Kuyambira mliri wa COVID-19, dzikolo layamba kuyang'ana kwambiri ntchito yophunzitsa zachipatala m'zipatala za mayunivesite. Kulimbitsa kuphatikiza kwa zamankhwala ndi maphunziro komanso kukonza ubwino ndi kugwira ntchito bwino kwa maphunziro azachipatala ndi mavuto akuluakulu omwe maphunziro azachipatala akukumana nawo. Kuvuta kophunzitsa za mafupa kuli m'matenda osiyanasiyana, ukatswiri wapamwamba komanso makhalidwe osamveka bwino, omwe amakhudza njira, changu ndi kugwira ntchito bwino kwa kuphunzitsa ophunzira azachipatala. Kafukufukuyu adapanga dongosolo lophunzitsira mkalasi losinthidwa pogwiritsa ntchito lingaliro la CDIO (Concept-Design-Implement-Operate) ndikuligwiritsa ntchito mu maphunziro a unamwino wa mafupa kuti akonze zotsatira zophunzirira bwino ndikuthandiza aphunzitsi kuzindikira kusintha tsogolo la maphunziro a unamwino komanso maphunziro azachipatala. Kuphunzira mkalasi kudzakhala kothandiza komanso kolunjika.
Ophunzira makumi asanu azachipatala omwe adamaliza maphunziro awo mu dipatimenti ya mafupa ya chipatala chapamwamba mu June 2017 adaphatikizidwa mu gulu lowongolera, ndipo ophunzira 50 a unamwino omwe adamaliza maphunziro awo mu dipatimentiyi mu June 2018 adaphatikizidwa mu gulu lothandizira. Gulu lothandizira linagwiritsa ntchito lingaliro la CDIO la chitsanzo chophunzitsira cha kalasi chosinthidwa, pomwe gulu lowongolera linagwiritsa ntchito chitsanzo chachikhalidwe chophunzitsira. Atamaliza ntchito zothandiza za dipatimentiyi, magulu awiri a ophunzira adayesedwa pa chiphunzitso, luso logwira ntchito, luso lophunzirira lodziyimira pawokha komanso luso loganiza mozama. Magulu awiri a aphunzitsi adamaliza miyeso isanu ndi itatu yowunika luso lochita zamankhwala, kuphatikiza njira zinayi za unamwino, luso la unamwino waumunthu, komanso kuwunika mtundu wa maphunziro azachipatala.
Pambuyo pa maphunziro, luso lochita zinthu zachipatala, luso loganiza mozama, luso lophunzira lodziyimira pawokha, luso lophunzitsa ndi kuchita zinthu motsatira mfundo, komanso zigoli zabwino zophunzitsira zachipatala za gulu lolowererapo zinali zapamwamba kwambiri kuposa za gulu lolamulira (onse P < 0.05).
Chitsanzo chophunzitsira chozikidwa pa CDIO chingalimbikitse kuphunzira kodziyimira pawokha kwa ophunzira ophunzirira unamwino komanso luso lawo loganiza mozama, kulimbikitsa kuphatikiza kwa chiphunzitso ndi machitidwe, kukulitsa luso lawo logwiritsa ntchito chidziwitso chonse cha chiphunzitso kuti afufuze ndikuthetsa mavuto ogwira ntchito, ndikuwonjezera zotsatira za kuphunzira.
Maphunziro azachipatala ndi gawo lofunika kwambiri pa maphunziro a unamwino ndipo limaphatikizapo kusintha kuchoka pa chidziwitso cha chiphunzitso kupita ku kuchita. Kuphunzira bwino zachipatala kungathandize ophunzira a unamwino kukhala ndi luso laukadaulo, kulimbitsa chidziwitso chaukadaulo, ndikukulitsa luso lawo lochita unamwino. Ndi gawo lomaliza la kusintha kwa ntchito kwa ophunzira azachipatala [1]. M'zaka zaposachedwa, ofufuza ambiri ophunzitsa zachipatala achita kafukufuku pa njira zophunzitsira monga kuphunzira kozikidwa pamavuto (PBL), kuphunzira kozikidwa pamilandu (CBL), kuphunzira kozikidwa pagulu (TBL), ndi kuphunzira kozikidwa pazochitika ndi kuphunzira kozikidwa pazochitika mu kuphunzitsa zachipatala. Komabe, njira zosiyanasiyana zophunzitsira zili ndi zabwino ndi zoyipa zake pankhani ya zotsatira za kuphunzira kwa kulumikizana kothandiza, koma sizikwaniritsa kuphatikiza kwa chiphunzitso ndi machitidwe [2].
"Kalasi yosinthika" ikutanthauza njira yatsopano yophunzirira momwe ophunzira amagwiritsa ntchito nsanja yodziwitsira kuti aphunzire pawokha zinthu zosiyanasiyana zophunzitsira asanayambe kalasi ndikumaliza homuweki mwanjira ya "kuphunzira kogwirizana" mkalasi pomwe aphunzitsi akutsogolera ophunzira. Yankhani mafunso ndikupereka chithandizo chaumwini [3]. Bungwe la American New Media Alliance linanena kuti kalasi yosinthika imasintha nthawi mkati ndi kunja kwa kalasi ndikusamutsa zisankho zophunzirira za ophunzira kuchokera kwa aphunzitsi kupita kwa ophunzira [4]. Nthawi yamtengo wapatali yomwe imagwiritsidwa ntchito mkalasi mu njira yophunzirira iyi imalola ophunzira kuyang'ana kwambiri kuphunzira kogwira ntchito, kochokera kumavuto. Deshpande [5] adachita kafukufuku pa kalasi yosinthika mu maphunziro a paramedic ndi kuphunzitsa ndipo adatsimikiza kuti kalasi yosinthika imatha kusintha chidwi cha ophunzira pakuphunzira komanso magwiridwe antchito amaphunziro ndikuchepetsa nthawi ya kalasi. Khe Fung HEW ndi Chung Kwan LO [6] adafufuza zotsatira za kafukufuku wa nkhani zofananira pa kalasi yosinthika ndikufupikitsa zotsatira zonse za njira yophunzitsira yosinthika kudzera mu meta-analysis, kusonyeza kuti poyerekeza ndi njira zophunzitsira zachikhalidwe, njira yophunzitsira yosinthika mu maphunziro azaumoyo waukadaulo ndi yabwino kwambiri ndipo imapangitsa ophunzira kuphunzira bwino. Zhong Jie [7] anayerekeza zotsatira za kuphunzira kwa hybrid classroom ndi flipped physical classroom pakupeza chidziwitso cha ophunzira, ndipo anapeza kuti mu ndondomeko ya hybrid learning mu flipped histology classroom, kukonza ubwino wa kuphunzitsa pa intaneti kungawongolere kukhutitsidwa ndi chidziwitso cha ophunzira. Kutengera zotsatira za kafukufuku zomwe zili pamwambapa, m'munda wa maphunziro a unamwino, akatswiri ambiri amaphunzira momwe classroom flipped classroom imagwirira ntchito bwino pophunzitsa m'kalasi ndipo amakhulupirira kuti kuphunzitsa kwa classroom flipped kungathandize ophunzira a unamwino kuchita bwino pamaphunziro, luso lawo lophunzira paokha, komanso kukhutitsidwa m'kalasi.
