Kubva pakatanga denda reCOVID-19, nyika yakatanga kutarisisa zvakanyanya basa rekudzidzisa kiriniki muzvipatara zveyunivhesiti. Kusimbisa kubatanidzwa kwemishonga nedzidzo uye kuvandudza mhando uye kushanda kwekudzidzisa kiriniki matambudziko makuru anotarisana nedzidzo yekurapa. Dambudziko rekudzidzisa orthopedics riri muzvirwere zvakasiyana-siyana, hunyanzvi hwepamusoro uye hunhu husina kujairika, izvo zvinopesvedzera kutanga, kufarira uye kushanda kwekudzidzisa kwevadzidzi vekurapa. Chidzidzo ichi chakagadzira hurongwa hwekudzidzisa mukirasi hwakachinjika hwakavakirwa papfungwa yeCDIO (Concept-Design-Implement-Operate) uye chakaishandisa mukosi yekudzidzisa vadzidzi veukoti hwemapfupa kuti vavandudze mhedzisiro yekudzidza inoshanda uye kubatsira vadzidzisi kuona kuchinja remangwana redzidzo yeukoti uye kunyange dzidzo yekurapa. Kudzidza mukirasi kuchave kwakanyatsobudirira uye kwakatarisana.
Vadzidzi makumi mashanu vezvekurapa vakapedza kudzidza mudhipatimendi remapfupa rechipatara chepamusoro muna Chikumi 2017 vakaverengerwa muboka rekutonga, uye vadzidzi makumi mashanu vekuchengeta varwere vakapedza kudzidza mudhipatimendi muna Chikumi 2018 vakaverengerwa muboka rekubatsira. Boka rekubatsira rakatora pfungwa yeCDIO yemuenzaniso wekudzidzisa wekirasi wakapindurwa, nepo boka rekutarisira rakatora muenzaniso wekudzidzisa wechinyakare. Mushure mekupedza mabasa ekushanda edhipatimendi, mapoka maviri evadzidzi akaongororwa padzidziso, hunyanzvi hwekushanda, kugona kudzidza kwakazvimirira uye kugona kufunga zvakadzama. Mapoka maviri evadzidzisi akapedza zviyero zvisere achiongorora kugona kwekurapa, kusanganisira maitiro mana ekurapa, kugona kwekuchengeta vanhu, uye kuongororwa kwemhando yekudzidzisa kwekiriniki.
Mushure mekudzidziswa, kugona kwekuita zvekiriniki, kugona kufunga zvakadzama, kugona kudzidza wega, kugona kwedzidziso uye kushanda, uye mamakisi emhando yepamusoro ekudzidzisa kwekiriniki eboka rekupindira aive akakwira zvakanyanya kupfuura eboka rekudzora (ese P < 0.05).
Muenzaniso wekudzidzisa wakavakirwa paCDIO unogona kukurudzira kudzidza kwakazvimiririra kwevadzidzi vanochengeta vanamukoti uye kugona kufunga zvakadzama, kukurudzira musanganiswa wedzidziso nemaitiro, kuvandudza kugona kwavo kushandisa ruzivo rwedzidziso zvakakwana kuongorora nekugadzirisa matambudziko anoshanda, uye kuvandudza mhedzisiro yekudzidza.
Dzidzo yekiriniki ndiyo nhanho inonyanya kukosha yedzidzo yeukoti uye inosanganisira kuchinja kubva paruzivo rwedzidziso kuenda kukudzidzira. Kudzidza kwekiriniki kunobudirira kunogona kubatsira vadzidzi veukoti kugona hunyanzvi hwebasa, kusimbisa ruzivo rwebasa, uye kuvandudza kugona kwavo kuita basa reukoti. Ndiyo nhanho yekupedzisira yekuchinja basa rebasa revadzidzi vekurapa [1]. Mumakore achangopfuura, vaongorori vazhinji vekudzidzisa kwekiriniki vakaita tsvakiridzo pamusoro penzira dzekudzidzisa dzakadai sekudzidza kwakavakirwa pamatambudziko (PBL), kudzidza kwakavakirwa pazviitiko (CBL), kudzidza kwakavakirwa pachikwata (TBL), uye kudzidza kwemamiriro ezvinhu uye kudzidza kwekufananidzira kwemamiriro ezvinhu mukudzidzisa kwekiriniki. . Zvisinei, nzira dzakasiyana dzekudzidzisa dzine zvadzinobatsira nezvadzisina kunaka maererano nemhedzisiro yekudzidza yekubatana kwemaitiro, asi hadzina kubatanidzwa kwedzidziso nemaitiro [2].
"Flipped classroom" inoreva nzira itsva yekudzidza umo vadzidzi vanoshandisa puratifomu yeruzivo kuti vadzidze vakazvimiririra zvinhu zvakasiyana-siyana zvedzidzo vasati vapinda mukirasi uye vapedzise basa rechikoro nenzira ye "kubatana mukudzidza" mukirasi uku vadzidzisi vachitungamira vadzidzi. Pindura mibvunzo uye vape rubatsiro rwemunhu oga [3]. American New Media Alliance yakataura kuti kirasi inochinja nguva mukati nekunze kwekirasi uye inotamisa sarudzo dzekudzidza kwevadzidzi kubva kuvadzidzisi kuenda kuvadzidzi [4]. Nguva inokosha inopedzerwa mukirasi mune iyi nzira yekudzidza inobvumira vadzidzi kuti vatarise zvakanyanya pakudzidza kunoshanda, kwakavakirwa pamatambudziko. Deshpande [5] akaita ongororo pakirasi inochinja mudzidzo yeparamedic uye kudzidzisa uye akagumisa kuti kirasi inochinja inogona kuvandudza kufarira kwevadzidzi kudzidza uye kuita kwavo muchikoro uye kuderedza nguva yekirasi. Khe Fung HEW naChung Kwan LO [6] vakaongorora mhedzisiro yekutsvagisa yezvinyorwa zvekuenzanisa pakirasi inochinja uye vakapfupikisa mhedzisiro yese yenzira yekudzidzisa inochinja kuburikidza nekuongorora, zvichiratidza kuti kana tichienzanisa nenzira dzechinyakare dzekudzidzisa, nzira yekudzidzisa inochinja mudzidzo yehutano hwehunyanzvi iri nani zvikuru uye inovandudza kudzidza kwevadzidzi. Zhong Jie [7] akaenzanisa mhedzisiro yekudzidza kwekirasi yakachinjika uye kudzidza kwekirasi yakachinjika pakuwana ruzivo rwevadzidzi, uye akawana kuti mukuita kwekudzidza kwakasanganiswa mukirasi yakachinjika, kuvandudza mhando yekudzidzisa online kunogona kuvandudza kugutsikana neruzivo rwevadzidzi. Zvichibva pane zvabuda mukutsvagisa kuri pamusoro apa, mumunda wedzidzo yeukoti, nyanzvi zhinji dzinodzidza mhedzisiro yekirasi yakachinjika pakubudirira kwekudzidzisa mukirasi uye dzinotenda kuti kudzidzisa kwekirasi yakachinjika kunogona kuvandudza mashandiro evadzidzi veukoti muzvidzidzo, kugona kwavo kudzidza vega, uye kugutsikana mukirasi.
