Kudzidza mashandisirwo emusanganiswa wetekinoroji ye3D imaging uye nzira yekudzidza ine matambudziko mukudzidziswa kwekiriniki ine chekuita nekuvhiyiwa kwemusana.
Pamwe chete, vadzidzi zana nevatanhatu vekosi yemakore mashanu yekudzidza mu "Clinical Medicine" vakasarudzwa sevanhu vekudzidza, avo muna 2021 vachange vachiita internship mudhipatimendi re orthopedics pachipatara chakabatana cheXuzhou Medical University. Vadzidzi ava vakakamurwa zvisina tsarukano mumapoka ekuyedza neokutonga, nevadzidzi makumi mashanu nevatatu muboka rega rega. Boka rekuyedza rakashandisa musanganiswa wetekinoroji ye3D imaging uye PBL learning mode, nepo boka rekutonga raishandisa nzira yekudzidza yechinyakare. Mushure mekudzidziswa, kushanda kwekudzidziswa mumapoka maviri aya kwakaenzaniswa uchishandisa bvunzo nemibvunzo.
Mapoinzi ese ebvunzo yedzidziso yevadzidzi veboka rekuyedza aive akakwira kupfuura evadzidzi veboka rekuyedza. Vadzidzi vemapoka maviri vakazviongorora vakazvimirira magiredhi avo muchidzidzo, nepo magiredhi evadzidzi veboka rekuyedza aive akakwira kupfuura evadzidzi veboka rekuyedza (P < 0.05). Kufarira kudzidza, mamiriro ekirasi, kutaurirana mukirasi, uye kugutsikana nekudzidzisa zvaive zvakakwirira pakati pevadzidzi muboka rekuyedza kupfuura muboka rekuyedza (P < 0.05).
Kusanganiswa kwetekinoroji ye3D imaging uye PBL learning mode pakudzidzisa kuvhiya musana kunogona kuwedzera kushanda zvakanaka kwekudzidza uye kufarira kwevadzidzi, uye kukurudzira kukura kwekufunga kwekiriniki kwevadzidzi.
Mumakore achangopfuura, nekuda kwekuwanda kweruzivo rwekiriniki netekinoroji, mubvunzo wekuti rudzii rwedzidzo yekurapa runogona kuderedza zvinobudirira nguva inotorwa kubva kuvadzidzi vekurapa kuenda kuchiremba uye kukura vagari vakanaka nekukurumidza wave nyaya yekunetseka. yakakwezva kutariswa kwakawanda [1]. Kudzidzira kwekiriniki idanho rakakosha mukukura kwekufunga kwekiriniki uye kugona kushanda kwevadzidzi vekurapa. Kunyanya, kuvhiyiwa kunoisa zvinodiwa zvakasimba pahunyanzvi hwekushanda hwevadzidzi uye ruzivo rwemuviri wemunhu.
Parizvino, nzira yechinyakare yekudzidzisa ichiri kutonga muzvikoro nemukurapa kwekiriniki [2]. Nzira yechinyakare yekudzidzisa inotarisa kumudzidzisi: mudzidzisi anomira pachikuva uye anopa ruzivo kuvadzidzi kuburikidza nenzira dzechinyakare dzekudzidzisa dzakadai semabhuku ekudzidzisa uye mapurogiramu emultimedia. Kosi yese inodzidziswa nemudzidzisi. Vadzidzi vanowanzoteerera hurukuro, mikana yekukurukurirana pachena uye mibvunzo mishoma. Nekuda kweizvozvo, maitiro aya anogona kushanduka nyore nyore kuita dzidziso yedivi rimwe chete kubva kuvadzidzisi uku vadzidzi vachigamuchira mamiriro acho ezvinhu. Saka, mukudzidzisa, vadzidzisi vanowanzoona kuti kufarira kwevadzidzi kudzidza hakuna kukwira, kufarira hakuna kukwira, uye mhedzisiro yacho yakaipa. Pamusoro pezvo, zvakaoma kutsanangura zvakajeka chimiro chakaoma chemusana uchishandisa mifananidzo ye2D senge PPT, mabhuku eanatomy nemifananidzo, uye hazvisi nyore kuti vadzidzi vanzwisise uye vagone ruzivo urwu [3].