Chifukwa chake, pakufunika kufufuza ndikupanga njira yatsopano yophunzitsira yomwe ingathandize ophunzira a unamwino kuphunzira ndikugwiritsa ntchito chidziwitso chaukadaulo ndikukweza luso lawo lochita zamankhwala komanso mtundu wonse. CDIO (Concept-Design-Implement-Operate) ndi chitsanzo cha maphunziro aukadaulo chomwe chidapangidwa mu 2000 ndi mayunivesite anayi, kuphatikiza Massachusetts Institute of Technology ndi Royal Institute of Technology ku Sweden. Ndi chitsanzo chapamwamba cha maphunziro aukadaulo chomwe chimalola ophunzira a unamwino kuphunzira ndikupeza luso mwanjira yogwira ntchito, yogwira ntchito, komanso yachilengedwe [8, 9]. Ponena za kuphunzira kwakukulu, chitsanzochi chimagogomezera "kuyang'ana kwambiri ophunzira," kulola ophunzira kutenga nawo mbali pakupanga, kupanga, kukhazikitsa, ndi kuyendetsa mapulojekiti, ndikusintha chidziwitso chopezedwa kukhala zida zothetsera mavuto. Kafukufuku wambiri wasonyeza kuti chitsanzo chophunzitsira cha CDIO chimathandizira kukonza luso lachipatala komanso mtundu wonse wa ophunzira azachipatala, kukonza kuyanjana kwa aphunzitsi ndi ophunzira, kukonza magwiridwe antchito ophunzitsira, komanso kuchita gawo pakulimbikitsa kusintha kwa chidziwitso ndikuwongolera njira zophunzitsira. Chimagwiritsidwa ntchito kwambiri pophunzitsa anthu aluso [10].
Ndi kusintha kwa njira yachipatala yapadziko lonse, zofuna za anthu pa zaumoyo zikuwonjezeka, zomwe zapangitsanso kuti udindo wa ogwira ntchito zachipatala ukule. Luso ndi ubwino wa anamwino zikugwirizana mwachindunji ndi ubwino wa chisamaliro chachipatala ndi chitetezo cha odwala. M'zaka zaposachedwapa, chitukuko ndi kuwunika luso lachipatala la ogwira ntchito ya unamwino kwakhala nkhani yofunika kwambiri pankhani ya unamwino [11]. Chifukwa chake, njira yowunikira yolunjika, yokwanira, yodalirika, komanso yovomerezeka ndiyofunikira kwambiri pa kafukufuku wamaphunziro azachipatala. Ntchito yowunikira ya mini-clinic (mini-CEX) ndi njira yowunikira luso lonse lachipatala la ophunzira azachipatala ndipo imagwiritsidwa ntchito kwambiri pankhani ya maphunziro azachipatala osiyanasiyana kunyumba ndi kunja. Pang'onopang'ono idawonekera m'munda wa unamwino [12, 13].
Kafukufuku wambiri wachitika pakugwiritsa ntchito chitsanzo cha CDIO, kalasi yosinthidwa, ndi mini-CEX mu maphunziro a unamwino. Wang Bei [14] adakambirana za momwe chitsanzo cha CDIO chimakhudzira kukonza maphunziro apadera a anamwino pazosowa za anamwino a COVID-19. Zotsatira zake zikusonyeza kuti kugwiritsa ntchito chitsanzo cha CDIO popereka maphunziro apadera a unamwino pa COVID-19 kudzathandiza ogwira ntchito ya unamwino kupeza bwino luso lapadera lophunzitsira unamwino ndi chidziwitso chofanana nacho, ndikukweza mokwanira luso lawo lonse la unamwino. Akatswiri monga Liu Mei [15] adakambirana za kugwiritsa ntchito njira yophunzitsira ya gulu limodzi ndi kalasi yosinthidwa pophunzitsa anamwino a mafupa. Zotsatira zake zasonyeza kuti chitsanzo ichi chophunzitsira chingawongolere bwino luso loyambira la anamwino a mafupa monga kumvetsetsa, kugwiritsa ntchito chidziwitso cha chiphunzitso, kugwira ntchito limodzi, kuganiza mozama, ndi kafukufuku wasayansi. Li Ruyue et al. [16] adaphunzira za momwe kugwiritsa ntchito Nursing Mini-CEX yokonzedwa bwino mu maphunziro okhazikika a anamwino atsopano opaleshoni ndipo adapeza kuti aphunzitsi angagwiritse ntchito Nursing Mini-CEX kuti ayese njira yonse yowunikira ndi magwiridwe antchito pophunzitsa zachipatala kapena ntchito. Maulalo ofooka mwa iye. anamwino ndikupereka ndemanga zenizeni. Kudzera mu njira yodziyang'anira ndi kudziganizira, mfundo zoyambira za kuwunika magwiridwe antchito a unamwino zimaphunziridwa, maphunziro amasinthidwa, mtundu wa kuphunzitsa zachipatala umawongoleredwa, luso lonse la unamwino wa opaleshoni wa ophunzira limawongoleredwa, ndipo kuphatikiza kwa makalasi osinthidwa kutengera lingaliro la CDIO kumayesedwa, koma pakadali pano palibe lipoti la kafukufuku. Kugwiritsa ntchito chitsanzo cha mini-CEX poyesa maphunziro a unamwino kwa ophunzira a mafupa. Wolembayo adagwiritsa ntchito chitsanzo cha CDIO popanga maphunziro ophunzitsira ophunzira a unamwino wa mafupa, adamanga kalasi yosinthidwa kutengera lingaliro la CDIO, ndipo adaphatikiza ndi chitsanzo cha mini-CEX poyesa kuti akhazikitse chidziwitso ndi luso la atatu mu chimodzi, komanso adathandizira pakukweza mtundu wa kuphunzitsa. Kupititsa patsogolo kosalekeza kumapereka maziko ophunzirira kochokera ku machitidwe m'zipatala zophunzitsira.
