目的：探讨眼科临床指南结合团队式学习(team-based learning,TBL)教学课程在眼科住院医师规范化培训中的应用及教学效果。方法：本研究选取2022年1月—2023年6月在广州医科大学附属第一医院眼科进行住院医师规范化培训的15名住院医师作为研究对象，先后交替使用自学讲课、TBL教学这两种教学模式进行眼科临床指南学习，通过填写满意度调查问卷及评估出科考通过率、学业水平测试成绩、结业考通过率，从主观及客观角度探讨临床指南结合TBL学习模式的教学效果。结果：住院医师对增加眼科临床指南学习具有较高评价，且不认为会增加其学习负担。开展指南学习后，住院医师出科考试及格率、学业水平测试通过率、结业考通过率均为100%。在培养团队合作能力、改善学习氛围两方面，TBL讲课的满意度均高于自学讲课(均P＜0.001)。93.3%(14/15)的住院医师更喜欢TBL教学模式。结论：眼科临床指南结合TBL教学是一种有效的教学模式，住院医师在主观满意度调查问卷及客观考试成绩的评估中，均达到满意的教学效果。
Objective: To investigate the application and teaching effect of clinical guidelines combined with team based learning(TBL) teaching courses in standardized training for ophthalmic residents. Methods: 15 residents who received standardized training in the ophthalmology department of the First Affiliated Hospital of Guangzhou Medical University were recruited from January 2022 to June 2023. Self-study teaching and TBL teaching were successively applied to teach the clinical guidelines of ophthalmology. The subjective and objective teaching effects were evaluated by satisfaction questionnaire, passing rate of phase examination, achievement of academic proficiency test and passing rate of final examination. Results: The clinical guidelines enjoy the high opinion in the residents, and would not be strengthen their learning burden. After the residents studied clinical guidelines, their passing rate of the phase exam, academic proficiency test and final examination were all 100%. In terms of cultivating teamwork ability and study atmosphere, the satisfaction of TBL lectures was significantly higher than that of self-study lectures (P< 0.001). 93.3% (14/15) of the residents preferred TBL lectures. Conclusions: The combination of ophthalmology clinical guidelines and TBL teaching was proved to be an effective teaching model. The residents achieved excellent teaching results in the subjective satisfaction questionnaire and objective examination scores.
目的：调查临床医学5年制本科生对见习教学的满意度，并分析其影响因素。方法：采用匿名线上问卷调查，向中山大学2019级临床医学5年制4年级的结束所有临床科室见习的本科生发放见习满意度问卷。结果：共有75人完成了问卷调查。在最满意的见习课程中，眼科学见习满意度最高(39人，52%)，其次是外科学(18人，24%)和内科学(7人，9.33%)。教学满意度的影响因素综合得分排名前5位的选项分别是“A课程设置合理，临床见习重点突出”“B见习小课授课水平高”“C师资配备好，小组教学”“D临床资源丰富，利于见习教学”以及“E教学方法先进，方式灵活多样，新型教学形式丰富”。在选择排序第一(B 33.33%，A 25.86%，E 21.15%)和第二(E 26.92%，B 24.56%，A 24.14%)的影响因素时，前三位的选项均为A、B、E，学生对见习课程设置、见习小课水平和见习教学方式、方法非常重视。在学生从事眼科专业的意愿方面，5人(6.67%)表示非常愿意、32人(42.67%)表示有可能今后从事眼科专业，二者比例合计与眼科学获得最满意见习课程的比例非常接近。结论：见习课程设置、小课授课水平以及见习教学的方式、方法是见习教学满意度的重要影响因素。临床见习的满意度对学生的职业导向具有一定的影响。
Objective: To investigate the satisfaction of 5-year undergraduate students in clinical medicine with clerkship teaching and analyze its influencing factors. Methods: Anonymous online questionnaire survey was conducted. Satisfaction questionnaires were distributed to undergraduate students in the 4th year of the 5-year clinical medicine at Sun Yat- sen University who had completed clerkship in all clinical departments. Results: A total of 75 students completed the questionnaire survey. Among the most satisfactory clerkship courses, ophthalmology had the highest satisfaction rate (39 votes, 52%), followed by surgery (18 votes, 24%) and internal medicine (7 votes, 9.33%). Te top 5 options in terms of comprehensive