Mai i te mate urutā COVID-19, kua tīmata te whenua ki te aro nui atu ki te mahi whakaako haumanu o ngā hōhipera whare wānanga. Ko te whakapakari i te whakaurunga o te rongoā me te mātauranga, me te whakapai ake i te kounga me te whai huatanga o te whakaako haumanu, he wero nui tēnei e pā ana ki te mātauranga hauora. Ko te uaua o te whakaako i ngā wheua kei roto i te whānuitanga o ngā mate, te ngaiotanga teitei me ngā āhuatanga āhua-kore, e awe ana i te kaupapa, te hihiri me te whai huatanga o te whakaako i ngā ākonga hauora. I whakawhanakehia e tēnei rangahau he mahere whakaako akomanga hurihuri i runga i te ariā CDIO (Concept-Design-Implement-Operate) ā, i whakatinanahia ki roto i tētahi akoranga whakangungu ākonga nēhi wheua hei whakapai ake i te pānga ako mahi, me te āwhina i ngā kaiako ki te mohio ki te hurihuri i te heke mai o te mātauranga nēhi me te mātauranga hauora. Ka whai hua ake, ka arotahi ake hoki te ako akomanga.
E rima tekau ngā ākonga hauora i whakaoti i tētahi mahi tauira i te tari orthopedic o tētahi hōhipera tuatoru i te marama o Hune 2017 i whakaurua ki te rōpū whakahaere, ā, e rima tekau ngā ākonga nēhi i whakaoti i tētahi mahi tauira i te tari i te marama o Hune 2018 i whakaurua ki te rōpū wawaotanga. I tangohia e te rōpū wawaotanga te ariā CDIO o te tauira whakaako akomanga hurihuri, ko te rōpū whakahaere ia i tango i te tauira whakaako tuku iho. I muri i te otinga o ngā mahi mahi a te tari, e rua ngā rōpū ākonga i aromatawaihia mō te ariā, ngā pūkenga whakahaere, te āheinga ako takitahi me te āheinga whakaaroaro arohaehae. E rua ngā rōpū kaiako i whakaoti i ngā inenga e waru e aromatawai ana i ngā āheinga mahi haumanu, tae atu ki ngā tukanga nēhi e whā, ngā āheinga nēhi tangata, me te aromatawai i te kounga o te whakaako haumanu.
I muri i te whakangungu, he nui ake ngā kaute mō te pūkenga mahi haumanu, te pūkenga whakaaroaro arohaehae, te pūkenga ako takitahi, te whakatutukitanga ariā me te mahi, me te kounga whakaako haumanu o te rōpū wawaotanga i ērā o te rōpū whakahaere (katoa P < 0.05).
Mā te tauira whakaako e ahu mai ana i te CDIO ka taea te whakaoho i te ako takitahi a ngā nēhi mahi tauira me te kaha ki te whakaaroaro arohaehae, te whakatairanga i te whakakotahitanga waro o te ariā me te mahi, te whakapai ake i tō rātou kaha ki te whakamahi whānui i ngā mātauranga ariā hei tātari me te whakaoti rapanga mahi, me te whakapai ake i te hua ako.
Ko te mātauranga haumanu te wāhanga tino nui o te mātauranga nēhi, ā, ko te whakawhiti mai i te mātauranga ariā ki te mahi. Ka taea e te ako haumanu whai hua te āwhina i ngā ākonga nēhi ki te ako i ngā pūkenga ngaio, te whakapakari i te mātauranga ngaio, me te whakapai ake i ō rātou pūkenga ki te mahi nēhi. Koinei hoki te wāhanga whakamutunga o te whakawhiti tūranga mahi mō ngā ākonga hauora [1]. I ngā tau tata nei, he maha ngā kairangahau whakaako haumanu kua rangahau i ngā tikanga whakaako pēnei i te ako e hangai ana ki te raruraru (PBL), te ako e hangai ana ki ngā take (CBL), te ako ā-rōpū (TBL), me te ako ā-tūranga me te ako whakaata ā-tūranga i roto i te whakaako haumanu. Heoi, he rerekē ngā tikanga whakaako me ō rātou painga me ō rātou ngoikoretanga e pā ana ki te pānga ako o ngā hononga mahi, engari kāore e tutuki i a rātou te whakaurunga o te ariā me te mahi [2].