Pofuna kuthandiza kukhazikitsa maphunzirowa, njira yosavuta yopezera zitsanzo inagwiritsidwa ntchito ngati ophunzira ophunzirira kuti asankhe ophunzira a unamwino kuyambira 2017 ndi 2018 omwe anali kuchita mu dipatimenti ya mafupa ya chipatala chapamwamba. Popeza pali ophunzira 52 pamlingo uliwonse, kukula kwa chitsanzo kudzakhala 104. Ophunzira anayi sanachite nawo ntchito yonse yachipatala. Gulu lowongolera linaphatikizapo ophunzira 50 a unamwino omwe adamaliza maphunziro a internship mu dipatimenti ya mafupa ya chipatala chapamwamba mu June 2017, pomwe amuna 6 ndi akazi 44 azaka zapakati pa 20 mpaka 22 (21.30 ± 0.60), omwe adamaliza maphunziro a internship ku dipatimenti yomweyi mu June 2018. Gulu lothandizira linaphatikizapo ophunzira 50 azachipatala, kuphatikiza amuna 8 ndi akazi 42 azaka zapakati pa 21 mpaka 22 (21.45 ± 0.37). Ophunzira onse adapereka chilolezo chodziwitsidwa. Zofunikira Zophatikizira: (1) Ophunzira a internship azachipatala a mafupa omwe ali ndi digiri ya bachelor. (2) Chilolezo chodziwitsidwa komanso kutenga nawo mbali mwaufulu mu kafukufukuyu. Zofunikira zochotsera: Anthu omwe sangathe kutenga nawo mbali mokwanira mu ntchito zachipatala. Palibe kusiyana kwakukulu pakati pa ziwerengero pakati pa chidziwitso cha magulu awiri a ophunzira azachipatala (p>0.05) ndipo ndi ofanana.
Magulu onse awiriwa adamaliza maphunziro a zachipatala kwa milungu 4, ndipo maphunziro onse adamalizidwa mu Dipatimenti ya Mafupa. Munthawi yowonera, panali magulu 10 a ophunzira azachipatala, ophunzira 5 mgulu lililonse. Maphunziro amachitidwa motsatira pulogalamu ya maphunziro a unamwino, kuphatikiza magawo a chiphunzitso ndi ukadaulo. Aphunzitsi m'magulu onsewa ali ndi ziyeneretso zofanana, ndipo mphunzitsi wa namwino ali ndi udindo wowunika ubwino wa kuphunzitsa.
Gulu lowongolera linkagwiritsa ntchito njira zophunzitsira zachikhalidwe. M'sabata yoyamba ya sukulu, makalasi amayamba Lolemba. Aphunzitsi amaphunzitsa chiphunzitso Lachiwiri ndi Lachitatu, ndipo amayang'ana kwambiri maphunziro ogwirira ntchito Lachinayi ndi Lachisanu. Kuyambira sabata yachiwiri mpaka yachinayi, membala aliyense wa aphunzitsi ali ndi udindo woti wophunzira zachipatala azipereka maphunziro nthawi zina mu dipatimentiyi. M'sabata yachinayi, mayeso adzamalizidwa masiku atatu maphunziro asanafike.
Monga tanenera kale, wolembayo akugwiritsa ntchito njira yophunzitsira yosinthidwa mkalasi kutengera lingaliro la CDIO, monga momwe zafotokozedwera pansipa.
Sabata yoyamba ya maphunziro ndi yofanana ndi ya gulu lowongolera; Masabata awiri mpaka anayi a maphunziro a opaleshoni ya mafupa amagwiritsa ntchito dongosolo lophunzitsira la kalasi losinthidwa kutengera lingaliro la CDIO kwa maola 36. Gawo la malingaliro ndi kapangidwe limamalizidwa mu sabata yachiwiri ndipo gawo lokhazikitsa limamalizidwa mu sabata yachitatu. Opaleshoni idamalizidwa mu sabata yachinayi, ndipo kuwunika ndi kuwunika zidamalizidwa masiku atatu asanatuluke. Onani Gome 1 kuti mudziwe nthawi yeniyeni ya kalasi.
Gulu lophunzitsa lomwe lili ndi namwino wamkulu m'modzi, aphunzitsi 8 a mafupa ndi katswiri m'modzi wa unamwino wa CDIO wosagwiritsa ntchito mafupa linakhazikitsidwa. Namwino Wamkulu amapatsa mamembala a gulu lophunzitsa maphunziro ndi luso la maphunziro ndi miyezo ya CDIO, buku la CDIO workshop ndi mfundo zina zokhudzana nazo komanso njira zina zogwiritsira ntchito (osachepera maola 20), ndipo nthawi zonse amafunsa akatswiri pa nkhani zovuta zophunzitsira. Aphunzitsi amakhazikitsa zolinga zophunzirira, amayendetsa maphunziro, ndikukonza maphunziro motsatizana mogwirizana ndi zofunikira za unamwino wa akuluakulu komanso pulogalamu yophunzirira.