scores for infuencing factors of teaching satisfaction are "A. Reasonable curriculum with prominent focuses", "B. High clerkship class teaching level", "C. Strong teaching staf", "D. Abundant clinical resources ", and "E. Advanced teaching methods ". When selecting the infuencing factors that rank frst (B 33.33%, A 25.86%, E 21.15%) and second (E 26.92%, B 24.56%, A 24.14%), the top three options are A, B, and E. Students atach great importance to the seting of clerkship courses, the level of clerkship courses, and the teaching methods. In terms of students' willingness to engage in ophthalmology, 5 students (6.67%) expressed great willingness, and 32 students (42.67%) expressed the possibility. Conclusions: Te seting of clerkship courses, the level of small class teaching, and the clerkship teaching method are important infuencing factors of clerkship satisfaction. Te satisfaction of clerkship has a certain impact on students' career selection.
目前Wetlab眼科手术教学采用猪眼球作为教学模型，与实际手术差别较大，且无法满足外眼手术教学的需求。通过使用带有眼球、眼外肌、眶组织、眶骨及眼睑结构的全眼模型，可高度模拟真实手术场景，覆盖更多眼科手术教学需求。基于全眼模型构建多个眼科手术教学平台，依照培养阶段设计手术课程，创建新的评价体系，改变传统将“内眼”“外眼”分开的教学理念，可使年轻医师从一开始就建立眼科“分科而不分割”的整体思维，从而使眼科手术培训更加规范和完善。
Porcine eyes have been used as animal model in ophthalmic surgery training. However, it differs greatly from real surgery and cannot meet the needs of external eye surgery teaching. Porcine orbit model with eyeball, extraocular muscles, orbital tissue, bones and eyelids can be more realistic simulation of real surgeries and cover more needs for ophthalmic surgery teaching. By setting up ophthalmic surgery teaching platforms, designing staged course and creating new assessment methods based on porcine orbit model, the traditional concept about separation of internal and external eye is changed. This helps young doctors to establish a holistic view from the very beginning,that ophthalmic surgeries should not be split because of subspeciality. In this way, ophthalmic surgery training will become more standardized and perfected.
目的：了解八年制医学生对全程导师的教学需求与满意度。方法：将中山大学八年制临床医学生分为低年级、高年级两组，均进行匿名线上问卷调查。分析问卷结果，并比较两组间的不同。结果：回收问卷352份。学生对导师个人“比较满意”占比高(低年级45.56% vs 高年级37.79%，P=0.087)，对全程导师制度“比较满意”占比高(低年级 36.67% vs 高年级33.14%，P=0.806)。对全程导师制度“很了解”与“比较了解”的学生在低年级中明显低于高年级的占比(16.67% vs77.91%，P<0.001)。低年级学生期待全程导师在职业规划、临床思维、科研思维、心理健康发挥较大影响的占比均高于高年级的实际评估(构成比4个方面均P<0.001，选择“有很大影响”及“比较有影响”在低、高年级占比分别为83.33% vs 36.63%，92.22% vs 29.07%，91.67% vs 31.39%，62.78% vs 38.37%)。结论：学生对全程导师个人及制度均较满意，但存在低年级对该制度了解少、师生联系少、导师实际作用低于学生预期、科研训练机会不足等问题。亟需完善全程导师制，推动临床医学高水平人才的培养。
Objective: To evaluate the teaching needs and satisfaction of the eight-year program medical students to the whole-course tutors. Methods: An anonymous online questionnaire survey was conducted among the eight-year program medical students at Sun Yat-sen University. All students were divided the junior group and the senior group, and the differences between the two groups were compared. Results: A total of 352 valid questionnaires were collected. The proportion of students who were fairly satisfied with their whole-course tutors was 45.56% in the junior group and 37.79% in the senior group (P=0.087). The proportion of students who were fairly satisfied