Ko te "flipped classroom" e pā ana ki tētahi tauira ako hou e whakamahi ana ngā ākonga i tētahi tūāpapa mōhiohio motuhake hei ako takitahi i ngā momo rauemi mātauranga i mua i te akomanga, me te whakaoti i ngā mahi kāinga i roto i tētahi momo "ako tahi" i roto i te akomanga, i a ngā kaiako e ārahi ana i ngā ākonga. Whakautuhia ngā pātai me te whakarato āwhina whaiaro[3]. I kite te American New Media Alliance ka whakatikatika te flipped classroom i te wā i roto, i waho hoki o te akomanga, ā, ka whakawhiti i ngā whakatau ako a ngā ākonga mai i ngā kaiako ki ngā ākonga [4]. Mā te wā nui e pau ana i roto i te akomanga i roto i tēnei tauira ako ka taea e ngā ākonga te arotahi ake ki te ako hohe, e ahu mai ana i ngā raruraru. I whakahaerehia e Deshpande [5] tētahi rangahau mō te flipped classroom i roto i te mātauranga me te whakaako paramedic, ā, i whakatau ko te flipped classroom ka taea te whakapai ake i te hihiri ako a ngā ākonga me te mahi mātauranga me te whakaiti i te wā akomanga. I tirotirohia e Khe Fung HEW rāua ko Chung Kwan LO [6] ngā hua rangahau o ngā tuhinga whakatairite mō te flipped classroom, ā, i whakarāpopototia te pānga whānui o te tikanga whakaako flipped classroom mā te tātaritanga-maha, e tohu ana i te whakataurite ki ngā tikanga whakaako tuku iho, he pai ake te tikanga whakaako flipped classroom i roto i te mātauranga hauora ngaio, ā, ka whakapai ake i te ako a ngā ākonga. I whakaritea e Zhong Jie [7] ngā pānga o te ako ā-tinana me te ako ā-tinana ki te ako mātauranga a ngā ākonga, ā, i kitea i roto i te tukanga ako ā-tinana i roto i te akomanga histology, mā te whakapai ake i te kounga o te whakaakoranga ipurangi ka taea te whakapai ake i te makona me te mōhiotanga o ngā ākonga. pupuri. I runga i ngā hua rangahau i runga ake nei, i roto i te mara o te mātauranga nēhi, he maha ngā tohunga e ako ana i te pānga o te akomanga ki te whai huatanga o te whakaakoranga ā-akomanga, ā, e whakapono ana ka taea e te whakaakoranga ā-tinana te whakapai ake i te mahi mātauranga a ngā ākonga nēhi, te kaha ako takitahi, me te makona o te akomanga.
Nō reira, he mea nui te tūhura me te whakawhanake i tētahi tikanga whakaako hou hei āwhina i ngā ākonga nēhi ki te whakauru me te whakatinana i ngā mātauranga ngaio pūnaha, me te whakapai ake i ō rātou pūkenga mahi haumanu me te kounga whānui. Ko te CDIO (Concept-Design-Implement-Operate) he tauira mātauranga hangarau i whakawhanakehia i te tau 2000 e ngā whare wānanga e whā, tae atu ki te Massachusetts Institute of Technology me te Royal Institute of Technology i Sweden. He tauira matatau tēnei o te mātauranga hangarau e āhei ai ngā ākonga nēhi ki te ako me te whiwhi pūkenga i roto i te huarahi hohe, mahi-ā-ringa, me te tikanga rauropi [8, 9]. Mō te ako matua, e whakanui ana tēnei tauira i te "arotahi ki te ākonga," e āhei ai ngā ākonga ki te whai wāhi ki te ariā, te hoahoa, te whakatinanatanga, me te whakahaere i ngā kaupapa, me te huri i ngā mātauranga ariā kua riro hei taputapu whakaoti rapanga. He maha ngā rangahau kua whakaatu ko te tauira whakaako CDIO e whai wāhi ana ki te whakapai ake i ngā pūkenga mahi haumanu me te kounga whānui o ngā ākonga hauora, te whakapai ake i te taunekeneke kaiako-ākonga, te whakapai ake i te whai huatanga o te whakaako, ā, he wāhi nui ki te whakatairanga i te whakahoutanga mōhiohio me te arotau i ngā tikanga whakaako. He whānuitia te whakamahinga i roto i te whakangungu taranata kua whakamahia [10].