Malinga ndi pulogalamu ya internship, ponena za pulogalamu yophunzitsira anthu aluso a CDIO ndi miyezo [17] komanso mogwirizana ndi makhalidwe ophunzitsira a namwino wa mafupa, zolinga zophunzirira za ophunzira ophunzirira unamwino zimayikidwa m'magawo atatu, omwe ndi: zolinga zodziwa (kudziwa bwino chidziwitso choyambira), chidziwitso chaukadaulo ndi njira zina zokhudzana ndi machitidwe, ndi zina zotero), zolinga zaukadaulo (kukweza luso loyambira laukadaulo, luso loganiza mozama komanso luso lodziyimira pawokha lophunzirira, ndi zina zotero) ndi zolinga zabwino (kumanga makhalidwe abwino aukadaulo ndi mzimu wosamala anthu ndi zina zotero). .). Zolinga zodziwa zimagwirizana ndi chidziwitso chaukadaulo ndi kulingalira kwa maphunziro a CDIO, luso laumwini, luso laukadaulo ndi ubale wa maphunziro a CDIO, ndipo zolinga zabwino zimagwirizana ndi luso lofewa la maphunziro a CDIO: kugwira ntchito limodzi ndi kulankhulana.
Pambuyo pa misonkhano iwiri, gulu lophunzitsa linakambirana za dongosolo lophunzitsira unamwino m'kalasi yosinthidwa kutengera lingaliro la CDIO, kugawa maphunzirowo m'magawo anayi, ndikutsimikiza zolinga ndi kapangidwe kake, monga momwe zasonyezedwera mu Table 1.
Pambuyo pofufuza ntchito ya unamwino pa matenda a mafupa, mphunzitsiyo adapeza milandu ya matenda ofala komanso ofala a mafupa. Tiyeni titenge dongosolo la chithandizo cha odwala omwe ali ndi lumbar disc herniation mwachitsanzo: Wodwala Zhang Moumou (mwamuna, wazaka 73, kutalika 177 cm, kulemera 80 kg) adadandaula za "ululu wam'mbuyo wotsatira dzanzi ndi ululu kumanzere kwa mwendo kwa miyezi iwiri" ndipo adagonekedwa m'chipatala chakunja kwa odwala. Monga wodwala Namwino wodalirika: (1) Chonde funsani mbiri ya wodwalayo mwadongosolo kutengera chidziwitso chomwe mwapeza ndikuzindikira zomwe zikuchitika kwa wodwalayo; (2) Sankhani kafukufuku wokhazikika komanso njira zowunikira akatswiri kutengera momwe zinthu zilili ndikupereka mafunso ofufuza omwe amafunikira kuwunika kwina; (3) Chitani matenda a unamwino. Pankhaniyi, ndikofunikira kuphatikiza database yofufuzira milandu; lembani njira zodzitetezera zokhudzana ndi unamwino zokhudzana ndi wodwalayo; (4) Kambiranani za mavuto omwe alipo pakudziyang'anira wodwala, komanso njira zomwe zilipo komanso zomwe wodwalayo amatsatira akatulutsidwa. Tumizani nkhani za ophunzira ndi mndandanda wa ntchito masiku awiri kalasi isanayambe. Mndandanda wa ntchito za nkhaniyi ndi izi: (1) Unikani ndikulimbitsa chidziwitso cha chiphunzitso chokhudza zomwe zimayambitsa komanso zizindikiro zachipatala za lumbar intervertebral disc herniation; (2) Pangani dongosolo losamalira odwala lomwe mukufuna; (3) Pangani nkhaniyi kutengera ntchito zachipatala ndikugwiritsa ntchito chisamaliro chisanachitike opaleshoni ndi chithandizo pambuyo pa opaleshoni ndizochitika ziwiri zazikulu pakuyeserera kwa polojekiti yophunzitsa. Ophunzira a unamwino amawunikanso zomwe zili mumaphunzirowa ndi mafunso ochita, funsani mabuku ndi ma database oyenera, ndikumaliza ntchito zodzifufuza polowa mu gulu la WeChat.
Ophunzira amapanga magulu momasuka, ndipo gululo limasankha mtsogoleri wa gulu yemwe ali ndi udindo wogawa ntchito ndikugwirizanitsa polojekitiyi. Mtsogoleri wa gulu loyambirira ali ndi udindo wofalitsa zinthu zinayi: chiyambi cha nkhani, kukhazikitsa njira za unamwino, maphunziro azaumoyo, ndi chidziwitso chokhudzana ndi matenda kwa membala aliyense wa gulu. Panthawi yophunzira, ophunzira amagwiritsa ntchito nthawi yawo yopuma kufufuza maziko a chiphunzitso kapena zida zothetsera mavuto a milandu, kuchita zokambirana za gulu, ndikuwongolera mapulani enaake a polojekiti. Pakukonza polojekiti, mphunzitsi amathandiza mtsogoleri wa gululo kugawa mamembala a gululo kuti akonze chidziwitso choyenera, kupanga ndi kupanga mapulojekiti, kuwonetsa ndikusintha mapangidwe, ndikuthandizira ophunzira a unamwino kuphatikiza chidziwitso chokhudzana ndi ntchito mu kapangidwe ndi kupanga. Kudziwa gawo lililonse. Mavuto ndi mfundo zazikulu za gulu lofufuzali zidasanthulidwa ndikupangidwa, ndipo dongosolo lokhazikitsa chitsanzo cha gulu lofufuzali lidakhazikitsidwa. Mu gawoli, aphunzitsi adakonzanso ziwonetsero zozungulira unamwino.