with the whole-course tutorial system was 36.67% in the junior group and 33.14% in the senior group (P=0.806). The proportion of students who “know well” and “know fairly well” about the whole-course tutorial system in the junior group was significantly lower than that in the senior group (16.67% vs 77.91%, P<0.001). The proportion of students in the junior group expecting their whole-course tutors “having a great impact” or “having some impact” on career planning, clinical thinking, scientific research thinking and mental health was significantly higher than that in the senior group (tests for proportions, all P<0.001, 83.33% vs 36.63%, 92.22% vs 29.07%, 91.67% vs 31.39%, 62.78% vs 38.37%). Conclusion: The eight-year program medical students are satisfied with their whole-course tutors and the whole-course tutorial system. However, some problems still exist, such as lower grade students lack of understanding of the whole-course tutorial system, insufficient contact between tutors and students, the actual influences of tutors failing to meet the students’ expectation, and insufficient opportunity of scientific research and training. It is urgent to improve the whole-course tutorial system and promote the cultivation of qualified medical talents.
目的：探索基于眼外伤急诊救治胜任力的教学模式。方法：通过分析眼外伤急诊救治的教学现状，结合医学生岗位胜任力特征，构建基于眼外伤急诊救治胜任力的教学体系。结果：基于胜任力构建的眼外伤急诊救治教学体系的优势在于一切以临床实际需求为出发点，使学生在临床实践能力、思辨能力、团队合作、自我认知、医学人文素养等几个方面得到提升，从而更好地胜任临床工作。结论：基于胜任力的教学模式可以全面提高培训医师眼外伤急诊救治的实际能力。
Objective: To explore the teaching mode based on competency in emergency treatment of ocular trauma.Methods: By analyzing the teaching status of emergency treatment for ocular trauma and combining with the competency characteristics of medical students, a competency-based teaching system for emergency treatment of ocular trauma was constructed. Results: The advantage of the teaching system for emergency treatment of ocular trauma based on competency was that it took actual clinical needs as the starting point, which could improve students’ clinical practice ability, critical thinking ability, team work, self-cognition, medical humanistic quality and other aspects, so as to be better qualified for clinical work. Conclusion: The teaching mode based on competency can comprehensively improve the practical ability of training doctors in emergency treatment of ocular trauma.
北京同仁医院积累了几十年的眼科进修医生的教学经验，近年来在进修医生教学实践中应用“以问题为导向”(Problem-Based Learning，PBL)教学法，逐步总结出独特的“辩误施教”教学法。这种教学方法有利于加深进修医生对基础知识理论的理解，提高进修医生发现问题、解决问题的能力及独立的临床思维能力。每月定期召开进修医生沙龙，进行必要的考核、多种形式的总结和交流有利于促进交流，提高教学效果。
Beijing Tongren Hospital has accumulated decades of ophthalmology teaching experience. In recent years, through the application of Problem-Based Learning (PBL) teaching method, we gradually summed up the unique error-distinguished teaching method, which may enhance the understanding of basic knowledge and theories, improve the ability of doctors to discover and solve problems and enhance their independent clinical thinking. At the same time, monthly salon for physician refresher, necessary assessments, various forms of summaries and communication are conducive to promote further learning and produce a good teaching efficiency.