Saka, pane chikonzero chikuru chekutsvaga nekugadzira nzira itsva yekudzidzisa iyo ichabatsira vadzidzi vekurera vana kutora nekushandisa ruzivo rwehunyanzvi rwakarongeka uye kuvandudza kugona kwavo kwekurapa uye hunhu hwakakwana. CDIO (Concept-Design-Implement-Operate) imhando yedzidzo yeinjiniya yakagadzirwa muna 2000 nemayunivhesiti mana, kusanganisira Massachusetts Institute of Technology neRoyal Institute of Technology muSweden. Imhando yepamusoro yedzidzo yeinjiniya inobvumira vadzidzi vekurera vana kudzidza nekuwana hunyanzvi nenzira inoshanda, inoshanda, uye yakasikwa [8, 9]. Panyaya yekudzidza kukuru, iyi modhi inosimbisa "kutarisisa vadzidzi," ichibvumira vadzidzi kutora chikamu mukufunga, kugadzira, kuita, uye kushanda kwemapurojekiti, uye kushandura ruzivo rwedzidziso rwakawanikwa kuita maturusi ekugadzirisa matambudziko. Ongororo dzakawanda dzakaratidza kuti modhi yekudzidzisa yeCDIO inobatsira mukuvandudza hunyanzvi hwekuita zvekiriniki uye hunhu hwakakwana hwevadzidzi vekurapa, kuvandudza kudyidzana kwemudzidzisi nevadzidzi, kuvandudza kushanda zvakanaka kwekudzidzisa, uye ine basa mukusimudzira shanduko yeruzivo uye kugadzirisa nzira dzekudzidzisa. Inoshandiswa zvakanyanya mukudzidziswa kwetarenda rinoshandiswa [10].
Nekushanduka kwemuenzaniso wezvekurapa wepasi rose, zvinodiwa nevanhu pahutano zviri kuwedzera, izvo zvakakonzerawo kuwedzera kwebasa revashandi vezvekurapa. Kugona uye hunhu hwevanamukoti zvine chekuita zvakananga nehunhu hwekutarisira varwere uye kuchengetedzeka kwevarwere. Mumakore achangopfuura, kuvandudzwa uye kuongororwa kwehunyanzvi hwekurapa hwevashandi vezvekurapa kwave nyaya inonyanya kutaurwa munyaya dzezvekurapa [11]. Nokudaro, nzira yekuongorora isina chinangwa, yakazara, yakavimbika, uye inoshanda yakakosha pakutsvagisa dzidzo yezvekurapa. Kudzidzira kwekuongorora kwemini-kiriniki (mini-CEX) inzira yekuongorora hunyanzvi hwekurapa hwevadzidzi vezvekurapa uye inoshandiswa zvakanyanya mumunda wedzidzo yezvekurapa yemarudzi akawanda kumba nekune dzimwe nyika. Yakaonekwa zvishoma nezvishoma mumunda wezvekurapa [12, 13].
Ongororo dzakawanda dzakaitwa pakushandiswa kweCDIO model, flipped classroom, uye mini-CEX mudzidzo yeukoti. Wang Bei [14] akakurukura nezvemhedzisiro yeCDIO model pakuvandudza kudzidziswa kwevanamukoti zvinoenderana nezvinodiwa nevakoti veCOVID-19. Mhedzisiro yacho inoratidza kuti kushandisa CDIO training model kupa specialized nursing training paCOVID-19 kuchabatsira vashandi veukoti kuwana zvirinani hunyanzvi hwekudzidzisa ukoti hwakakosha uye ruzivo rwakabatana narwo, uye kuvandudza zvizere hunyanzvi hwavo hwese hweukoti. Nyanzvi dzakadai saLiu Mei [15] dzakakurukura nezvekushandiswa kwetimu yekudzidzisa pamwe chete neflipped classroom mukudzidzisa vanamukoti vemapfupa. Mhedzisiro yacho yakaratidza kuti iyi training model inogona kuvandudza zvinobudirira hunyanzvi hwekutanga hwevanamukoti vemapfupa senge kunzwisisa. uye kushandiswa kweruzivo rwedzidziso, kushanda pamwe chete, kufunga zvakadzama, uye kutsvagisa kwesainzi. Li Ruyue et al. [16] vakadzidza mhedzisiro yekushandisa yakagadziridzwa Nursing Mini-CEX mukudzidziswa kwakajairika kwevanamukoti vatsva vekuvhiya uye vakawana kuti vadzidzisi vanogona kushandisa Nursing Mini-CEX kuongorora maitiro ese ekuongorora uye mashandiro mukudzidzisa kwekiriniki kana basa. Zvisungo zvisina simba maari. vanamukoti uye kupa mhinduro chaiyo. Kuburikidza nemaitiro ekuzviongorora uye kuzvifungisisa, pfungwa huru dzekuongorora mashandiro evakoti dzinodzidzwa, purogiramu yezvidzidzo inogadziriswa, mhando yekudzidzisa kwekiriniki inovandudzwa, kugona kwakakwana kwevakoti vekuvhiya kunovandudzwa, uye musanganiswa wekirasi yakachinjika zvichibva papfungwa yeCDIO unoedzwa, asi parizvino hapana mushumo wekutsvagisa. Kushandiswa kwemuenzaniso wemini-CEX wekuongorora mudzidzo yevakoti kuvadzidzi vemapfupa. Munyori akashandisa muenzaniso weCDIO mukuvandudza makosi ekudzidzisa vadzidzi vemapfupa, akavaka kirasi yakachinjika yakavakirwa papfungwa yeCDIO, uye akabatanidzwa nemuenzaniso wemini-CEX wekuongorora kuti aise ruzivo nehunyanzvi hwekudzidza nehunhu hwevatatu-mu-mumwe, uye akabatsirawo mukuvandudza mhando yekudzidzisa. Kuvandudzwa kunoenderera mberi kunopa hwaro hwekudzidza kwakavakirwa pakudzidzira muzvipatara zvekudzidzisa.