Ophunzira amagwira ntchito m'magulu ang'onoang'ono kuti apereke mapulojekiti. Pambuyo pa lipotilo, mamembala ena a gulu ndi aphunzitsi adakambirana ndikupereka ndemanga pa gulu lopereka malipoti kuti apititse patsogolo dongosolo la chisamaliro cha unamwino. Mtsogoleri wa gulu amalimbikitsa mamembala a gulu kuti atsanzire njira yonse yosamalira anamwino, ndipo mphunzitsi amathandiza ophunzira kufufuza kusintha kwa matenda kudzera mu machitidwe oyeserera, kukulitsa kumvetsetsa kwawo ndi kumanga chidziwitso cha chiphunzitso, komanso kukulitsa luso loganiza mozama. Zonse zomwe ziyenera kumalizidwa pakukula kwa matenda apadera zimamalizidwa motsogozedwa ndi aphunzitsi. Aphunzitsi amapereka ndemanga ndikuwongolera ophunzira a unamwino kuti achite machitidwe apafupi ndi bedi kuti akwaniritse kuphatikiza chidziwitso ndi machitidwe azachipatala.
Pambuyo poyesa gulu lililonse, mphunzitsi adapereka ndemanga ndipo adalemba mphamvu ndi zofooka za membala aliyense wa gululo pakukonza zomwe zili mkati ndi njira yophunzitsira kuti apititse patsogolo kumvetsetsa kwa ophunzira a unamwino pazomwe akuphunzira. Aphunzitsi amasanthula ubwino wophunzitsa ndikuwongolera maphunziro kutengera kuwunika kwa ophunzira a unamwino ndi kuwunika kophunzitsa.
Ophunzira a unamwino amalemba mayeso a zamaganizo ndi zamaganizo atamaliza maphunziro othandiza. Mafunso a zamaganizo a zamaganizo amafunsidwa ndi aphunzitsi. Mapepala ophunzitsira amagawidwa m'magulu awiri (A ndi B), ndipo gulu limodzi limasankhidwa mwachisawawa kuti lichite nawo. Mafunso ophunzitsira amagawidwa m'magawo awiri: chidziwitso chaukadaulo cha zamaganizo ndi kusanthula milandu, chilichonse chili ndi mapointi 50 kuti chikhale ndi mapointi 100. Ophunzira, akamayesa luso la unamwino, amasankha mwachisawawa chimodzi mwa izi, kuphatikizapo njira yosinthira axial, njira yabwino yoyikira miyendo kwa odwala omwe ali ndi vuto la msana, kugwiritsa ntchito njira yothandizira kupuma, njira yogwiritsira ntchito makina obwezeretsa mafupa a CPM, ndi zina zotero. Mapointi onse ndi mapointi 100.
Mu sabata yachinayi, Muyeso Wodziyimira Payekha Woyesa Kuphunzira udzayesedwa masiku atatu maphunziro asanafike. Muyeso wodziyimira payekha woyesa luso lophunzira womwe unapangidwa ndi Zhang Xiyan [18] unagwiritsidwa ntchito, kuphatikizapo chilimbikitso chophunzirira (zinthu 8), kudziletsa (zinthu 11), kuthekera kogwirizana pakuphunzira (zinthu 5), ndi chidziwitso (zinthu 6). Chinthu chilichonse chimayesedwa pa sikelo ya Likert ya 5-point kuyambira "yosakhazikika konse" mpaka "yogwirizana kwathunthu," yokhala ndi zigoli kuyambira 1 mpaka 5. Zigoli zonse ndi 150. Zigoli zikakwera, luso lophunzira palokha limakula. Chiŵerengero cha alpha cha Cronbach cha sikelo ndi 0.822.
Mu sabata yachinayi, sikelo yowunikira luso loganiza mozama inayesedwa masiku atatu asanatuluke. Mtundu wa Chitchaina wa Sikelo Yowunikira Mphamvu Yoganiza Mozama yomasuliridwa ndi Mercy Corps [19] unagwiritsidwa ntchito. Uli ndi magawo asanu ndi awiri: kupeza chowonadi, kuganiza momasuka, luso losanthula ndi luso lokonzekera, ndi zinthu 10 mu gawo lililonse. Sikelo ya mfundo 6 imagwiritsidwa ntchito kuyambira "sindikugwirizana kwenikweni" mpaka "ndikugwirizana kwambiri" kuyambira 1 mpaka 6, motsatana. Mawu oipa amalembedwa molakwika, ndi zigoli zonse kuyambira 70 mpaka 420. Zigoli zonse za ≤210 zimasonyeza magwiridwe antchito oipa, 211–279 zimasonyeza magwiridwe antchito osalowerera, 280–349 zimasonyeza magwiridwe antchito abwino, ndipo ≥350 zimasonyeza mphamvu yoganiza mozama kwambiri. Chiŵerengero cha alpha cha Cronbach cha sikelo ndi 0.90.
Mu sabata yachinayi, kuwunika luso lachipatala kudzachitika masiku atatu asanatuluke. Muyeso wa mini-CEX womwe wagwiritsidwa ntchito mu kafukufukuyu unasinthidwa kuchokera ku Medical Classic [20] kutengera mini-CEX, ndipo kulephera kunapezeka kuyambira mfundo 1 mpaka 3. Kukwaniritsa zofunikira, mfundo 4-6 kuti zikwaniritse zofunikira, mfundo 7-9 kuti zikwaniritse zonse. Ophunzira azachipatala amamaliza maphunziro awo atamaliza maphunziro apadera. Chiŵerengero cha alpha cha Cronbach cha muyeso uwu ndi 0.780 ndipo chiŵerengero chodalirika cha magawo awiri ndi 0.842, kusonyeza kudalirika kwabwino.
Mu sabata yachinayi, tsiku limodzi asanachoke ku dipatimentiyi, msonkhano wa aphunzitsi ndi ophunzira ndi kuwunika ubwino wa kuphunzitsa unachitika. Fomu yowunikira ubwino wa kuphunzitsa idapangidwa ndi Zhou Tong [21] ndipo ikuphatikizapo mbali zisanu: malingaliro ophunzitsira, zomwe zili mu kuphunzitsa, ndi kuphunzitsa. Njira, zotsatira za maphunziro ndi makhalidwe a maphunziro. Sikelo ya Likert ya mapointi 5 idagwiritsidwa ntchito. Ziwerengero zikakwera, ndiye kuti ubwino wa kuphunzitsa umakhala wabwino. Yamalizidwa mutamaliza maphunziro apadera. Mafunso ali ndi kudalirika kwabwino, ndipo alpha ya sikelo ya Cronbach ndi 0.85.