I te panonitanga o te tauira hauora o te ao, kei te piki haere ngā tono a te tangata mō te hauora, ā, kua piki ake hoki te kawenga o ngā kaimahi hauora. E pā tika ana te pūkenga me te kounga o ngā nēhi ki te kounga o te tiaki haumanu me te haumaru o te tūroro. I ngā tau tata nei, kua noho te whanaketanga me te aromatawai i ngā pūkenga haumanu o ngā kaimahi nēhi hei kaupapa wera i roto i te mara o te nēhi [11]. Nō reira, he mea nui te tikanga aromatawai whai take, whānui, pono, me te tika mō te rangahau mātauranga hauora. Ko te mahi aromatawai iti-haumanu (mini-CEX) he tikanga mō te aromatawai i ngā pūkenga haumanu whānui o ngā ākonga hauora, ā, e whakamahia whānuitia ana i roto i te mara o te mātauranga hauora maha-mātauranga i te kāinga me tāwāhi. I puta haere i roto i te mara o te nēhi [12, 13].
He maha ngā rangahau kua mahia mō te whakamahinga o te tauira CDIO, te akomanga hurihuri, me te mini-CEX i roto i te mātauranga nēhi. I kōrero a Wang Bei [14] mō te pānga o te tauira CDIO ki te whakapai ake i te whakangungu motuhake ki te nēhi mō ngā hiahia o ngā nēhi COVID-19. E kī ana ngā hua mā te whakamahi i te tauira whakangungu CDIO hei whakarato whakangungu nēhi motuhake mō te COVID-19 ka āwhina i ngā kaimahi nēhi ki te whiwhi pūkenga whakangungu nēhi motuhake me ngā mōhiotanga e pā ana, me te whakapai ake i ō rātou pūkenga nēhi whānui. I kōrero ngā tohunga pērā i a Liu Mei [15] mō te whakamahinga o te tikanga whakaako tīma me te akomanga hurihuri i roto i te whakangungu nēhi wheua. I whakaatu ngā hua ka taea e tēnei tauira whakaako te whakapai ake i ngā pūkenga taketake o ngā nēhi wheua pērā i te mārama me te whakamahinga o te mōhiotanga ariā, te mahi tahi, te whakaaroaro arohaehae, me te rangahau pūtaiao. I ako a Li Ruyue me ētahi atu [16] i te pānga o te whakamahi i te Mini-CEX Nēhi kua whakapaitia i roto i te whakangungu paerewa o ngā nēhi pokanga hou, ā, i kitea e rātou ka taea e ngā kaiako te whakamahi i te Mini-CEX Nēhi hei aromatawai i te tukanga aromatawai me te mahi katoa i roto i te whakaakoranga haumanu, i te mahi rānei. Mā te tukanga aroturuki-ā-tangata me te whakaaroaro-ā-tangata, ka akohia ngā kaupapa matua o te aromatawai mahi nēhi, ka whakarerekētia te marautanga, ka whakapai ake i te kounga o te whakaakoranga haumanu, ka whakapai ake i te pūkenga nēhi haumanu pokanga whānui o ngā ākonga, ā, ka whakamatautauria te huinga akomanga hurihuri i runga i te ariā CDIO, engari kāore anō kia puta he pūrongo rangahau i tēnei wā. Te whakamahinga o te tauira aromatawai mini-CEX ki te mātauranga nēhi mō ngā ākonga wheua. I whakamahia e te kaituhi te tauira CDIO ki te whakawhanake i ngā akoranga whakangungu mō ngā ākonga nēhi wheua, i hangaia he akomanga hurihuri i runga i te ariā CDIO, ā, i honoa ki te tauira aromatawai mini-CEX hei whakatinana i tētahi tauira ako me te kounga e toru-i-te-kotahi. Te mātauranga me ngā pūkenga, ā, i whai wāhi hoki ki te whakapai ake i te kounga o te whakaako. Ko te whakapai tonu te pūtake mō te ako mahi-ā-ringa i roto i ngā hōhipera whakaako.