Kuti zviite nyore kushandisa kosi iyi, nzira yekuyedza kutora sampuli yakashandiswa sevadzidzi vekudzidza kusarudza vadzidzi vekurapa kubva muna 2017 na2018 vaidzidzira mudhipatimendi remapfupa echipatara chepamusoro. Sezvo paine vadzidzi makumi mashanu nevaviri padanho rega rega, huwandu hwemuenzaniso huchava zana nemana. Vadzidzi vana havana kutora chikamu mukuita kwekiriniki kwakazara. Boka rekutonga raisanganisira vadzidzi makumi mashanu vekurapa vakapedza kudzidza mudhipatimendi remapfupa echipatara chepamusoro muna Chikumi 2017, varume vatanhatu nevakadzi makumi mana nemana vane makore makumi maviri kusvika makumi maviri nemaviri (21.30 ± 0.60), vakapedza kudzidza mudhipatimendi rimwe chete iroro muna Chikumi 2018. Boka rekupindira raisanganisira vadzidzi vekurapa makumi mashanu, kusanganisira varume vasere nevakadzi makumi mana nevaviri vane makore makumi maviri nerimwe kusvika makumi maviri nemaviri (21.45 ± 0.37). Vadzidzi vese vakapa mvumo yekuziva. Zvinodiwa zveKusanganisira: (1) Vadzidzi vekudzidzira kurapa kwemapfupa vane dhigirii reBachelor. (2) Kubvuma kwekuziva uye kutora chikamu kwekuzvidira muchidzidzo ichi. Zvinodiwa zvekusabatanidzwa: Vanhu vasingakwanise kutora chikamu zvizere mukurapa. Hapana musiyano wakakosha muhuwandu hweruzivo rwemapoka maviri evadzidzi vekurapa (p>0.05) uye vanoenzana.
Mapoka ese ari maviri akapedza kudzidza kwekiriniki kwemavhiki mana, uye makosi ese akapedzwa muDhipatimendi reMafupa. Munguva yekutarisa, kwaive nemapoka gumi evadzidzi vekurapa, vadzidzi vashanu muboka rega rega. Kudzidziswa kunoitwa zvichienderana nechirongwa chekudzidzira vadzidzi veukoti, kusanganisira zvikamu zvedzidziso nehunyanzvi. Vadzidzisi mumapoka ese ari maviri vane zvitupa zvakafanana, uye mudzidzisi weukoti ane basa rekutarisa mhando yekudzidzisa.
Boka revatungamiriri raishandisa nzira dzekudzidzisa dzechinyakare. Muvhiki yekutanga yechikoro, makirasi anotanga neMuvhuro. Vadzidzisi vanodzidzisa dzidziso neChipiri neChitatu, uye vanonyanya kutarisa pakudzidziswa kwekushanda neChina neChishanu. Kubva vhiki yechipiri kusvika yechina, nhengo yega yega yepurazi ine basa rekuti mudzidzi wezvekurapa ape hurukuro dzimwe nguva mudhipatimendi. Muvhiki yechina, bvunzo dzichapedzwa mazuva matatu kosi isati yapera.
Sezvambotaurwa, munyori anoshandisa nzira yekudzidzisa mukirasi yakashandurwa zvichibva pane pfungwa yeCDIO, sezvakatsanangurwa pazasi.
Vhiki yekutanga yekudzidziswa yakafanana neiri muboka rekutonga; vhiki yechipiri kusvika yechina yekudzidziswa kwemapfupa panguva yekuvhiyiwa inoshandisa hurongwa hwekudzidzisa mukirasi hwakachinjika hwakavakirwa papfungwa yeCDIO kwemaawa makumi matatu nematanhatu. Chikamu chepfungwa nedhizaini chinopedzwa muvhiki yechipiri uye chikamu chekuitwa chinopedzwa muvhiki yechitatu. Kuvhiyiwa kwakapedzwa muvhiki yechina, uye kuongororwa nekuongororwa kwakapedzwa mazuva matatu vasati vabuda. Ona Tafura 1 yemigove chaiyo yenguva yekirasi.
Chikwata chevadzidzisi chine mukoti mukuru mumwe chete, vafundisi vasere vemapfupa uye nyanzvi imwe chete yevanochengeta varwere veCDIO isina mabvi chakatangwa. Mukoti Mukuru anopa nhengo dzechikwata chevadzidzisi kudzidza nehunyanzvi hwezvidzidzo zveCDIO nemitemo, bhuku reCDIO workshop nedzimwe dzidziso dzakabatana uye nzira dzakananga dzekushandisa (anenge maawa makumi maviri), uye anobvunza nyanzvi nguva dzese panyaya dzakaoma dzekudzidzisa. Vadzidzisi vanoisa zvinangwa zvekudzidza, vanoronga zvidzidzo, uye vanogadzirira zvidzidzo nenzira inoenderana nezvinodiwa nevanochengeta varwere vakuru uye chirongwa chekugara.