Deta idasanthulidwa pogwiritsa ntchito pulogalamu ya ziwerengero ya SPSS 21.0. Deta yoyezera imafotokozedwa ngati mean ± standard deviation (\(\strike X \pm S\)) ndipo gulu lolowererapo t limagwiritsidwa ntchito poyerekeza magulu. Deta yowerengera idafotokozedwa ngati chiwerengero cha milandu (%) ndipo idayerekezeredwa pogwiritsa ntchito chi-square kapena Fisher's exact intervention. P value <0.05 imasonyeza kusiyana kwakukulu kwa ziwerengero.
Kuyerekeza kwa ziwerengero za chiphunzitso ndi ntchito za magulu awiri a anamwino ophunzira ntchito kukuwonetsedwa mu Table 2.
Kuyerekeza kwa luso lophunzira lodziyimira pawokha komanso luso loganiza mozama la magulu awiri a anamwino ophunzira ntchito kukuwonetsedwa mu Table 3.
Kuyerekeza kwa kuwunika kwa luso la ogwira ntchito zachipatala pakati pa magulu awiri a anamwino ophunzira. Luso la ophunzira pantchito ya unamwino m'gulu lothandizira linali labwino kwambiri kuposa la gulu lowongolera, ndipo kusiyana kunali kofunikira kwambiri pa ziwerengero (p < 0.05) monga momwe zasonyezedwera mu Table 4.
Zotsatira za kuyesa ubwino wa kuphunzitsa kwa magulu awiriwa zinasonyeza kuti chiwerengero chonse cha ubwino wa kuphunzitsa cha gulu lolamulira chinali 90.08 ± 2.34 points, ndipo chiwerengero chonse cha ubwino wa kuphunzitsa cha gulu lolowererapo chinali 96.34 ± 2.16 points. Kusiyanako kunali kofunikira kwambiri pa ziwerengero. (t = – 13.900, p < 0.001).
Kupititsa patsogolo kwa zamankhwala kumafuna kusonkhanitsa luso la zachipatala mokwanira. Ngakhale kuti pali njira zambiri zophunzitsira zoyeserera ndi zoyeserera, sizingalowe m'malo mwa machitidwe azachipatala, zomwe zimagwirizana mwachindunji ndi kuthekera kwa luso la zamankhwala mtsogolo kuchiza matenda ndikupulumutsa miyoyo. Kuyambira mliri wa COVID-19, dzikolo lakhala likuyang'ana kwambiri ntchito yophunzitsa zachipatala m'zipatala za mayunivesite [22]. Kulimbitsa kuphatikiza kwa zamankhwala ndi maphunziro ndikukweza ubwino ndi magwiridwe antchito a maphunziro azachipatala ndizovuta zazikulu zomwe maphunziro azachipatala akukumana nazo. Vuto lophunzitsa za mafupa lili m'mitundu yosiyanasiyana ya matenda, ukatswiri wapamwamba komanso makhalidwe osamveka bwino, zomwe zimakhudza kuyambitsa, changu ndi luso lophunzira la ophunzira azachipatala [23].
Njira yophunzitsira yosinthidwa m'kalasi mkati mwa lingaliro la kuphunzitsa la CDIO imagwirizanitsa zomwe zili mumaphunziro ndi njira yophunzitsira, kuphunzira ndi kuchita. Izi zimasintha kapangidwe ka makalasi ndikuyika ophunzira a unamwino pakati pa kuphunzitsa. Panthawi yophunzitsa, aphunzitsi amathandiza ophunzira a unamwino kupeza chidziwitso chofunikira pa nkhani zovuta za unamwino nthawi zambiri [24]. Kafukufuku akuwonetsa kuti CDIO imaphatikizapo chitukuko cha ntchito ndi ntchito zophunzitsa zachipatala. Pulojekitiyi imapereka chitsogozo chatsatanetsatane, imagwirizanitsa bwino chidziwitso chaukadaulo ndi chitukuko cha luso logwira ntchito, ndikuzindikira mavuto panthawi yoyeserera, zomwe zimathandiza ophunzira a unamwino pakukweza luso lawo lophunzira pawokha komanso kuganiza mozama, komanso chitsogozo panthawi yophunzira pawokha. -kuphunzira. Zotsatira za kafukufukuyu zikuwonetsa kuti patatha milungu 4 yophunzitsidwa, ophunzira a unamwino omwe ali mgulu lolowererapo anali okwera kwambiri kuposa omwe ali mgulu lolamulira (onse p < 0.001). Izi zikugwirizana ndi zotsatira za kafukufuku wa Fan Xiaoying pa zotsatira za CDIO kuphatikiza njira yophunzitsira ya CBL mu maphunziro a unamwino [25]. Njira yophunzitsira iyi ikhoza kusintha kwambiri kuganiza mozama kwa ophunzira komanso kuphunzira pawokha. Pa nthawi yoganizira, mphunzitsi amagawana mfundo zovuta ndi ophunzira a unamwino mkalasi. Ophunzira a unamwino amaphunzira paokha mfundo zoyenera kudzera m'mavidiyo ang'onoang'ono ophunzitsira ndipo amafunafuna zinthu zofunikira kuti awonjezere kumvetsetsa kwawo ntchito ya unamwino wa mafupa. Pa nthawi yokonza mapulani, ophunzira a unamwino ankachita ntchito yamagulu ndi luso loganiza mozama kudzera m'makambirano amagulu, motsogozedwa ndi aphunzitsi komanso pogwiritsa ntchito maphunziro a milandu. Pa nthawi yokhazikitsa, aphunzitsi amaona chisamaliro cha matenda enieni nthawi ya opaleshoni ngati mwayi ndipo amagwiritsa ntchito njira zophunzitsira zoyeserera kuti aphunzitse ophunzira a unamwino kuchita masewera olimbitsa thupi mogwirizana ndi gulu kuti adziwe bwino ndikupeza mavuto pantchito ya unamwino. Nthawi yomweyo, pophunzitsa milandu yeniyeni, ophunzira a unamwino amatha kuphunzira mfundo zazikulu za chisamaliro cha opaleshoni isanachitike opaleshoni komanso itatha opaleshoni kuti amvetsetse bwino kuti mbali zonse za chisamaliro cha opaleshoni ndi zinthu zofunika kwambiri pakuchira kwa wodwalayo pambuyo pa opaleshoni. Pa mlingo wa opaleshoni, aphunzitsi amathandiza