Hei whakahaere i te whakatinanatanga o te akoranga, i whakamahia he tikanga tauira watea hei kaupapa ako hei whiriwhiri i ngā ākonga nēhi mai i te tau 2017 me te 2018 e mahi ana i te tari orthopedic o tētahi hōhipera tuatoru. Nā te mea e 52 ngā tauira i ia taumata, ko te rahi o te tauira ka 104. Tokowhā ngā ākonga kāore i uru ki te mahi haumanu katoa. I roto i te rōpū whakahaere ko te 50 ngā ākonga nēhi i whakaoti i tētahi mahi tauira i te tari orthopedic o tētahi hōhipera tuatoru i te marama o Hune 2017, ā, e 6 ngā tāne me te 44 ngā wāhine i waenga i te 20 ki te 22 tau (21.30 ± 0.60) tau te pakeke, i whakaoti i tētahi mahi tauira i taua tari anō i te marama o Hune 2018. I roto i te rōpū wawao ko te 50 ngā ākonga hauora, tae atu ki te 8 ngā tāne me te 42 ngā wāhine i waenga i te 21 ki te 22 tau (21.45 ± 0.37) tau te pakeke. I whakaae ngā kaupapa katoa. Ngā Paearu Whakauru: (1) Ngā ākonga mahi tauira hauora orthopedic me te tohu paetahi. (2) Te whakaae tauira me te whai wāhi tūao ki tēnei rangahau. Ngā paearu whakakore: Ngā tāngata kāore e taea te whai wāhi katoa ki te mahi haumanu. Kāore he rerekētanga nui ā-tatauranga i roto i ngā mōhiohio whānui o ngā rōpū e rua o ngā tauira hauora e whakangungua ana (p>0.05) ā, he rite tonu.
I oti i ngā rōpū e rua tētahi mahi whakangungu haumanu e whā wiki te roa, ā, i oti katoa ngā akoranga i te Tari Orthopedic. I te wā tirotiro, e 10 katoa ngā rōpū tauira hauora, e 5 ngā tauira i ia rōpū. Ka whakahaerehia ngā whakangungu i runga anō i te kaupapa whakangungu mō ngā tauira nēhi, tae atu ki ngā wāhanga ariā me ngā wāhanga hangarau. He ōrite ngā tohu mātauranga o ngā kaiako i ngā rōpū e rua, ā, ko te kaiako nēhi te kawenga mō te aroturuki i te kounga o te whakaako.
I whakamahia e te rōpū whakahaere ngā tikanga whakaako tuku iho. I te wiki tuatahi o te kura, ka tīmata ngā akomanga i te Mane. Ka whakaako ngā kaiako i ngā ariā i ngā Tūrei me ngā Wenerei, ā, ka arotahi ki ngā whakangungu whakahaere i ngā Taite me ngā Paraire. Mai i te wiki tuarua ki te wiki tuawhā, ko ia mema kaiako te kawenga mō tētahi tauira hauora e tuku ana i ngā kauhau i roto i te tari. I te wiki tuawhā, ka oti ngā aromatawai i ngā rā e toru i mua i te mutunga o te akoranga.
E ai ki te kōrero i mua ake nei, e whakamahi ana te kaituhi i tētahi tikanga whakaako akomanga hurihuri e ahu mai ana i te ariā CDIO, e whakamāramahia ana i raro nei.
He rite tonu te wiki tuatahi o te whakangungu ki tā te rōpū whakahaere; Mai i te wiki tuarua ki te wiki tuawhā o te whakangungu orthopedic perioperative ka whakamahia he mahere whakaako akomanga hurihuri e hangai ana ki te ariā CDIO mō te katoa o ngā haora 36. Ka oti te wāhanga whakaaro me te hoahoa i te wiki tuarua, ā, ka oti te wāhanga whakatinanatanga i te wiki tuatoru. I oti te pokanga i te wiki tuawhā, ā, i oti te aromatawai me te aromatawai i ngā rā e toru i mua i te tukunga. Tirohia te Ripanga 1 mō ngā tohatoha wā akomanga motuhake.
I whakatūria he tīma whakaako, arā, kotahi te nēhi matua, e waru ngā kaiako wheua, me tētahi tohunga nēhi CDIO kāore i te wheua. Ka whakaratohia e te Nēhi Matua ki ngā mema o te tīma whakaako te ako me te matatau ki te marautanga me ngā paerewa CDIO, te pukapuka ā-awheawhe CDIO me ētahi atu ariā me ngā tikanga whakatinanatanga motuhake (neke atu i te 20 hāora), ā, ka kōrero tahi me ngā tohunga i ngā wā katoa mō ngā take whakaako ariā uaua. Ka whakatakoto ngā kaiako i ngā whāinga ako, ka whakahaere i te marautanga, ā, ka whakarite akoranga i runga i te huarahi ōrite e rite ana ki ngā whakaritenga nēhi pakeke me te kaupapa noho.