Zvinoenderana nechirongwa chekudzidzira basa, tichitarisa chirongwa chekudzidzisa tarenda reCDIO uye mwero [17] uye pamwe chete nehunhu hwekudzidzisa kwemukoti wemapfupa, zvinangwa zvekudzidza zvevadzidzi vanodzidzira basa rekuchengeta vana zviri muzvikamu zvitatu, zvinoti: zvinangwa zveruzivo (kuziva ruzivo rwekutanga), ruzivo rwehunyanzvi uye maitiro ane chekuita nehurongwa, nezvimwewo), zvinangwa zvehunyanzvi (kuvandudza hunyanzvi hwekutanga hwebasa, hunyanzvi hwekufunga zvakadzama uye hunyanzvi hwekudzidza hwakazvimiririra, nezvimwewo) uye zvinangwa zvemhando yepamusoro (kuvaka tsika dzakanaka dzehunyanzvi uye mweya wekutarisira vanhu nezvimwewo). .). Zvinangwa zveruzivo zvinoenderana neruzivo rwehunyanzvi uye kufunga kwechirongwa cheCDIO, hunyanzvi hwemunhu, hunyanzvi hwehunyanzvi uye hukama hwechirongwa cheCDIO, uye zvinangwa zvemhando yepamusoro zvinoenderana nehunyanzvi hwakapfava hwechirongwa cheCDIO: kushanda pamwe chete nekutaurirana.
Mushure memisangano miviri, timu yekudzidzisa yakakurukura nezvehurongwa hwekudzidzisa vanamukoti mukirasi yakachinjika zvichibva papfungwa yeCDIO, vakakamura kudzidziswa muzvikamu zvina, uye vakasarudza zvinangwa nedhizaini, sezvakaratidzwa muTafura 1.
Mushure mekuongorora basa rekuchengeta varwere vane zvirwere zvemapfupa, mudzidzisi akaona zviitiko zvezvirwere zvemapfupa zvakajairika uye zvakajairika. Ngatitorei hurongwa hwekurapa varwere vane lumbar disc herniation semuenzaniso: Murwere Zhang Moumou (murume, ane makore 73 ekuberekwa, kureba 177 cm, huremu 80 kg) akanyunyuta nezve "kurwadziwa kwemusana wepazasi pamwe chete nekusanzwa uye kurwadziwa mugumbo repazasi rekuruboshwe kwemwedzi miviri" uye akaiswa muchipatara mukiriniki yekunze kwechipatara. Semurwere Mukoti ane mutoro: (1) Ndokumbirawo mubvunze nhoroondo yemurwere zvakarongeka zvichibva paruzivo rwawakawana uye ona zviri kuitika kumurwere; (2) Sarudza ongororo yakarongeka uye nzira dzekuongorora dzehunyanzvi zvichibva pamamiriro ezvinhu uye upe mibvunzo yekuongorora inoda kuongororwa kwakawedzerwa; (3) Ita kuongororwa kwekuchengeta. Muchiitiko ichi, zvakakosha kusanganisa database yekutsvaga nyaya; nyora zvirongwa zvekuchengeta zvine chekuita nemurwere; (4) Kurukurai matambudziko aripo mukuzvitarisira kwemurwere, pamwe nenzira dziripo uye zviri mukati mekutevera kwemurwere paanobuda. Tumira nyaya dzevadzidzi uye runyorwa rwemabasa mazuva maviri kirasi isati yasvika. Rondedzero yebasa renyaya iyi ndeiyi inotevera: (1) Ongorora uye simbisa ruzivo rwedzidziso nezve etiology uye zviratidzo zvekiriniki zve lumbar intervertebral disc herniation; (2) Gadzira hurongwa hwekutarisira hwakanangwa; (3) Gadzira nyaya iyi zvichibva pabasa rekiriniki uye shandisa kutarisirwa kwepamberi pekuvhiyiwa uye mushure mekuvhiyiwa ndiwo mamiriro maviri makuru ekudzidzisa mapurojekiti ekufananidzira. Vadzidzi vekurera vanoongorora vega zviri mukati mekosi nemibvunzo yekudzidzira, tarisa mabhuku akakodzera uye databases, uye pedzisa mabasa ekuzvidzidza nekupinda muboka reWeChat.
Vadzidzi vanoumba mapoka vakasununguka, uye boka rinosarudza mutungamiri weboka ane basa rekuparadzanisa vashandi nekutungamira chirongwa. Mutungamiriri wechikwata asati apinda muchikwata ane basa rekuparadzira zviri mukati zvina: sumo yenyaya, kuita maitiro ekurera vana, dzidzo yehutano, uye ruzivo rwakabatana nezvirwere kune nhengo yega yega yechikwata. Munguva yekudzidzira basa, vadzidzi vanoshandisa nguva yavo yekusununguka kutsvagisa ruzivo rwedzidziso kana zvinhu zvekugadzirisa matambudziko enyaya, kuita hurukuro dzechikwata, uye kuvandudza zvirongwa zvepurojekiti. Mukugadzira chirongwa, mudzidzisi anobatsira mutungamiri wechikwata mukupa nhengo dzechikwata kuronga ruzivo rwakakodzera, kugadzira nekugadzira mapurojekiti, kuratidza nekugadzirisa magadzirirwo, uye kubatsira vadzidzi vekurera mukubatanidza ruzivo rwakabatana nebasa mukugadzira nekugadzira. Wana ruzivo rwemodule yega yega. Matambudziko nepfungwa huru dzeboka iri rekutsvagisa zvakaongororwa uye kugadzirwa, uye hurongwa hwekushandisa hwemuenzaniso weboka iri rekutsvagisa hwakaitwa. Munguva iyi, vadzidzisi vakarongawo kuratidzira kwedenderedzwa rekurera vana.