ophunzira azachipatala kukhala akatswiri a malingaliro ndi luso lochita. Pochita izi, amaphunzira kuwona kusintha kwa mikhalidwe m'zochitika zenizeni, kuganizira za zovuta zomwe zingatheke, komanso kusakumbukira njira zosiyanasiyana za unamwino kuti athandize ophunzira azachipatala. Njira yomangira ndi kukhazikitsa imaphatikiza zomwe zili mu maphunziro. Mu njira yophunzirira yogwirizana, yolumikizana komanso yokumana ndi zochitika, luso lophunzira la ophunzira a unamwino lodziwongolera komanso chidwi chawo pakuphunzira zimalimbikitsidwa bwino ndipo luso lawo loganiza mozama limakulitsidwa. Ofufuza adagwiritsa ntchito Design Thinking (DT)-Conceive-Design-Implement-Operate (CDIO)) kuti akhazikitse dongosolo la kapangidwe ka uinjiniya m'maphunziro operekedwa pa intaneti kuti akonze magwiridwe antchito a ophunzira pamaphunziro ndi luso lawo loganiza pakompyuta (CT), ndipo zotsatira zake zikuwonetsa kuti magwiridwe antchito a ophunzira pamaphunziro ndi luso lawo loganiza pakompyuta limakulitsidwa kwambiri [26].
Kafukufukuyu amathandiza ophunzira a unamwino kutenga nawo mbali mu ndondomeko yonseyi malinga ndi njira ya Mafunso-Kupanga-Kukhazikitsa-Kugwira Ntchito-Kufotokozera. Zochitika zachipatala zakonzedwa. Cholinga chake ndi kugwirira ntchito limodzi ndi kuganiza pawokha, kuwonjezeredwa ndi mphunzitsi woyankha mafunso, ophunzira akupereka mayankho a mavuto, kusonkhanitsa deta, masewera olimbitsa thupi, ndipo potsiriza masewera olimbitsa thupi apafupi ndi bedi. Zotsatira za kafukufukuyu zasonyeza kuti ziwerengero za ophunzira azachipatala m'gulu lothandizira pakuwunika chidziwitso cha chiphunzitso ndi luso logwira ntchito zinali zabwino kuposa za ophunzira m'gulu lolamulira, ndipo kusiyana kunali kofunikira kwambiri pa ziwerengero (p < 0.001). Izi zikugwirizana ndi mfundo yakuti ophunzira azachipatala m'gulu lothandizira anali ndi zotsatira zabwino pakuwunika chidziwitso cha chiphunzitso ndi luso logwira ntchito. Poyerekeza ndi gulu lolamulira, kusiyana kunali kofunikira pa ziwerengero (p <0.001). Kuphatikiza ndi zotsatira zoyenera za kafukufuku [27, 28]. Chifukwa cha kusanthulaku ndikuti chitsanzo cha CDIO choyamba chimasankha mfundo zodziwitsa matenda zomwe zili ndi kuchuluka kwa zochitika, ndipo chachiwiri, zovuta za pulojekitiyi zikugwirizana ndi maziko. Mu chitsanzo ichi, ophunzira akamaliza zomwe zili mu projekitiyi, amamaliza buku la ntchito ya projekitiyi ngati pakufunika kutero, kusintha zomwe zili mu projekitiyi, ndikukambirana ntchito zomwe apatsidwa ndi mamembala a gulu kuti amvetsetse ndikumvetsetsa zomwe zili mu phunziroli ndikupanga chidziwitso chatsopano ndi kuphunzira. Chidziwitso chakale m'njira yatsopano. Kuzindikira chidziwitso kumakula.
Kafukufukuyu akuwonetsa kuti pogwiritsa ntchito njira yophunzirira zachipatala ya CDIO, ophunzira ophunzitsa unamwino m'gulu lothandizira anali abwino kuposa ophunzira ophunzitsa unamwino m'gulu lolamulira pochita upangiri wa unamwino, mayeso akuthupi, kudziwa matenda a unamwino, kukhazikitsa njira zothandizira unamwino, ndi zotsatira za chisamaliro cha unamwino. Kuphatikiza apo, panali kusiyana kwakukulu pakati pa magulu awiriwa (p < 0.05), komwe kunali kofanana ndi zotsatira za Hongyun [29]. Zhou Tong [21] adaphunzira zotsatira za kugwiritsa ntchito njira yophunzitsira ya Concept-Design-Implement-Operate (CDIO) muzochita zachipatala zophunzitsa unamwino wamtima, ndipo adapeza kuti ophunzira m'gulu loyesera adagwiritsa ntchito njira zachipatala za CDIO. Njira yophunzitsira muzochita za unamwino, zaumunthu. Magawo asanu ndi atatu, monga luso la unamwino ndi kusamala, ndi abwino kwambiri kuposa a ophunzira ophunzitsa unamwino pogwiritsa ntchito njira zachikhalidwe zophunzitsira. Izi zitha kukhala chifukwa chakuti munjira yophunzirira, ophunzira ophunzitsa unamwino salandiranso chidziwitso, koma amagwiritsa ntchito luso lawo. amapeza chidziwitso m'njira zosiyanasiyana. Amembala a gulu amatulutsa mzimu wawo wa gulu, kuphatikiza zinthu zophunzirira, ndikupereka malipoti mobwerezabwereza, kuchita, kusanthula, ndikukambirana za mavuto omwe alipo pakali pano a unamwino. Chidziwitso chawo chikukula kuchokera pamwamba mpaka pansi, kulabadira kwambiri zomwe zili mu kusanthula chifukwa, mavuto azaumoyo, kupanga zolinga za unamwino ndi kuthekera kwa njira zothandizira unamwino. Aphunzitsi amapereka chitsogozo ndi kuwonetsa panthawi yokambirana kuti apange kulimbikitsira kwa malingaliro ndi machitidwe, kuthandiza ophunzira unamwino kumaliza njira yophunzirira yothandiza, kukweza luso la ophunzira unamwino kuchita masewera olimbitsa thupi, kukulitsa chidwi ndi kugwira ntchito bwino kwa kuphunzira, komanso kupititsa patsogolo luso la ophunzira kuchipatala - anamwino. . . luso. Kutha kuphunzira kuchokera ku chiphunzitso kupita ku kuchita, kumaliza kuphunzira.