Muna 1969, nzira itsva yekudzidzisa, yekudzidza kwakavakirwa pamatambudziko (PBL), yakaedzwa paMcMaster University School of Medicine muCanada. Kusiyana nenzira dzekudzidzisa dzechinyakare, nzira yekudzidza yePBL inobata vadzidzi sechikamu chikuru chedzidzo uye inoshandisa mibvunzo yakakodzera senzira yekugonesa vadzidzi kudzidza, kukurukura nekushandira pamwe vari vega mumapoka, kubvunza mibvunzo uye kuwana mhinduro pane kungozvigamuchira chete. , 5]. Mukuongorora nekugadzirisa matambudziko, kudziridza kugona kwevadzidzi kudzidza vakazvimiririra uye kufunga zvine musoro [6]. Pamusoro pezvo, nekuda kwekuvandudzwa kwetekinoroji yekurapa yedhijitari, nzira dzekudzidzisa dzekiriniki dzakapfumiswawo zvakanyanya. Tekinoroji ye3D imaging (3DV) inotora data rakaomeswa kubva kumifananidzo yekurapa, inoiisa musoftware yekuenzanisa ye3D kuvakazve, uye yobva yagadzirisa data racho kugadzira modhi ye3D. Nzira iyi inokunda zvipingamupinyi zvemuenzaniso wekudzidzisa wechinyakare, inounganidza kutarisisa kwevadzidzi munzira dzakawanda uye inobatsira vadzidzi nekukurumidza kugona maumbirwo akaomarara eatomu [7, 8], kunyanya mudzidzo yemapfupa. Nokudaro, chinyorwa chino chinosanganisa nzira idzi mbiri kudzidza mhedzisiro yekubatanidza PBL netekinoroji ye3DV uye modhi yekudzidza yechinyakare mukushandiswa kwechokwadi. Mhedzisiro yacho inotevera.
Chinangwa chechidzidzo ichi chaive vadzidzi 106 vakapinda muchidzidzo chekuvhiya musana muchipatara chedu muna 2021, avo vakakamurwa kuita mapoka ekuyedza neokutonga vachishandisa tafura yenhamba dzisina kurongeka, vadzidzi 53 muboka rega rega. Boka rekuyedza raive nevarume 25 nevakadzi 28 vane makore 21 kusvika 23, avhareji yemakore 22.6±0.8. Boka rekutonga raive nevarume 26 nevakadzi 27 vane makore 21-24, avhareji yemakore 22.6±0.9, vadzidzi vese vari interns. Pakanga pasina musiyano mukuru wezera nehunhu pakati pemapoka maviri aya (P>0.05).
Zvinodiwa zvekubatanidzwa ndeizvi: (1) Vadzidzi vegore rechina rechikoro chenguva yakazara; (2) Vadzidzi vanogona kutaura zvakajeka manzwiro avo echokwadi; (3) Vadzidzi vanogona kunzwisisa uye kutora chikamu mukuita kwese kwechidzidzo ichi uye kusaina fomu rekubvumidza ruzivo. Zvinodiwa zvekuregererwa ndeizvi: (1) Vadzidzi vasingasvike pane chero zvinodiwa zvekubatanidzwa; (2) Vadzidzi vasingade kutora chikamu mukudzidziswa uku nekuda kwezvikonzero zvavo; (3) Vadzidzi vane ruzivo rwekudzidzisa rwePBL.
Tumira data reCT raw musoftware yekufananidza uye tumira modhi yakavakwa musoftware yekudzidzira yakasarudzika kuti ionekwe. Modhi iyi ine mapfupa, ma disc e intervertebral uye tsinga dzemusana (Mufananidzo 1). Zvikamu zvakasiyana zvinomiririrwa nemavara akasiyana, uye modhi inogona kuwedzerwa nekutenderedzwa sezvaunoda. Chinhu chikuru cheiyi nzira ndechekuti CT layers dzinogona kuiswa pamodhi uye kujeka kwezvikamu zvakasiyana kunogona kugadziriswa kuti zvisavharike.
a Kumashure uye b Kumativi. muL1, L3 uye chiuno chemuenzaniso chakajeka. d Mushure mekubatanidza mufananidzo weCT cross-section nemuenzaniso, unogona kuufambisa kumusoro nekudzika kuti ugadzire mapuraneti akasiyana eCT. e Muenzaniso wakabatanidzwa wemifananidzo yeCT yesagittal uye kushandiswa kwemirairo yakavanzika yekugadzirisa L1 neL3
Zviri mukati mekudzidziswa uku ndeizvi: 1) Kuongorora nekurapa zvirwere zvakajairika mukuvhiyiwa kwemusana; 2) Ruzivo rwemaumbirwo emusana, kufunga nekunzwisisa kuitika uye kukura kwezvirwere; 3) Mavhidhiyo ekushanda achidzidzisa ruzivo rwekutanga. Matanho ekuvhiyiwa kwemusana kwakajairika, 4) Kuona zvirwere zvakajairika mukuvhiyiwa kwemusana, 5) Ruzivo rwekare rwedzidziso yekurangarira, kusanganisira dzidziso yemusana waDennis une makoramu matatu, kupatsanurwa kwemusana, uye kupatsanurwa kwemusana welumbar.