Vadzidzi vanoshanda mumapoka madiki kuti vape mapurojekiti. Mushure memushumo, vamwe nhengo dzeboka nevadzidzisi vakakurukura nekutaura nezveboka rekuzivisa kuti vawedzere kuvandudza hurongwa hwekuchengeta vanochengeta varwere. Mutungamiriri wechikwata anokurudzira nhengo dzechikwata kuti dzitevedzere maitiro ese ekutarisira, uye mudzidzisi anobatsira vadzidzi kuongorora shanduko dzinochinja dzechirwere kuburikidza nekudzidzira kwakaitwa, kuwedzera kunzwisisa kwavo nekuvaka ruzivo rwedzidziso, uye kukudziridza hunyanzvi hwekufunga zvakadzama. Zvese zviri mukati zvinofanirwa kupedzwa mukukura kwezvirwere zvakasiyana zvinopedzwa pasi pekutungamirirwa kwevadzidzisi. Vadzidzisi vanotaura uye vanotungamira vadzidzi vekurapa kuti vaite kudzidzira padivi pemubhedha kuti vawane musanganiswa weruzivo nekudzidzira kwekiriniki.
Mushure mekuongorora boka rega rega, mudzidzisi akapa mhinduro uye akataura simba nekushaya simba kwenhengo yega yega yeboka mukuronga zviri mukati uye maitiro ehunyanzvi kuti varambe vachivandudza kunzwisisa kwevadzidzi vekuresa nezvezviri mukati mekudzidza. Vadzidzisi vanoongorora hunhu hwekudzidzisa uye vanogadzirisa makosi zvichibva pakuongorora kwevadzidzi vekuresa uye kuongororwa kwekudzidzisa.
Vadzidzi vekukoti vanonyora bvunzo dzedzidziso nedzebasa mushure mekudzidziswa kwekushanda. Mibvunzo yedzidziso yekupindira inobvunzwa nemudzidzisi. Mapepa ekupindira akakamurwa kuita mapoka maviri (A naB), uye boka rimwe chete rinosarudzwa zvisina kurongeka kuti ripindire. Mibvunzo yekupindira yakakamurwa kuita zvikamu zviviri: ruzivo rwehunyanzvi rwedzidziso uye kuongorora nyaya, imwe neimwe iine mapoinzi makumi mashanu kuti iwane mapoinzi zana. Vadzidzi, pavanenge vachiongorora hunyanzvi hwekukoti, vachasarudza chimwe chezvinotevera zvisina kurongeka, kusanganisira nzira yekuchinja axial, nzira yakanaka yekuisa mitezo yevarwere vane kukuvara kwemusana, kushandisa nzira yekurapa nepneumatic, nzira yekushandisa muchina weCPM joint rehabilitation, nezvimwewo. Mapoinzi akazara mapoinzi zana.
Muvhiki rechina, Independent Learning Assessment Scale ichaongororwa mazuva matatu kosi isati yapera. Chiyero chekuongorora chakazvimirira chekugona kudzidza chakagadzirwa naZhang Xiyan [18] chakashandiswa, kusanganisira kukurudzira kudzidza (zvinhu zvisere), kuzvidzora (zvinhu gumi nerimwe), kugona kushanda pamwe chete mukudzidza (zvinhu zvishanu), uye ruzivo rwemashoko (zvinhu zvitanhatu). Chinhu chimwe nechimwe chinoongororwa pachikero che5-point Likert kubva pa "kusaenderana zvachose" kusvika "kuenderana zvachose," nemapoinzi ari kubva pa1 kusvika pa5. Mapoinzi ese i150. Kana mamakisi akakwira, kugona kudzidza kwakasimba. Cronbach's alpha coefficient yechikero i0.822.
Muvhiki rechina, chiyero chekuyera kugona kufunga zvakadzama chakaongororwa mazuva matatu vasati vabuda muchikoro. Shanduro yechiChinese yeCritical Thinking Ability Assessment Scale yakashandurirwa naMercy Corps [19] yakashandiswa. Ine zviyero zvinomwe: kuwana chokwadi, kufunga pachena, kugona kuongorora uye kugona kuronga, nezvinhu gumi muchikamu chimwe nechimwe. Chiyero che6-point chinoshandiswa kubva pa "handibvumirani zvachose" kusvika pa "ndinobvumirana zvakasimba" kubva pa1 kusvika pa6, zvichiteerana. Mashoko asina kunaka anotsanangurwa ne reverse scored, nemamaki ese ari pakati pe70 kusvika 420. Mamaki ese ari pakati pe ≤210 anoratidza kushanda zvisina kunaka, 211–279 anoratidza kushanda zvisina kusimba, 280–349 anoratidza kushanda zvakanaka, uye ≥350 inoratidza kugona kufunga kwakasimba. Chiyero cheCronbach chealpha coefficient chechiyero ichi i0.90.
Muvhiki rechina, kuongororwa kwehunyanzvi hwekiriniki kuchaitwa mazuva matatu vasati vabuda muchipatara. Chikero chemini-CEX chakashandiswa muchidzidzo ichi chakagadziriswa kubva kuMedical Classic [20] zvichibva pamini-CEX, uye kukundikana kwakawanikwa kubva pamapoinzi 1 kusvika ku3. Chinosangana nezvinodiwa, mapoinzi 4-6 pakusangana nezvinodiwa, mapoinzi 7-9 zvachose. Vadzidzi vekurapa vanopedza kudzidziswa kwavo mushure mekupedza kudzidza kwakasarudzika. Chikero cheCronbach chealpha chechiyero ichi i0.780 uye chikero chekuvimbika chepakati pehafu i0.842, zvichiratidza kuvimbika kwakanaka.
Muvhiki rechina, zuva risati rasvika kubva kubazi, musangano wevadzidzisi nevadzidzi wakaitwa pamwe nekuongorora hunhu hwekudzidzisa. Fomu rekuongorora hunhu hwekudzidzisa rakagadzirwa naZhou Tong [21] uye rinosanganisira zvinhu zvishanu: maitiro ekudzidzisa, zviri mukati mekudzidzisa, uye kudzidzisa. Nzira, mhedzisiro yekudzidziswa uye hunhu hwekudzidziswa. Chikero cheLikert che5-point chakashandiswa. Kana mamakisi akakwira, hunhu hwekudzidzisa hunowedzera. Yakapedzwa mushure mekupedza internship yakasarudzika. Mibvunzo yacho yakavimbika zvakanaka, ne alpha yaCronbach yechikero ichi iri 0.85.