Kukhazikitsa mapulogalamu ophunzitsira zachipatala ozikidwa pa CDIO kumakweza ubwino wa maphunziro azachipatala. Zotsatira za kafukufuku wa Ding Jinxia [30] ndi ena zikusonyeza kuti pali mgwirizano pakati pa zinthu zosiyanasiyana monga chilimbikitso chophunzirira, luso lodziyimira pawokha, ndi khalidwe lophunzitsa bwino la aphunzitsi azachipatala. Mu kafukufukuyu, ndi chitukuko cha kuphunzitsa zachipatala kwa CDIO, aphunzitsi azachipatala adalandira maphunziro apamwamba aukadaulo, malingaliro atsopano ophunzitsira, komanso luso lophunzitsa labwino. Kachiwiri, kumawonjezera zitsanzo zophunzitsira zachipatala ndi zomwe zili mu maphunziro a unamwino wamtima, kumawonetsa dongosolo ndi magwiridwe antchito a chitsanzo chophunzitsira kuchokera pamalingaliro akuluakulu, ndikulimbikitsa kumvetsetsa kwa ophunzira ndi kusunga zomwe zili mumaphunziro. Ndemanga pambuyo pa nkhani iliyonse zimatha kulimbikitsa kudzidziwa bwino kwa aphunzitsi azachipatala, kulimbikitsa aphunzitsi azachipatala kuti aganizire za luso lawo, mulingo wawo waukadaulo ndi makhalidwe aumunthu, kuzindikira bwino kuphunzira kwa anzawo, ndikukweza mtundu wa kuphunzitsa zachipatala. Zotsatira zake zidawonetsa kuti khalidwe lophunzitsira la aphunzitsi azachipatala m'gulu lolowererapo linali labwino kuposa lomwe lili mu gulu lolamulira, lomwe linali lofanana ndi zotsatira za kafukufuku wa Xiong Haiyang [31].
Ngakhale zotsatira za kafukufukuyu ndi zothandiza pa maphunziro azachipatala, kafukufuku wathu akadali ndi zoletsa zingapo. Choyamba, kugwiritsa ntchito zitsanzo zosavuta kungachepetse kuthekera kwa zomwe zapezekazi, ndipo chitsanzo chathu chinali chipatala chimodzi chapamwamba. Kachiwiri, nthawi yophunzitsira ndi milungu 4 yokha, ndipo ophunzira a anamwino amafunika nthawi yochulukirapo kuti apange luso loganiza mozama. Chachitatu, mu kafukufukuyu, odwala omwe adagwiritsidwa ntchito mu Mini-CEX anali odwala enieni omwe sanaphunzitsidwe, ndipo khalidwe la maphunziro a anamwino ophunzira limatha kusiyana kuchokera kwa wodwala kupita kwa wodwala. Izi ndi nkhani zazikulu zomwe zimalepheretsa zotsatira za kafukufukuyu. Kafukufuku wamtsogolo ayenera kukulitsa kukula kwa zitsanzo, kuwonjezera maphunziro a aphunzitsi azachipatala, ndikugwirizanitsa miyezo yopanga maphunziro amilandu. Kafukufuku wautali amafunikanso kuti afufuze ngati kalasi yosinthidwa kutengera lingaliro la CDIO ikhoza kukulitsa luso la ophunzira azachipatala kwa nthawi yayitali.
Kafukufukuyu adapanga chitsanzo cha CDIO mu kapangidwe ka maphunziro a ophunzira a unamwino wa mafupa, adapanga kalasi yosinthika kutengera lingaliro la CDIO, ndipo adaiphatikiza ndi chitsanzo cha mini-CEX assessment. Zotsatira zake zikuwonetsa kuti kalasi yosinthika kutengera lingaliro la CDIO sikuti imangowonjezera ubwino wa kuphunzitsa zachipatala, komanso imapangitsa ophunzira kuphunzira pawokha, kuganiza mozama, komanso luso lawo lochita zachipatala. Njira yophunzitsira iyi ndi yodalirika komanso yothandiza kuposa maphunziro achikhalidwe. Titha kunena kuti zotsatira zake zitha kukhala ndi tanthauzo pa maphunziro azachipatala. Kalasi yosinthika, kutengera lingaliro la CDIO, imayang'ana kwambiri kuphunzitsa, kuphunzira ndi zochitika zothandiza ndipo imagwirizanitsa bwino chidziwitso chaukadaulo ndi chitukuko cha luso lothandiza kuti ophunzira akonzekere ntchito zachipatala. Popeza kufunika kopatsa ophunzira mwayi wochita nawo mwachangu kuphunzira ndi kuchita, ndikuganizira mbali zonse, akuti chitsanzo chophunzirira zachipatala kutengera CDIO chigwiritsidwe ntchito mu maphunziro azachipatala. Njirayi ingalimbikitsidwenso ngati njira yatsopano, yoganizira ophunzira pophunzitsa zachipatala. Kuphatikiza apo, zomwe zapezekazi zidzakhala zothandiza kwambiri kwa opanga mfundo ndi asayansi popanga njira zowongolera maphunziro azachipatala.
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Nthawi yotumizira: Feb-24-2024