Boka rekuyedza: Nzira yekudzidzisa inosanganiswa nePBL ne3D imaging technology. Nzira iyi inosanganisira zvinotevera. 1) Kugadzirira zviitiko zvakajairika mukuvhiyiwa kwemusana: Kurukurai zviitiko zve cervical spondylosis, lumbar disc herniation, uye pyramidal compression fractures, nyaya yega yega ichitarisa papfungwa dzakasiyana dzeruzivo. Zviitiko, 3D models uye mavhidhiyo ekuvhiya zvinotumirwa kuvadzidzi vhiki imwe chete vasati vapedza kudzidza uye vanokurudzirwa kushandisa 3D modell kuyedza ruzivo rwe anatomic. 2) Kugadzirira: maminetsi gumi vasati vapedza kudzidza, zivisai vadzidzi maitiro chaiwo ekudzidza ePBL, kurudzirai vadzidzi kuti vatore chikamu, vashandise nguva yakazara, uye vapedzise mabasa nekuchenjera. Kuisa mapoka kwakaitwa mushure mekuwana mvumo yevatori vechikamu vese. Torai vadzidzi 8 kusvika ku10 muboka, patsanurai kuita mapoka makasununguka kuti mufunge nezveruzivo rwekutsvaga nyaya, fungai nezvekudzidza mega, torai chikamu muhurukuro dzeboka, pindurai mumwe nemumwe, pakupedzisira tsanangurai pfungwa huru, gadzirai data rakarongeka, uye nyorai hurukuro. Sarudzai mudzidzi ane hunyanzvi hwakasimba hwekuronga uye hwekutaura semutungamiri weboka kuti aronge hurukuro dzeboka uye mharidzo. 3) Gwaro Revadzidzisi: Vadzidzisi vanoshandisa software yekufananidzira kutsanangura maumbirwo emusana pamwe chete nezviitiko zvakajairika, uye kubvumira vadzidzi kushandisa software iyi nemazvo kuita mabasa akadai sekudhonza, kutenderera, kuisa CT panzvimbo itsva uye kugadzirisa kujeka kwetishu; Kuti vave nekunzwisisa kwakadzama uye kurangarira chimiro chechirwere, uye kuvabatsira kufunga vakazvimiririra nezvehukama hukuru pakutanga, kukura uye mafambiro echirwere. 4) Kuchinjana maonero nekukurukurirana. Mukupindura mibvunzo yakanyorwa pamberi pekirasi, ipa hurukuro dzekukurukurirana mukirasi uye koka mutungamiriri weboka rega rega kuti ataure nezvemhedzisiro yekukurukurirana kweboka mushure menguva yakakwana yekukurukurirana. Munguva iyi, boka rinogona kubvunzana mibvunzo nekubatsirana, ukuwo mudzidzisi achifanira kunyora nekunyatsonzwisisa mafungiro evadzidzi nematambudziko anobatanidzwa nawo. 5) Pfupiso: Mushure mekukurukura nezvevadzidzi, mudzidzisi achataura nezvemaitiro evadzidzi, opfupikisa uye opindura zvakadzama mimwe mibvunzo yakajairika uye inokakavadzana, uye otsanangura gwara rekudzidza mune ramangwana kuitira kuti vadzidzi vagone kuchinjika nenzira yekudzidzisa yePBL.
Boka rekutonga rinoshandisa nzira yekudzidza yechinyakare, richiraira vadzidzi kuti vaongorore zvinhu vasati vapinda mukirasi. Kuti vadzidzise hurukuro dzedzidziso, vadzidzisi vanoshandisa mabhodhi machena, mapurogiramu emultimedia, zvinhu zvemavhidhiyo, mienzaniso yemuenzaniso nezvimwe zvinobatsira pakudzidzisa, uye vanorongawo kosi yekudzidzisa zvichienderana nezvinhu zvekudzidzisa. Sekuwedzera kune zvidzidzo, maitiro aya anotarisa pamatambudziko akakodzera uye pfungwa huru dzebhuku. Mushure mehurukuro, mudzidzisi akapfupikisa zvinhu uye akakurudzira vadzidzi kuti vadzidze nemusoro uye vanzwisise ruzivo rwakakodzera.
Zvichienderana nezviri mukudzidziswa, bvunzo yebhuku rakavharwa yakatorwa. Mibvunzo isina chinangwa inosarudzwa kubva mumibvunzo yakakodzera inobvunzwa nevarapi mumakore apfuura. Mibvunzo ine chekuita nepfungwa inoumbwa neDhipatimendi reMabvi uye pakupedzisira inoongororwa nevadzidzisi vasinganyore bvunzo. Tora chikamu mukudzidza. Chibodzwa chakazara chebvunzo i100 mapoinzi, uye zvirimo zvinosanganisira zvikamu zviviri zvinotevera: 1) Mibvunzo ine chinangwa (kazhinji mibvunzo ine sarudzo dzakawanda), iyo inonyanya kuyedza kugona kwevadzidzi kuziva zvinhu zveruzivo, iyo iri 50% yemapoinzi ese; 2) Mibvunzo ine chekuita nepfungwa (mibvunzo yekuongorora nyaya), inonyanya kutarisa pakunzwisisa kwakarongeka uye kuongorora zvirwere nevadzidzi, iyo iri 50% yemapoinzi ese.