Data rakaongororwa uchishandisa SPSS 21.0 statistical software. Data rekuyera rinoratidzwa se mean ± standard deviation (\(\strike X \pm S\)) uye boka rekupindira t rinoshandiswa kuenzanisa mapoka. Data rekuverengwa rakaratidzwa senhamba yezviitiko (%) uye rakaenzaniswa uchishandisa chi-square kana Fisher's exact intervention. A p value <0.05 inoratidza musiyano wakakosha muhuwandu hwezviitiko.
Kuenzanisa kwezvibodzwa zvedzidziso uye zvekushanda kwemapoka maviri evanodzidzira basa revanamukoti kunoratidzwa muTafura 2.
Kuenzanisa kugona kudzidza kwakazvimirira uye kufunga zvakadzama kwemapoka maviri evadzidzi vevanamukoti kunoratidzwa muTafura 3.
Kuenzanisa kwekuongorora kugona kwekurapa pakati pemapoka maviri evanamukoti vari internship. Kugona kwevadzidzi mukurapa kwevanamukoti muboka rekupindira kwaive kuri nani zvikuru pane kwemuboka rekutonga, uye musiyano wacho waive wakakosha muhuwandu hwemashoko (p < 0.05) sezvakaratidzwa muTafura 4.
Mhedzisiro yekuongorora hunhu hwekudzidzisa hwemapoka maviri yakaratidza kuti huwandu hwese hwehunhu hwekudzidzisa hweboka rekutonga hwaive mapoinzi 90.08 ± 2.34, uye huwandu hwese hwehunhu hwekudzidzisa hweboka repakati pechirongwa hwaive mapoinzi 96.34 ± 2.16. Musiyano wacho waive wakakosha muhuwandu. (t = – 13.900, p < 0.001).
Kuvandudzwa nekufambira mberi kwemishonga kunoda kuunganidzwa kwakakwana kwetarenda rezvekurapa. Kunyangwe nzira dzakawanda dzekudzidzisa zvekufananidzira nekuenzanisa dziripo, hadzigone kutsiva tsika dzekurapa, izvo zvine chekuita zvakananga nekugona kwetarenda rezvekurapa remangwana kurapa zvirwere nekuponesa hupenyu. Kubva padenda reCOVID-19, nyika yave ichinyanya kutarisisa basa rekudzidzisa zvekurapa muzvipatara zveyunivhesiti [22]. Kusimbisa kubatanidzwa kwemishonga nedzidzo uye kuvandudza mhando nekushanda kwekudzidzisa zvekurapa matambudziko makuru anotarisana nedzidzo yezvekurapa. Dambudziko rekudzidzisa maorthopedics riri muzvirwere zvakasiyana-siyana, hunyanzvi hwepamusoro uye hunhu husina kujairika, izvo zvinokanganisa kutanga, kufarira uye kugona kudzidza kwevadzidzi vezvekurapa [23].
Nzira yekudzidzisa mukirasi yakashandurwa mukati mepfungwa yekudzidzisa yeCDIO inobatanidza zvirimo zvekudzidza nemaitiro ekudzidzisa, kudzidza uye kudzidzira. Izvi zvinoshandura chimiro chemakirasi uye zvinoisa vadzidzi vekurera vana pakati pekudzidzisa. Munguva yedzidzo, vadzidzisi vanobatsira vadzidzi vekurera vana kuti vawane ruzivo rwakakodzera panyaya dzakaoma dzekurera vana muzviitiko zvakajairika [24]. Tsvagiridzo inoratidza kuti CDIO inosanganisira kugadzira mabasa nemabasa ekudzidzisa ekiriniki. Chirongwa ichi chinopa nhungamiro yakadzama, chinobatanidza zvakanyanya kubatanidzwa kweruzivo rwehunyanzvi nekuvandudzwa kwehunyanzvi hwebasa, uye chinoona matambudziko panguva yekuenzanisa, izvo zvinobatsira vadzidzi vekurera vana mukuvandudza kugona kwavo kudzidza nekufunga zvakadzama, pamwe nekutungamira panguva yekudzidza vakazvimiririra. -kudzidza. Mhedzisiro yechidzidzo ichi inoratidza kuti mushure memavhiki mana ekudzidziswa, huwandu hwevadzidzi vekurera vana vakazvimiririra uye kugona kufunga zvakadzama hwakakwira zvakanyanya kupfuura hwevari muboka rekutonga (zvese p < 0.001). Izvi zvinoenderana nemhedzisiro yechidzidzo chaFan Xiaoying pamusoro pemhedzisiro yeCDIO yakabatana nenzira yekudzidzisa yeCBL mudzidzo yekurera [25]. Iyi nzira yekudzidzisa inogona kuvandudza zvakanyanya kufunga kwakadzama kwevadzidzi uye kugona kwavo kudzidza vakazvimiririra. Munguva yekufunga, mudzidzisi anotanga ataurirana nevadzidzi vekurera vana vari mukirasi. Vadzidzi vekurera vana vanobva vadzidza ruzivo rwakakosha kuburikidza nemavhidhiyo ehurukuro diki uye vakatsvaga zvinhu zvakakodzera kuti vawedzere kunzwisisa kwavo basa rekurera vana vane mapfupa. Munguva yekugadzira, vadzidzi vekurera vana vaidzidzira kushanda pamwe chete uye hunyanzvi hwekufunga zvakadzama kuburikidza nekukurukurirana kwemapoka, vachitungamirirwa nevadzidzisi uye vachishandisa zvidzidzo zvezviitiko. Munguva yedanho rekushandisa, vadzidzisi vanoona kutarisirwa kwezvirwere zvehupenyu chaihwo panguva yekuvhiyiwa semukana uye vanoshandisa nzira dzekudzidzisa dzekufananidzira nyaya kudzidzisa vadzidzi vekurera kuti vaite maekisesaizi ezviitiko mukubatana kweboka kuti vajairane nekuwana matambudziko mubasa rekurera vana. Panguva imwe chete, nekudzidzisa nyaya chaidzo, vadzidzi vekurera vana vanogona kudzidza pfungwa huru dzekutarisirwa kwepamberi pekuvhiyiwa uye mushure mekuvhiyiwa kuitira kuti vanzwisise zvakajeka kuti zvese zvinoitwa pakutarisira kwepamberi pekuvhiyiwa zvinhu zvakakosha