko ophawulekayo wezibalo kupharamitha ngayinye phakathi kwamaqembu amabili (p <0.05), eyayifana nemiphumela ye-Hongyun [29].U-Zhou Tong [21] ufunde umphumela wokusebenzisa imodeli yokufundisa ye-Concept-Design-Implement-Operate (CDIO) kumkhuba womtholampilo wokufundisa ubuhlengikazi benhliziyo, futhi wathola ukuthi abafundi eqenjini lokuhlola basebenzisa umkhuba womtholampilo we-CDIO .Indlela yokufundisa enqubweni yobuhlengikazi, ubuntu Imingcele eyisishiyagalombili, efana nekhono lobuhlengikazi kanye nonembeza, ingcono kakhulu kunaleyo yabafundi abahlengikazi abasebenzisa izindlela zokufundisa zendabuko.Lokhu kungenzeka kungenxa yokuthi ohlelweni lokufunda, abafundi abahlengikazi abasamukeli nje ulwazi , kodwa basebenzisa amakhono abo.ukuthola ulwazi ngezindlela ezahlukene.Amalungu eqembu awukhulula ngokugcwele umoya wabo weqembu, ahlanganise izinsiza zokufunda, futhi abike ngokuphindaphindiwe, azilolonge, ahlaziye, futhi axoxe ngezinkinga zamanje zobunesi basemtholampilo.Ulwazi lwabo luthuthuka lusuka phezulu luye ekujuleni, lunaka kakhulu okuqukethwe okuthile kokuhlaziya imbangela.izinkinga zempilo, ukwakhiwa kwezinjongo zobunesi kanye nokuba nokwenzeka kokungenelela kobuhlengikazi.I-Faculty inikeza isiqondiso nokubonisa phakathi nezingxoxo ukuze yenze umjikelezo wokukhuthazwa kokubona-umkhuba-impendulo, isize abafundi abahlengikazi baqedele inqubo yokufunda enengqondo, bathuthukise amakhono omtholampilo wabafundi abahlengikazi, bathuthukise intshisekelo yokufunda nokusebenza ngempumelelo, futhi baqhubeke bethuthukisa inkambiso yomtholampilo yabafundi - abahlengikazi. ..ikhono.Ikhono lokufunda kusuka kuthiyori ukuze uzijwayeze, ukuqedela ukulinganisa kolwazi.
Ukuqaliswa kwezinhlelo zemfundo yomtholampilo ezisekelwe ku-CDIO kuthuthukisa ikhwalithi yemfundo yomtholampilo.Imiphumela yocwaningo luka-Ding Jinxia [30] kanye nabanye ibonisa ukuthi kukhona ukuhlobana phakathi kwezici ezihlukahlukene ezifana nesisusa sokufunda, ikhono lokufunda elizimele, nokuziphatha okuphumelelayo kokufundisa kothisha basemtholampilo.Kulolu cwaningo, ngokuthuthukiswa kokufundisa komtholampilo kwe-CDIO, othisha basemtholampilo bathola ukuqeqeshwa okuthuthukisiwe kochwepheshe, imiqondo yokufundisa ethuthukisiwe, namakhono okufundisa athuthukisiwe.Okwesibili, ithuthukisa izibonelo zokufundisa komtholampilo kanye nokuqukethwe kwemfundo yobuhlengikazi benhliziyo, ikhombisa ukuhleleka nokusebenza kwemodeli yokufundisa ngokombono omkhulu, futhi ithuthukisa ukuqonda kwabafundi nokugcina okuqukethwe kwesifundo.Impendulo ngemva kwenkulumo ngayinye ingakhuthaza ukuzazi kothisha basemtholampilo, ikhuthaze othisha basemtholampilo ukuthi bazindle ngamakhono abo, izinga lomsebenzi nezimfanelo zobuntu, babone ngempela ukufunda kontanga, futhi bathuthukise ikhwalithi yokufundisa emtholampilo.Imiphumela yabonisa ukuthi ikhwalithi yokufundisa yothisha bemitholampilo eqenjini lokungenelela yayingcono kuneqembu lokulawula, elalifana nemiphumela yocwaningo luka-Xionng Haiyang [31].
Nakuba imiphumela yalolu cwaningo ibalulekile ekufundiseni emtholampilo, ucwaningo lwethu lusenemikhawulo eminingana.Okokuqala, ukusetshenziswa kwesampula esilula kungase kukhawulele ukutholakala kwalokhu okutholakele, futhi isampula yethu yayilinganiselwe esibhedlela esisodwa sokunakekelwa kwemfundo ephakeme.Okwesibili, isikhathi sokuqeqeshwa singamaviki ama-4 kuphela, kanti abahlengikazi abaqeqeshwayo badinga isikhathi esengeziwe sokuthuthukisa amakhono okucabanga okujulile.Okwesithathu, kulolu cwaningo, iziguli ezisetshenziswe ku-Mini-CEX kwakuyiziguli zangempela ngaphandle kokuqeqeshwa, futhi izinga lokusebenza kwezifundo zabahlengikazi abaqeqeshwayo lingahluka kuye ngesiguli.Lezi yizindaba ezisemqoka ezibeka umkhawulo emiphumeleni yalolu cwaningo.Ucwaningo lwesikhathi esizayo kufanele lunwebe usayizi wesampula, lukhulise ukuqeqeshwa kothisha basemtholampilo, futhi luhlanganise amazinga okuthuthukisa izifundo eziyisibonelo.Ucwaningo lwesikhathi eside luyadingeka ukuze kuphenywe ukuthi ikilasi eliphendukile elisuselwe kumqondo we-CDIO lingathuthukisa amakhono aphelele abafundi bezokwelapha esikhathini eside.
Lolu cwaningo luthuthukise imodeli ye-CDIO ekuklanyweni kwezifundo zabafundi abahlengikazi bamathambo, lwakha ikilasi eliphendukile ngokusekelwe kumqondo we-CDIO, futhi lahlanganiswa nemodeli yokuhlola ye-mini-CEX.Imiphumela ibonisa ukuthi ikilasi eliphendukile elisekelwe kumqondo we-CDIO alithuthukisi nje kuphela ikhwalithi yokufundisa emtholampilo, kodwa futhi lithuthukisa ikhono lokufunda elizimele labafundi, ukucabanga okujulile, nekhono lokuzijwayeza lomtholampilo.Le ndlela yokufundisa ithembekile futhi isebenza ngempumelelo kunezinkulumo zendabuko.Kungaphethwa ngokuthi imiphumela ingase ibe nomthelela emfundweni yezokwelapha.Ikilasi eliphendukile, elisekelwe emcabangweni we-CDIO, ligxile ekufundiseni, ekufundeni nasezenzweni ezingokoqobo futhi lihlanganisa eduze ukuqiniswa kolwazi lobungcweti nokuthuthukiswa kwamakhono asebenzayo ukulungiselela abafundi umsebenzi womtholampilo.Uma kubhekwa ukubaluleka kokunikeza abafundi ithuba lokubamba iqhaza ngenkuthalo ekufundeni nasekuzilolongeni, futhi kucatshangelwa zonke izici, kuphakanyiswa ukuthi imodeli yokufunda yasemtholampilo esekelwe ku-CDIO isetshenziswe emfundweni yezokwelapha.Le ndlela ingase futhi inconywe njengendlela entsha, egxile kumfundi ekufundiseni komtholampilo.Ngaphezu kwalokho, okutholakele kuzoba usizo kakhulu kubenzi bezinqubomgomo nososayensi lapho bethuthukisa amasu okuthuthukisa imfundo yezokwelapha.
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Isikhathi sokuthumela: Feb-24-2024