Pakupera kwekosi, mibvunzo ine zvikamu zviviri nemibvunzo mipfumbamwe yakapihwa. Zviri mukati memibvunzo iyi zvinoenderana nezvinhu zvakaratidzwa mutafura, uye vadzidzi vanofanira kupindura mibvunzo pazvinhu izvi nemaki akazara emapoinzi gumi uye maki mashoma epoinzi imwe. Maki epamusoro anoratidza kugutsikana kwevadzidzi kwakanyanya. Mibvunzo iri muTafura 2 ndeye kana musanganiswa wePBL ne3DV learning modes ungabatsira vadzidzi kunzwisisa ruzivo rwakaoma rwehunyanzvi. Zvinhu zveTafura 3 zvinoratidza kugutsikana kwevadzidzi nenzira dzese dzekudzidza.
Data rese rakaongororwa uchishandisa software yeSPSS 25; mhinduro dzebvunzo dzakaratidzwa se mean ± standard deviation (x ± s). Data yehuwandu yakaongororwa ne ANOVA yenzira imwe chete, data yemhando yepamusoro yakaongororwa ne χ2 test, uye kugadziriswa kwaBonferroni kwakashandiswa pakuenzanisa kwakawanda. Musiyano wakakosha (P<0.05).
Mhedzisiro yekuongorora nhamba dzemapoka maviri yakaratidza kuti mamakisi emibvunzo isina chinangwa (mibvunzo yekusarudza zvakawanda) yevadzidzi veboka rekutonga aive akakwirira zvakanyanya kupfuura evadzidzi veboka rekuedza (P < 0.05), uye mamakisi evadzidzi veboka rekutonga aive akakwira zvakanyanya, kupfuura vadzidzi veboka rekuedza (P < 0.05). Mamakisi emibvunzo yekuzvifungira (mibvunzo yekuongorora nyaya) yevadzidzi veboka rekuedza aive akakwira zvakanyanya kupfuura evadzidzi veboka rekutonga (P < 0.01), ona Tafura 1.
Mibvunzo isina kuzivikanwa yakagoverwa mushure memakirasi ese. Pakazara, mibvunzo 106 yakagoverwa, 106 yacho yakadzorerwa, nepo mwero wekupora waiva 100.0%. Mafomu ese akazadzwa. Kuenzanisa mhedzisiro yeongororo yemibvunzo pamusoro pehuwandu hweruzivo rwehunyanzvi pakati pemapoka maviri evadzidzi kwakaratidza kuti vadzidzi veboka rekuyedza vanonyatsogona matanho makuru ekuvhiyiwa kwemusana, ruzivo rwekuronga, kupatsanurwa kwezvirwere zvekare, nezvimwewo. Musiyano wacho waive wakakosha muhuwandu (P<0.05) sezvakaratidzwa muTafura 2.
Kuenzanisa mhinduro dzemibvunzo ine chekuita nekugutsikana kwekudzidzisa pakati pemapoka maviri: vadzidzi vari muboka rekuyedza vakawana mamakisi akakwira kupfuura vadzidzi vari muboka rekutonga maererano nekufarira kudzidza, mamiriro ekirasi, kutaurirana mukirasi, uye kugutsikana nekudzidzisa. Musiyano wacho waive wakakosha muhuwandu (P<0.05). Tsanangudzo dzakaratidzwa muTafura 3.