目的：评价手术视频辅助Wetlab眼睑手术教学的效果。方法：回顾性分析2021年4月至2021年9月在中山大学中山眼科中心住院医师规范化培训学员中使用全眼模型开展Wetlab外眼手术教学的情况。对照组(12人)采用传统教学方法，实验组(15人)在传统教学方法的基础上引入手术视频辅助教学，对学员第3、6、9次练习视频进行评分，分析教学效果。结果：2组学员的基线水平与学习曲线相似，练习第3次到第6次之间评分提高快(对照组P3~6=0.001，实验组P3~6<0.001)，第6次到第9次之间提高速度放缓(对照组P6~9=0.007，实验组P6~9=0.012)。对照组学员在练习第3次用时更长[(80.3±16.1) min]，随着练习次数增多，用时逐渐缩短并保持稳定(P3~6=0.040，P6~9=0.886，P3~9=0.020)，而实验组学员在练习第3次用时更短[(71.7±15.0) min]，练习过程中保持稳定(P3~6=0.568，P3~9=0.519)。结论：手术视频辅助教学有助于学员熟悉手术操作，提高练习效率。
Objective: To assess the efficacy of video-assisted Wetlab eyelid surgery teaching. Methods: From April 2021 to September 2021, the porcine orbit model was used to conduct a Wetlab teaching course on eyelid surgeries among trainees of standardized training for residents in Zhongshan Ophthalmic Center, Sun Yat-sen University. The control group (12 trainees) used conventional teaching methods. Video-assisted teaching was offered to the test group (15 trainees) based on conventional teaching methods. The videos records of the 3rd, 6th, and 9th practices were scored to analyze the teaching efficiency. Results: Trainees from the 2 groups showed a simila baseline and learning curve. Rapid improvement was found between the 3rd and 6th practice (P3–6=0.001 in control group, P3–6<0.001 in test group). The increment was slower between the 6th and 9th practice (P6–9=0.007 from control group, P6–9=0.012 from test group). Longer time was required by trainees from the control group at the 3rd practice [(80.3±16.1) min]. As they practiced more, the time required gradually decreased and remained stable (P3–6=0.040, P6–9=0.886, P3–9=0.020 from control group). Trainees from the test group spent less time at the 3rd practice [(71.7±15.0) min]. The time remained stable during all practices (P3–6=0.568, P3–9=0.519 from test group). Conclusion: Video-assisted teaching can help trainees get familiar with surgical operations and improve the efficiency of practices.
目的：探讨基于微信的图像存储和传输系统(picture archiving and communication system，PACS)教学在眼眶科规培医生中的教学效果及质量评价。方法：将中山眼科中心眼眶科轮训的66名规培医生分为A组(PACS组)与B组(微信+PACS组)。通过出科考核和问卷分析比较两组学生的教学效果及满意度。结果：B组学生的基础知识测试和阅片技能测试得分均显著高于A组(P<0.001，P=0.037)。教学效果自我评估量表显示B组学生对解剖结构位置的熟悉程度、影像学诊断、鉴别诊断能力、工作中解读CT或MRI图像的能力预判，以及对CT或MRI影像学的兴趣，明显优于A组(均P<0.001)。所有学生(100.00%)对这种教学模式感到非常满意。结论：在眼眶科住院医师规划化培训中应用基于微信的PACS教学模式能显著提高教学效果和满意度，提高教学质量。
Objective: To evaluate the application quality of picture archiving and communication system (PACS) based on WeChat in standardized resident training in orbital department. Methods: A total of 66 doctors trained in the Orbital Department of Zhongshan Ophthalmic Center were divided into group A (PACS group) and Group B (WeChat +PACS group). The quality and feedback of teaching of the two groups of students were compared through examination and questionnaire. Results: The scores of basic knowledges and reading skills of group B were significantly higher than those of group A (P<0.001, P=0.037). The self-assessment scale for teaching quality showed that the students in group B were superior to group A in understanding the position of anatomical structure, imaging diagnosis and differential diagnosis according to CT or MRI, interpreting CT or MRI images in the future, and interest in CT or MRI imaging (all P<0.001). All the students (100.00%) were very satisfied with this mode of teaching. Conclusion: The application of PACS based on WeChat in standardized resident training in orbital department can significantly improve the quality and satisfaction of ophthalmology teaching.
