翻转课堂结合Mini-CEX在内分泌科临床本科实习教学中的应用

Application of Flipped Classroom Combined with Mini-CEX in Clinical Undergraduate Internship Teaching of Endocrinology

摘要: 目的：探讨翻转课堂联合迷你临床演练评估(Mini-CEX)在内分泌科临床本科实习教学中的应用效果。方法：将60名内分泌科实习的临床医学本科学员随机分为试验组与对照组，每组30人。试验组采用“课前自学–课堂病例讨论–床边Mini-CEX评估”的融合教学模式，对照组采用传统讲授式教学。比较两组学员的理论考核成绩、临床技能考核(OSCE)成绩、Mini-CEX各维度得分及教学满意度。结果：试验组理论考核成绩(86.5 ± 4.8 vs. 81.2 ± 5.3)、临床技能考核成绩(88.3 ± 4.1 vs. 83.7 ± 4.9)均显著高于对照组(P < 0.05)。试验组在Mini-CEX的“体格检查”、“临床判断”、“医患沟通”等维度得分提升明显(P < 0.05)，教学满意度各条目认可度亦显著高于对照组(P < 0.05)。结论：翻转课堂结合Mini-CEX的教学模式有助于提升实习学员的理论水平、临床技能与自主学习能力，形成“学–用–评–馈”的闭环学习路径，具有较好的临床适用性与推广价值。

Abstract: Objective: To evaluate the application effectiveness of a flipped classroom combined with Mini-Clinical Evaluation Exercise (Mini-CEX) in the clinical undergraduate internship teaching of endocrinology. Methods: Sixty undergraduate clinical medicine students undergoing endocrinology training were randomly divided into an experimental group and a control group, with 30 students in each group. The experimental group adopted a blended teaching model integrating “pre-class self-study, in-class case discussion, and bedside Mini-CEX assessment”, while the control group received traditional lecture-based instruction. The theoretical examination scores, clinical skills assessment (OSCE) scores, Mini-CEX dimension scores, and teaching satisfaction were compared between the two groups. Results: The theoretical assessment scores (86.5 ± 4.8 vs. 81.2 ± 5.3) and clinical skills assessment scores (88.3 ± 4.1 vs. 83.7 ± 4.9) of the experimental group were significantly higher than those of the control group (P < 0.05). The experimental group showed significant improvements in the dimensions of “Physical Examination”, “Clinical Judgment”, and “Doctor-Patient Communication” on the Mini-CEX (P < 0.05), and the satisfaction scores for each item of teaching satisfaction were also significantly higher than those of the control group (P < 0.05). Conclusion: The flipped classroom combined with Mini-CEX teaching model helps to improve the theoretical level, clinical skills and self-learning ability of interns, forming a closed-loop learning path of “learning-practice-evaluation-feedback”, which demonstrates good clinical applicability and is worthy of promotion.