Nekuunganidzwa kuri kuramba kuchienderera mberi nekukura kwesainzi netekinoroji, kunyanya sezvatinopinda muzana remakore rechi21, basa rekurapa muzvipatara riri kuramba richioma. Kuti tive nechokwadi chekuti vadzidzi vekurapa vanogona kukurumidza kujairana nebasa rekurapa uye kugadzira matarenda ekurapa emhando yepamusoro kuti zvibatsire nzanga, dzidziso dzechinyakare uye nzira yakabatana yekudzidza zvinosangana nematambudziko mukugadzirisa matambudziko anoshanda ekurapa. Muenzaniso wechinyakare wedzidzo yekurapa munyika yangu une zvakanakira zveruzivo rwakawanda mukirasi, zvinodiwa zvishoma zvezvakatipoteredza, uye sisitimu yeruzivo rwekudzidzisa inogona kusangana nezvinodiwa zvekudzidzisa makosi edzidziso [9]. Zvisinei, rudzi urwu rwedzidzo runogona kutungamira nyore nyore kumusiyano pakati pedzidziso nemaitiro, kudzikira kwekutanga uye kufarira kwevadzidzi mukudzidza, kutadza kuongorora zvizere zvirwere zvakaoma mukiriniki uye, nekudaro, hazvigone kusangana nezvinodiwa zvedzidzo yepamusoro yekurapa. Mumakore achangopfuura, huwandu hwekuvhiyiwa kwemusana munyika yangu hwakawedzera nekukurumidza, uye kudzidzisa kuvhiyiwa kwemusana kwakatarisana nematambudziko matsva. Munguva yekudzidziswa kwevadzidzi vekurapa, chikamu chakaoma chekuvhiyiwa inyanzvi dzemapfupa, kunyanya kuvhiyiwa kwemusana. Pfungwa dzeruzivo hadzina kunyanya kukosha uye dzine chekuita nekuremara kwemusana nehutachiona chete, asiwo kukuvara uye bundu remapfupa. Pfungwa idzi hadzisi dzekufungidzira chete uye dzakaoma, asiwo dzine chekuita neanatomy, pathology, imaging, biomechanics, nedzimwe nzira, zvichiita kuti zviri mukati madzo zviome kunzwisisa nekurangarira. Panguva imwe chete, nzvimbo dzakawanda dzekuvhiyiwa kwemusana dziri kukura nekukurumidza, uye ruzivo rwuri mumabhuku aripo rwava rwekare, izvo zvinoita kuti zviomere vadzidzisi kudzidzisa. Saka, kuchinja nzira yekudzidzisa yechinyakare uye kuisa budiriro dzichangoburwa mukutsvagisa kwenyika dzese kunogona kuita kuti kudzidzisa ruzivo rwakakodzera rwedzidziso kuve kwechokwadi, kuvandudza kugona kwevadzidzi kufunga zvine musoro, uye kukurudzira vadzidzi kufunga zvakadzama. Kusakwana uku mukudzidza kuripo kunofanirwa kugadziriswa nekukurumidza kuitira kuti tiongorore miganhu nemiganhu yeruzivo rwekurapa rwemazuva ano uye kukunda zvipingamupinyi zvechinyakare [10].
Modhi yekudzidza yePBL inzira yekudzidza inotarisa mudzidzi. Kuburikidza nekudzidza kwakazvimirira, kudzidza kwakazvimirira uye kukurukurirana kwekudyidzana, vadzidzi vanogona kuburitsa shungu dzavo zvizere uye kubva pakugamuchira ruzivo vasingashande kuenda pakutora chikamu mukudzidzisa kwemudzidzisi. Zvichienzaniswa nemodhi yekudzidza yakavakirwa pahurukuro, vadzidzi vanotora chikamu mumodhi yekudzidza yePBL vane nguva yakakwana yekushandisa mabhuku, Internet, uye software yekutsvaga mhinduro dzemibvunzo, kufunga vakazvimiririra, uye kukurukura misoro ine chekuita munzvimbo yeboka. Nzira iyi inovandudza kugona kwevadzidzi kufunga vakazvimiririra, kuongorora matambudziko nekugadzirisa matambudziko [11]. Mukuita kwekukurukurirana kwakasununguka, vadzidzi vakasiyana vanogona kuva nemafungiro akasiyana-siyana nezvenyaya imwe chete, izvo zvinopa vadzidzi puratifomu yekuwedzera kufunga kwavo. Kuvandudza kufunga kwekugadzira uye kugona kufunga zvine musoro kuburikidza nekufunga nguva dzose, uye kukudziridza kugona kutaura nemuromo uye mweya wekubatana kuburikidza nekutaurirana pakati pevanodzidza navo [12]. Chinonyanya kukosha, kudzidzisa PBL kunobvumira vadzidzi kunzwisisa maitiro ekuongorora, kuronga uye kushandisa ruzivo rwakakodzera, kugona nzira dzekudzidzisa dzakakodzera uye kuvandudza hunyanzvi hwavo hwakakwana [13]. Munguva yekudzidza kwedu, takaona kuti vadzidzi vainyanya kufarira kudzidza mashandisirwo esoftware ye3D imaging pane kunzwisisa pfungwa dzehunyanzvi dzekurapa dzinofinha kubva mumabhuku, saka mukudzidza kwedu, vadzidzi vari muboka rekuyedza vanowanzo kurudzirwa kutora chikamu mukudzidza. zviri nani pane boka rekutonga. Vadzidzisi vanofanira kukurudzira vadzidzi kutaura vakashinga, kukudziridza ruzivo rwevadzidzi pamusoro penyaya iyi, uye kukurudzira kufarira kwavo kutora chikamu muhurukuro. Mhedzisiro yebvunzo inoratidza kuti, zvichienderana neruzivo rwekurangarira kwemuchina, mashandiro evadzidzi vari muboka rekuyedza akaderera pane eboka rekutonga, zvisinei, pakuongorora nyaya yekiriniki, inoda kushandiswa kwakaoma kweruzivo rwakakodzera, mashandiro evadzidzi vari muboka rekuyedza ari nani kupfuura muboka rekutonga, izvo zvinosimbisa hukama huripo pakati pe3DV neboka rekutonga. Mabhenefiti ekubatanidza mishonga yechivanhu. Nzira yekudzidzisa yePBL ine chinangwa chekuvandudza hunyanzvi hwevadzidzi hwese.