pakupora kwemurwere mushure mekuvhiyiwa. Padanho rekushanda, vadzidzisi vanobatsira vadzidzi vekurapa kugona dzidziso nehunyanzvi mukuita. Mukuita izvi, vanodzidza kuona shanduko mumamiriro ezvinhu chaiwo, kufunga nezvematambudziko angangoitika, uye kwete kurangarira maitiro akasiyana-siyana ekurera vana kuti vabatsire vadzidzi vekurapa. Maitiro ekuvaka nekushandisa anobatanidza zviri mukati mekudzidziswa. Mukudzidza uku kwekubatsirana, kudyidzana uye ruzivo, kugona kwevadzidzi vekurera vana vachizvitungamira uye kufarira kudzidza zvinokurudzirwa uye hunyanzvi hwavo hwekufunga zvakadzama hunovandudzwa. Vaongorori vakashandisa Design Thinking (DT)-Conceive-Design-Implement-Operate (CDIO)) kuti vaunze hurongwa hwekugadzira engineering mumakosi ewebhu anopiwa kuti vavandudze kugona kwevadzidzi muzvidzidzo uye kugona kwekufunga kwekombiyuta (CT), uye mhedzisiro yacho inoratidza kuti kugona kwevadzidzi muzvidzidzo uye kugona kwekufunga kwekombiyuta kuri kuvandudzwa zvakanyanya [26].
Chidzidzo ichi chinobatsira vadzidzi vekurera vana kuti vatore chikamu muchirongwa chose zvichienderana nemaitiro eKubvunza-Kugadzira-Kuita-Kushanda-Kuongorora-Kushanda-Kuongorora. Mamiriro ezvinhu ekiriniki akagadzirwa. Chinangwa ndechekubatana kweboka uye kufunga kwakazvimirira, zvichiwedzerwa nemudzidzisi achipindura mibvunzo, vadzidzi vachipa mhinduro dzematambudziko, kuunganidzwa kwedata, maekisesaizi ezviitiko, uye pakupedzisira maekisesaizi ari padivi pemubhedha. Mhedzisiro yechidzidzo ichi yakaratidza kuti mamakisi evadzidzi vezvokurapa muboka rekupindira pakuongororwa kweruzivo rwedzidziso nehunyanzvi hwekushanda aive nani pane evadzidzi muboka rekudzora, uye musiyano wacho waive wakakosha (p < 0.001). Izvi zvinoenderana nekuti vadzidzi vezvokurapa muboka rekupindira vaive nemigumisiro iri nani pakuongororwa kweruzivo rwedzidziso nehunyanzvi hwekushanda. Zvichienzaniswa neboka rekudzora, musiyano wacho waive wakakosha (p<0.001). Pamwe chete nemigumisiro yekutsvagisa yakakodzera [27, 28]. Chikonzero chekuongorora ndechekuti modhi yeCDIO inotanga yasarudza mapoinzi eruzivo rwezvirwere ane huwandu hwakawanda hwekuitika, uye chechipiri, kuoma kwezvirongwa zvepurojekiti kunoenderana nepakutanga. Mumuenzaniso uyu, mushure mekunge vadzidzi vapedza zviri mukati mebasa, vanopedzisa bhuku rebasa reprojekiti sezvinodiwa, vogadzirisa zviri mukati mazvo, uye vokurukura mabasa nenhengo dzeboka kuti vanzwisise nekuisa mukati mezviri mukati mekudzidza uye vagadzire ruzivo rutsva nekudzidza. Ruzivo rwekare nenzira itsva. Kubatanidzwa kweruzivo kunovandudzika.
Chidzidzo ichi chinoratidza kuti kuburikidza nekushandisa modhi yekudzidza yekiriniki yeCDIO, vadzidzi vekurera vari muboka rekupindira vaive nani pane vadzidzi vekurera vari muboka rekudzora pakuita mazano ekuchengeta, kuongororwa kwemuviri, kuona kuongororwa kwevarere, kuita zvirongwa zvekuchengeta, uye mhedzisiro yekutarisira varere. Uye kutarisirwa kwevanhu. Pamusoro pezvo, paive nemusiyano wakakosha muchikamu chimwe nechimwe pakati pemapoka maviri (p < 0.05), izvo zvaive zvakafanana nemhedzisiro yaHongyun [29]. Zhou Tong [21] akadzidza mhedzisiro yekushandisa modhi yekudzidzisa yeConcept-Design-Implement-Operate (CDIO) mukiriniki yekudzidzisa varere vemwoyo, uye akawana kuti vadzidzi muboka rekuyedza vaishandisa maitiro ekiriniki eCDIO. Nzira yekudzidzisa mukiriniki, humanities. Zvikamu zvisere, zvakaita sekugona kurera uye kungwarira, zviri nani zvakanyanya kupfuura zvevadzidzi vekurera vachishandisa nzira dzechinyakare dzekudzidzisa. Izvi zvinogona kunge zviri nekuti mukudzidza, vadzidzi vekurera havachagamuchire ruzivo, asi vanoshandisa hunyanzvi hwavo. vanowana ruzivo munzira dzakasiyana-siyana. Nhengo dzechikwata dzinoburitsa mweya wavo wechikwata zvizere, kubatanidza zviwanikwa zvekudzidza, uye dzinogara dzichishuma, dzichidzidzira, dzichiongorora, uye dzichikurukura nyaya dziripo dzekiriniki dzekiriniki. Ruzivo rwavo runokura kubva pakusava nemusoro kusvika pakadzika, vachinyatsotarisa zviri mukati mekuongorora chikonzero. matambudziko ehutano, kuumbwa kwezvinangwa zveukoti uye kugona kwezvirongwa zveukoti. Vadzidzisi vanopa nhungamiro nekuratidzira panguva yekukurukurirana kuti vagadzire kukurudzira kutenderera kwemhinduro yekunzwisisa-maitiro, kubatsira vadzidzi veukoti kupedzisa maitiro ekudzidza ane chinangwa, kuvandudza hunyanzvi hwevadzidzi veukoti hwekurapa, kuwedzera kufarira kudzidza uye kushanda zvakanaka, uye kuramba vachivandudza maitiro ekiriniki evadzidzi - vakoti. . kugona. Kugona kudzidza kubva mudzidziso kuenda kune imwe, kupedzisa kubatanidzwa kwezivo.
