| 引用本文: |
邹芳, 许红淼, 杨冬梅, 刘惠娜, 冯惠玲, 逯晶.基于DPT和“云CBL”的临床思维训练虚拟仿真平台的构建与应用研究[J].湖南中医药大学学报,2026,46(2):374-380[点击复制] |
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| 基于DPT和“云CBL”的临床思维训练虚拟仿真平台的构建与应用研究 |
| 邹芳,许红淼,杨冬梅,刘惠娜,冯惠玲,逯晶 |
| (湖南中医药大学医学院, 湖南 长沙 410208;长沙市第四医院(长沙市中西医结合医院)神经外科, 湖南 长沙 410200) |
| 摘要: |
| 目的 在刻意练习理论（DPT）的指导下，探讨构建基于云平台的案例式教学（CBL，即“云CBL”）的临床思维训练虚拟仿真平台的方法及其应用效果。方法 组建研究团队，基于临床实际案例，以临床常见症状为起点，以临床诊断步骤为框架，构建适合临床医学类专业学生的临床思维训练虚拟仿真平台。选取305例湖南中医药大学2022级临床医学专业本科生作为研究对象，采用随机数字表法将学生分成对照组和试验组，其中对照组153人，试验组152人。试验组使用该平台开展“云CBL”教学模式，对照组使用传统临床案例分析教学模式，比较两组学生课程考核评价成绩，并对平台使用满意度进行调查。结果 在过程性评价中，与对照组比较，实验组病例书写、团队协作、医德医风等方面的成绩均升高（P＜0.001）；在终结性评价中，与对照组比较，试验组病史采集、辅助检查、分析决策等方面的成绩均升高（P＜0.001）。在教学案例方面，95.30%（非常同意67.78%，比较同意27.52%）学生同意教学案例体现了临床诊断流程，94.63%（非常同意66.44%，比较同意28.19%）学生同意有效地培养我的临床思维能力，89.94%（非常同意57.05%，比较同意32.89%）学生同意相信我能够迅速适应角色；在界面设计方面，91.94%（非常同意61.74%，比较同意30.20%）学生认为操作界面设计布局合理，89.27%（非常同意52.36%，比较同意36.91%）学生认为能合理使用图片、音视频等多媒体；在使用体验和技术服务满意度方面，87.25%（非常同意63.76%，比较同意23.49%）学生认为平台操作简明便捷，85.23%（非常同意56.37%，比较同意28.86%）学生认为平台操作流畅、响应速度快，86.57%（非常同意60.40%，比较同意26.17%）学生认为平台运行稳定；课程总体满意度方面，94.63%（非常同意75.17%，比较同意19.46%）学生总体满意。结论 基于DPT和“云CBL”的临床思维训练虚拟仿真平台具有较好的应用价值，能够有效地帮助学生熟悉临床诊断流程，提高学生的临床思维，团队协作和分析决策能力，增强学生的职业自信，可以进一步推广应用。 |
| 关键词: 刻意练习理论 云CBL 虚拟仿真 临床思维训练 教学模式 |
| DOI：10.3969/j.issn.1674-070X.2026.02.022 |
| 投稿时间：2025-08-25 |
| 基金项目:湖南省普通本科高校教学改革研究项目(202401000754);湖南省教育科学“十四五”规划课题(XJK25CGD020)。 |
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| Construction and application research of a virtual simulation platform for clinical thinking training based on DPT and “cloud-based CBL” |
| ZOU Fang, XU Hongmiao, YANG Dongmei, LIU Huina, FENG Huiling, LU Jing |
| (School of Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Department of Neurosurgery, the Fourth Hospital of Changsha (Changsha Hospital of Integrated Chinese and Western Medicine, Changsha, Hunan 410200, China) |
| Abstract: |
| Objective To explore the construction methods and application effects of a virtual simulation platform for clinical thinking training through cloud-based case-based learning (CBL), namely "cloud-based CBL", under the guidance of deliberate practice theory (DPT). Methods A research team was established to develop a virtual simulation platform tailored for clinical medicine students. The platform was constructed based on real clinical cases, starting with common clinical symptoms and framed around clinical diagnostic procedures. A total of 305 undergraduates majoring in clinical medicine of Grade 2022 of Hunan University of Chinese Medicine were selected as research subjects. The students were divided into control group and experimental group by the random number table method, with 153 students in the control group and 152 in the experimental group. The experimental group adopted the "cloud-based CBL" teaching model using the platform, while the control group followed the traditional clinical case analysis teaching approach. The course assessment scores of the two groups were compared, and a satisfaction survey regarding platform usage was conducted. Results In formative evaluation, compared with the control group, the experimental group showed improved scores in case documentation, teamwork, and medical ethics (P<0.001). In summative evaluation, the experimental group also outperformed the control group in areas such as medical history taking, auxiliary examinations, and analytical decision-making (P<0.001). Regarding teaching cases, 95.30% of students (with 67.78% strongly agreeing and 27.52% agreeing) believed that the teaching cases reflected the clinical diagnostic process. Additionally, 94.63% of students (66.44% strongly agreeing and 28.19% agreeing) felt that the cases effectively cultivated their clinical thinking abilities, and 89.94% of students (57.05% strongly agreeing and 32.89% agreeing) were confident in their ability to quickly adapt to their roles. In terms of interface design, 91.94% of students (61.74% strongly agreeing and 30.20% agreeing) considered the layout of the operational interface to be reasonable, while 89.27% of students (52.36% strongly agreeing and 36.91% agreeing) believed that multimedia elements such as images, audio, and video were used appropriately. Regarding user experience and satisfaction with technical services, 87.25% of students (63.76% strongly agreeing and 23.49% agreeing) found the platform operations to be simple and convenient, 85.23% of students (56.37% strongly agreeing and 28.86% agreeing) considered the platform to operate smoothly with fast response times, and 86.57% of students (60.40% strongly agreeing and 26.17% agreeing) believed the platform ran stably. Overall, 94.63% of students (75.17% strongly agreeing and 19.46% agreeing) expressed satisfaction with the course. Conclusion The virtual simulation platform for clinical thinking training based on DPT and "cloud-based CBL" demonstrates favorable application value. It can effectively help students familiarize themselves with the clinical diagnosis processes, enhance their clinical thinking, teamwork, analytical and decision-making abilities, and boosts their professional confidence. Therefore, it is worthy of further promotion and application. |
| Key words: deliberate practice theory cloud-based CBL virtual simulation clinical thinking training teaching model |
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