Kudzidziswa kwemaumbirwo emuviri ndiko kuri pakati pedzidziso yekiriniki yekuvhiyiwa kwemusana. Nekuda kwechimiro chakaoma chemusana uye chokwadi chekuti kuvhiyiwa kwacho kunosanganisira matishu akakosha akadai semusana, tsinga dzemusana, netsinga dzeropa, vadzidzi vanofanirwa kuve nepfungwa dzenzvimbo kuti vadzidze. Kare, vadzidzi vaishandisa mifananidzo ine mativi maviri senge mifananidzo yemabhuku nemifananidzo yemavhidhiyo kutsanangura ruzivo rwakakodzera, asi pasinei nehuwandu hwakadai hwezvinhu, vadzidzi vaisava nepfungwa yekunzwisisa uye ine mativi matatu mune izvi, izvo zvakakonzera kuoma kunzwisisa. Tichifunga nezvezvinhu zvakaoma zvemuviri uye zvezvirwere zvemusana, zvakaita sehukama huripo pakati petsinga dzemusana nezvikamu zvemuviri wemusana, kune zvimwe zvinhu zvakakosha uye zvakaoma, zvakaita sekutsanangurwa uye kurongwa kwemapfupa emutsipa wemutsipa. Vadzidzi vazhinji vakataura kuti zviri mukati mekuvhiyiwa kwemusana hazvina kunyatsojeka, uye havakwanise kuzvinzwisisa zvizere panguva yezvidzidzo zvavo, uye ruzivo rwakawanikwa runokanganwika nekukurumidza mushure mekirasi, izvo zvinotungamira kumatambudziko mubasa chairo.
Achishandisa tekinoroji yekuona ye3D, munyori anopa vadzidzi mifananidzo yakajeka ye3D, zvikamu zvakasiyana zvinomiririrwa nemavara akasiyana. Nekuda kwemabasa akadai sekutenderera, kukura uye kujeka, modhi yemusana uye mifananidzo yeCT zvinogona kuonekwa muzvikamu. Hazvingogone kucherechedzwa chete kuti hunhu hwemuviri wemusana hunofinha, asiwo zvinokurudzira chishuwo chevadzidzi chekuwana mufananidzo weCT unofinha wemusana. uye kusimbisa ruzivo mumunda wekuona. Kusiyana nemamodheru nezvishandiso zvekudzidzisa zvakashandiswa kare, basa rekugadzirisa rakajeka rinogona kugadzirisa zvinobudirira dambudziko rekuvharika, uye zviri nyore kuti vadzidzi vaone chimiro chakanaka chemuviri uye nhungamiro yakaoma yetsinga, kunyanya kune vanotanga. Vadzidzi vanogona kushanda vakasununguka chero bedzi vachiuya nemakomputa avo, uye hapana mari yakawanda inobatanidzwa. Iyi nzira inotsiva kudzidziswa kwechinyakare uchishandisa mifananidzo ye2D [14]. Muchidzidzo ichi, boka rekutonga rakaita zviri nani pamibvunzo isina chinangwa, zvichiratidza kuti modhi yekudzidzisa hurukuro haigone kurambwa zvachose uye ichiri nekubatsira mukudzidzisa kwekiriniki kwekuvhiyiwa kwemusana. Kuwanikwa uku kwakaita kuti tifunge kana tingabatanidza nzira yekudzidza yechinyakare nePBL learning mode yakasimbiswa ne3D visualization technology, ichinangidzira mhando dzakasiyana dzebvunzo nevadzidzi vemazinga akasiyana, kuitira kuwedzera mhedzisiro yedzidzo. Zvisinei, hazvina kujeka kuti nzira mbiri idzi dzingabatanidzwa here uye sei uye kuti vadzidzi vachagamuchira musanganiswa wakadaro here, izvo zvinogona kuva gwara rekutsvagisa mune ramangwana. Chidzidzo ichi chinosanganawo nezvimwe zvipingamupinyi zvakaita sekugona kusimbiswa kana vadzidzi vapedza bvunzurudzo mushure mekuona kuti vachave vachitora chikamu mumhando itsva yedzidzo. Kuedza uku kwekudzidzisa kunoitwa chete mumamiriro ekuvhiyiwa kwemusana uye kumwe kuongororwa kunodiwa kana kuchigona kushandiswa pakudzidzisa kwese kuvhiyiwa.