目的：分析新型冠状病毒肺炎疫情期间实时面对面线上教学(以“腾讯会议”教学为例)在医学教育中的利弊及其与医学生眼表疾病的相关性，为改进线上教育方案、预防干眼提供依据。方法：以中南大学湘雅医学院本科学生为研究对象，采用横断面研究的方法，使用问卷星收集数据，研究实时面对面线上教学的效果及对眼表疾病的影响。结果：共收集到131份有效数据，绝大多数学生(84.73%)认为实时面对面线上教学是有效的，96.18%的学生认为实时面对面线上教学达到或部分达到了学习的目的，但是实时面对面线上教学的师生互动与课堂氛围有待加强，另外网络设备问题也是实时面对面线上教学需要面对的问题。同时，调查显示实时面对面线上教学参与学生的干眼患病率达66.41%，家庭所在地、家庭人均月收入、使用设备、是否全程专注听课与干眼患病率之间无相关性。结论：新型冠状病毒疫情期间实时面对面线上教学在医学教育中是有效的，但是师生互动不足、课堂氛围不够活跃、网络连接不稳定是其主要问题。此外，实时面对面线上教学会增加干眼的发病率，需要提高护眼意识，积极预防。
Objective: To analyze the advantages and disadvantages of real-time face-to-face online teaching (taking “Tencent Conference” teaching as an example) in medical education and its correlation with ocular surface diseases during the COVID-19 pandemic, and to provide basis for improving online education programs and preventing dry eye. Methods: The undergraduate students of Xiangya School of Medicine of Central South University were selected as the research objects. The method of cross-sectional study was used to collect data using questionnaires to study the effect of real-time face-to-face online teaching and its impact on ocular surface diseases. Results: A total of 131 valid data were collected. Among them, the vast majority of students (84.73%) think real time face to face online teaching is effective, and 96.18% of the students believe that real-time face-to-face online teaching at least partly achieved the purpose of learning. However, the interaction between teachers and students and the classroom atmosphere of real-time face-to-face online teaching needs to be strengthened. In addition, network equipment is also a problem that real-time face-to-face online teaching needs to face. Meanwhile, the survey showed that the prevalence rate of dry eye among the students who participated in real-time face-to-face online teaching reached 66.41%, and there was no correlation between the incidence rate of dry eye and the location of family, the per capita monthly income of family, the equipment, and whether they paid full attention to the lectures. Conclusion: Real-time face-to-face online teaching is effective in medical education during COVID-19, but the main problems are insufficient teacher-student interaction, inactive classroom atmosphere and unstable Internet connection. In addition, real-time face-to face online teaching will increase the incidence of dry eye, so it is necessary to improve the awareness of eye protection and actively prevent it.
纳入126名中山大学临床医学五年制4年级学生，对其接受为期1周的直接检眼镜见习教学后，进行问卷调查，了解学生对直接检眼镜学教学的看法以及学习过程中的操作难点。结果显示大部分学生认为直接检眼镜对临床工作有重要作用。但学生普遍反映学习过程难度大，师生视野无法共享，进而阻碍了师生直接的教学沟通。多数学生愿意接受更进一步的直接检眼镜教学。
A total of 126 senior of 5-year clinical medicine students in Sun Yat-sen University were recruited. After 1-week internship and direct ophthalmoscope training, a questionnaire survey was conducted to scrutinize students’ feedback about the training methods and learning difficulties during the internship. The results showed that most students thought that the direct ophthalmoscope played an important role in clinical work. However, students generally felt complicated and hard during the learning process due to the communication obstacle between teachers and students caused by the unavailability of vision sharing. In spite of this, most students are still willing to accept further direct ophthalmoscopy training.