Kuitwa kwezvirongwa zvedzidzo yekiriniki zvinoenderana neCDIO kunovandudza mhando yedzidzo yekiriniki. Zvakabuda muongororo yaDing Jinxia [30] nedzimwe zvinoratidza kuti pane hukama pakati pezvinhu zvakasiyana-siyana zvakaita sekukurudzira kudzidza, kugona kudzidza kwakazvimirira, uye maitiro ekudzidzisa anoshanda evadzidzisi vekiriniki. Muchidzidzo ichi, nekuvandudzwa kwekudzidzisa kwekiriniki kweCDIO, vadzidzisi vekiriniki vakawana kudzidziswa kwakawedzerwa kwehunyanzvi, pfungwa dzekudzidzisa dzakagadziridzwa, uye kugona kudzidzisa kwakagadziridzwa. Chechipiri, zvinovandudza mienzaniso yekudzidzisa kwekiriniki uye zviri mukati medzidzo yekurapa kwemwoyo, zvinoratidza kurongeka uye mashandiro emuenzaniso wekudzidzisa kubva pamaonero makuru, uye zvinosimudzira kunzwisisa kwevadzidzi uye kuchengetedza zviri mukati mezvidzidzo. Mhinduro mushure mehurukuro yega yega inogona kukurudzira kuziva vadzidzisi vekiriniki, kukurudzira vadzidzisi vekiriniki kuti vafungisise nezvehunyanzvi hwavo, nhanho yehunyanzvi uye hunhu hwevanhu, kunyatsonzwisisa kudzidza kwevezera, uye kuvandudza mhando yekudzidzisa kwekiriniki. Zvakabuda zvakaratidza kuti hunhu hwekudzidzisa kwevadzidzisi vekiriniki muboka rekupindira hwaive nani pane hweboka rekutonga, hwakafanana nemhedzisiro yechidzidzo chaXiong Haiyang [31].
Kunyangwe mhedzisiro yechidzidzo ichi ichikosha pakudzidzisa kwekiriniki, chidzidzo chedu chichiri nemiganhu yakati wandei. Chekutanga, kushandiswa kwesampuli yekurerutsira kunogona kuderedza kugona kwezviwanikwa izvi, uye muenzaniso wedu wakaganhurirwa kuchipatara chimwe chete chekurapa chepamusoro. Chechipiri, nguva yekudzidziswa imavhiki mana chete, uye vadzidzi vevanamukoti vanoda nguva yakawanda yekuvandudza hunyanzvi hwekufunga zvakadzama. Chechitatu, muchidzidzo ichi, varwere vakashandiswa muMini-CEX vaive varwere chaivo vasina kudzidziswa, uye mhando yekushanda kwekosi yevanamukoti vari kudzidzira inogona kusiyana kubva kumurwere mumwe kuenda kune mumwe. Aya ndiwo matambudziko makuru anoganhurira mhedzisiro yechidzidzo ichi. Tsvagiridzo yeramangwana inofanira kuwedzera saizi yesampuro, kuwedzera kudzidziswa kwevadzidzisi vekiriniki, uye kubatanidza mwero wekugadzira zvidzidzo zvemuenzaniso. Chidzidzo chenguva refu chinodiwawo kuti uongorore kana kirasi yakachinjika yakavakirwa papfungwa yeCDIO ichigona kukudziridza hunyanzvi hwakakwana hwevadzidzi vekurapa kwenguva refu.
Chidzidzo ichi chakagadzira modhi yeCDIO mukugadzira kosi yevadzidzi vanochengeta vana, chakavaka kirasi yakachinjika yakavakirwa papfungwa yeCDIO, ndokuisanganisa nemuenzaniso wekuongorora wemini-CEX. Mhedzisiro yacho inoratidza kuti kirasi yakachinjika yakavakirwa papfungwa yeCDIO haingogadzirisi chete mhando yekudzidzisa kwekiriniki, asiwo inovandudza kugona kwevadzidzi kudzidza vakazvimiririra, kufunga zvakadzama, uye kugona kwekuita zvekiriniki. Iyi nzira yekudzidzisa yakavimbika uye inoshanda kupfuura hurukuro dzechinyakare. Zvinogona kugumiswa kuti mhedzisiro inogona kuve nezvainoreva padzidzo yekurapa. Kirasi yakachinjika, yakavakirwa papfungwa yeCDIO, inotarisa pakudzidzisa, kudzidza uye mabasa anoshanda uye inobatanidza zvakanyanya kubatanidzwa kweruzivo rwehunyanzvi nekuvandudzwa kwehunyanzvi hwekuita kuti vadzidzi vagadzirire basa rekiriniki. Zvichienderana nekukosha kwekupa vadzidzi mukana wekutora chikamu mukudzidza nekuita, uye tichifunga nezvezvinhu zvese, zvinokurudzirwa kuti modhi yekudzidza kwekiriniki yakavakirwa paCDIO ishandiswe mudzidzo yekurapa. Maitiro aya anogonawo kukurudzirwa senzira itsva, yakatarisana nevadzidzi yekudzidzisa kwekiriniki. Pamusoro pezvo, zvakawanikwa zvichabatsira zvikuru kune vanogadzira mitemo nemasayendisiti pakugadzira nzira dzekuvandudza dzidzo yekurapa.
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Nguva yekutumira: Kukadzi-24-2024