Tinobatanidza tekinoroji ye3D imaging nePBL training mode, tinokunda zvipingamupinyi zvemaitiro ekudzidzisa echinyakare nezvishandiso zvekudzidzisa, uye tinodzidza mashandisirwo anoitwa musanganiswa uyu mukudzidziswa kwekiriniki mukuvhiyiwa kwemusana. Tichitarisa mhedzisiro yebvunzo, mhedzisiro yebvunzo dzevadzidzi veboka rekuyedza iri nani pane yevadzidzi veboka rekuyedza (P < 0.05), uye ruzivo rwehunyanzvi nekugutsikana nezvidzidzo zvevadzidzi veboka rekuyedza zviri naniwo pane zvevadzidzi veboka rekuyedza. (P < 0.05). Mhedzisiro yebvunzo yaive nani pane yeboka rekutonga (P < 0.05). Saka, ongororo yedu inosimbisa kuti kusanganiswa kwetekinoroji dzePBL ne3DV kunobatsira mukugonesa vadzidzi kushandisa kufunga kwekiriniki, kuwana ruzivo rwehunyanzvi, uye kuwedzera kufarira kwavo kudzidza.
Kubatanidzwa kwetekinoroji yePBL ne3DV kunogona kuvandudza mashandiro ekiriniki yevadzidzi vekurapa mumunda wekuvhiyiwa kwemusana, kuwedzera kushanda zvakanaka kwekudzidza uye kufarira kwevadzidzi, uye kubatsira kukudziridza mafungiro ekiriniki evadzidzi. Tekinoroji ye3D imaging ine zvakanakira zvakakosha mukudzidzisa anatomi, uye mhedzisiro yekudzidzisa yese iri nani pane nzira yekudzidzisa yechinyakare.
Madhata akashandiswa uye/kana akaongororwa muchidzidzo chiripo anowanikwa kubva kuvanyori kana zvikakumbirwa zvine musoro. Hatina mvumo yekuisa madhata kunzvimbo yekuchengetedza. Ndapota cherechedzai kuti data rese rechidzidzo harina kuzivikanwa nekuda kwekuchengetedza zvakavanzika.
Cook DA, Reid DA Nzira dzekuongorora mhando yekutsvagisa dzidzo yezvekurapa: Chishandiso Chemhando Yekutsvagisa Dzidzo Yezvekurapa uye Chikero Chedzidzo cheNewcastle-Ottawa. Academy of Medical Sciences. 2015;90(8):1067–76. https://doi.org/10.1097/ACM.0000000000000786.
Chotyarnwong P, Bunnasa W, Chotyarnwong S, et al. Kudzidza kwakavakirwa pavhidhiyo kuenzanisa nekudzidza kwakavakirwa pahurukuro yechinyakare mudzidzo ye osteoporosis: bvunzo yakadzorwa isina kurongeka. Zvidzidzo zvekiriniki zvekuyedza kukwegura. 2021;33(1):125–31. https://doi.org/10.1007/s40520-020-01514-2.
Parr MB, Sweeney NM Kushandisa Kutevedzera Varwere Vevanhu muMakosi eUndergraduate Intensive Care. Critical Care Nurse V. 2006;29(3):188–98. https://doi.org/10.1097/00002727-200607000-00003.
Upadhyay SK, Bhandari S., Gimire SR Kusimbiswa kwezvishandiso zvekuongorora kudzidza zvinoenderana nemibvunzo. dzidzo yezvekurapa. 2011;45(11):1151–2. https://doi.org/10.1111/j.1365-2923.2011.04123.x.
Khaki AA, Tubbs RS, Zarintan S. nevamwe. Maonero evadzidzi vezvokurapa vegore rekutanga uye kugutsikana nekudzidza kwakavakirwa pamatambudziko zvichienzaniswa nedzidziso yechinyakare yehunhu hwemuviri: kuunza hunhu hwemuviri hune matambudziko muchirongwa chetsika cheIran. International Journal of Medical Sciences (Qasim). 2007;1(1):113–8.
Henderson KJ, Coppens ER, Burns S. Bvisa Zvipingamupinyi Pakuita Kudzidza Kwakavakirwa Pamatambudziko. Ana J. 2021;89(2):117–24.
Ruizoto P, Juanes JA, Contador I, nevamwe. Humbowo hwekuyedza hwekuvandudza dudziro yemifananidzo yeuropi uchishandisa mamodheru e3D graphical. Kuongororwa kwedzidzo yesainzi. 2012;5(3):132–7. https://doi.org/10.1002/ase.1275.
Weldon M., Boyard M., Martin JL nevamwe. Kushandisa 3D visualization inopindirana mudzidzo yepfungwa dzepfungwa. Advanced experimental medical biology. 2019;1138:17–27. https://doi.org/10.1007/978-3-030-14227-8_2.
Oderina OG, Adegbulugbe IS, Orenuga OO nevamwe. Kuenzanisa kudzidza kwakavakirwa pamatambudziko uye nzira dzekudzidzisa dzechinyakare pakati pevadzidzi vechikoro chemazino chekuNigeria. European Journal of Dental Education. 2020;24(2):207–12. https://doi.org/10.1111/eje.12486.
Lyons, ML Epistemology, Medicine, uye Problem-Based Learning: Kusuma Epistemological Dimension muMedical School Curriculum, Handbook of the Sociology of Medical Education. Routledge: Taylor & Francis Group, 2009. 221-38.
Ghani ASA, Rahim AFA, Yusof MSB, nevamwe. Maitiro ekudzidza anoshanda mukudzidza kwakavakirwa pamatambudziko: Ongororo yehukuru hwekudzidza. Dzidzo yezvekurapa. 2021;31(3):1199–211. https://doi.org/10.1007/s40670-021-01292-0.
Hodges HF, Messi AT. Zvakabuda muchirongwa chekudzidzisana pakati pevadzidzi vePre-Bachelor of Nursing neDoctor of Pharmacy. Journal of Nursing Education. 2015;54(4):201–6. https://doi.org/10.3928/01484834-20150318-03.
Wang Hui, Xuan Jie, Liu Li nevamwe. Kudzidza kwakavakirwa pamatambudziko uye kwakavakirwa pamisoro mudzidzo yemazino. Ann anoshandura mushonga. 2021;9(14):1137. https://doi.org/10.21037/atm-21-165.
Branson TM, Shapiro L., Venter RG 3D yakadhindwa 3D ongororo yemuviri wemurwere uye tekinoroji ye3D imaging inovandudza ruzivo rwenzvimbo mukuronga kuvhiya uye kuita mukamuri rekuvhiya. Advanced experimental medical biology. 2021;1334:23–37. https://doi.org/10.1007/978-3-030-76951-2_2.
Dhipatimendi reKuvhiya Musana, Xuzhou Medical University Branch Hospital, Xuzhou, Jiangsu, 221006, China
Vanyori vese vakabatsira pakufunga nekugadzira chidzidzo ichi. Kugadzirira zvinhu, kuunganidzwa kwedata uye kuongororwa kwakaitwa naSun Maji, Chu Fuchao naFeng Yuan. Chinyorwa chekutanga chechinyorwa chakanyorwa naChunjiu Gao, uye vanyori vese vakataura nezveshanduro dzekare dzechinyorwa. Vanyori vakaverenga ndokubvumidza chinyorwa chekupedzisira.
Chidzidzo ichi chakatenderwa neXuzhou Medical University Affiliate Hospital Ethics Committee (XYFY2017-JS029-01). Vese vakatora chikamu vakabvuma vasati vatanga chidzidzo ichi, vanhu vese vaive vakuru vane hutano hwakanaka, uye chidzidzo ichi hachina kutyora Chiziviso cheHelsinki. Ita shuwa kuti nzira dzese dzaitwa zvinoenderana nemirairo nemitemo yakakodzera.
Springer Nature inoramba isina kwayakarerekera panyaya dzekutonga dziri mumamepu akaburitswa uye kubatana kwemasangano.
Kupinda pachena. Chinyorwa ichi chinogoverwa pasi peCreative Commons Attribution 4.0 International License, iyo inobvumira kushandiswa, kugovana, kugadzirisa, kugovera, uye kukopa mune chero nzira uye fomati, chero bedzi uchipa zita remunyori wekutanga uye kwakabva, chero bedzi rezenisi reCreative Commons richibatanidza uye kuratidza kana shanduko dzakaitwa. Mifananidzo kana zvimwe zvinhu zvevamwe vari muchinyorwa chino zvinosanganisirwa pasi perezenisi reCreative Commons rechinyorwa chino, kunze kwekunge zvataurwa neimwe nzira mukupa ruzivo rwechinyorwa. Kana zvinhu zvacho zvisina kubatanidzwa murezenisi reCreative Commons rechinyorwa uye kushandiswa kwacho kusingabvumidzwe nemutemo kana mutemo kana kupfuura kushandiswa kwakabvumidzwa, uchafanirwa kuwana mvumo zvakananga kubva kumuridzi wekodzero. Kuti uone kopi yerezenisi iyi, shanyira http://creativecommons.org/licenses/by/4.0/. Chiziviso cheCreative Commons (http://creativecommons.org/publicdomain/zero/1.0/) chinoshanda kune data rakapihwa muchinyorwa chino, kunze kwekunge zvataurwa neimwe nzira mukunyora kwedata.
Sun Ming, Chu Fang, Gao Cheng, nevamwe. Kufungidzira kwe3D kwakabatana nemuenzaniso wekudzidza wakavakirwa pamatambudziko mukudzidzisa kuvhiya musana BMC Medical Education 22, 840 (2022). https://doi.org/10.1186/s12909-022-03931-5
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