E ai ki te kaupapa mahi tauira, me te aro ki te kaupapa whakangungu taranata CDIO me ngā paerewa [17] me te hono atu ki ngā āhuatanga whakaako o te nēhi wheua, ko ngā whāinga ako a ngā kaimahi nēhi kua whakatakotoria ki ngā taha e toru, arā: ngā whāinga mātauranga (te matatau ki te mātauranga taketake), te mātauranga ngaio me ngā tukanga pūnaha e pā ana, me ētahi atu), ngā whāinga matatau (te whakapai ake i ngā pūkenga ngaio taketake, ngā pūkenga whakaaroaro arohaehae me ngā āheinga ako takitahi, me ētahi atu) me ngā whāinga kounga (te hanga uara ngaio pakari me te wairua manaaki tangata me ētahi atu). .). Ko ngā whāinga mātauranga e rite ana ki te mātauranga hangarau me te whakaaro o te marautanga CDIO, ngā āheinga whaiaro, ngā āheinga ngaio me ngā whanaungatanga o te marautanga CDIO, ā, ko ngā whāinga kounga e rite ana ki ngā pūkenga ngohengohe o te marautanga CDIO: te mahi tahi me te whakawhitiwhiti kōrero.
I muri i ngā wāhanga hui e rua, i matapakihia e te tīma kaiako tētahi mahere mō te whakaako i te mahi nēhi i roto i tētahi akomanga hurihuri i runga i te ariā CDIO, i wehea te whakangungu kia whā ngā wāhanga, ā, i whakatauhia ngā whāinga me te hoahoa, e whakaaturia ana i te Ripanga 1.
I muri i te tātari i ngā mahi nēhi mō ngā mate wheua, i tautuhia e te kaiako ngā take o ngā mate wheua noa me ngā mate wheua noa. Me tango te mahere maimoatanga mō ngā tūroro he herniation kōpae lumbar hei tauira: I amuamu te tūroro Zhang Moumou (tāne, 73 tau te pakeke, teitei 177 cm, taumaha 80 kg) mō te "mamae o raro o te tuara me te ngoikore me te mamae i te waewae maui o raro mō te 2 marama" ā, i tukuna ki te hōhipera i roto i te whare hauora o waho. Hei tūroro nēhi kawenga: (1) Tena koa pātaihia te hītori o te tūroro i runga i te mōhiotanga kua riro i a koe, me te whakatau he aha te mea e pā ana ki te tūroro; (2) Kōwhiria he rangahau pūnaha me ngā tikanga aromatawai ngaio i runga i te āhuatanga me te whakaaro i ngā pātai rangahau e hiahia ana kia arotakehia anō; (3) Whakahaerehia te tātaritanga nēhi. I tēnei take, me whakakotahi te pātengi raraunga rapu take; tuhia ngā wawaotanga nēhi kua arotahihia e pā ana ki te tūroro; (4) Matapakihia ngā raruraru o nāianei i roto i te whakahaere whaiaro a te tūroro, me ngā tikanga o nāianei me ngā ihirangi o te aroturukitanga a te tūroro i te putanga mai. Tukuna ngā kōrero a ngā ākonga me ngā rārangi mahi e rua ngā rā i mua i te akomanga. Ko te rārangi mahi mō tēnei take e whai ake nei: (1) Arotake me te whakapakari i ngā mōhiotanga ariā mō te take me ngā whakaaturanga haumanu o te herniation o te kōpae intervertebral lumbar; (2) Whakawhanake i tētahi mahere tiaki kua whakaritea; (3) Whakawhanake i tēnei take i runga i ngā mahi haumanu me te whakatinana i te tiaki i mua i te pokanga me te tiaki i muri i te pokanga ko ngā āhuatanga matua e rua o te whakatauira kaupapa whakaako. Ka arotake takitahi ngā ākonga nēhi i ngā ihirangi akoranga me ngā pātai whakaharatau, ka tirotiro i ngā tuhinga me ngā pātengi raraunga e tika ana, ā, ka whakaoti i ngā mahi ako-whaiaro mā te takiuru ki te rōpū WeChat.
Ka whakatū rōpū noa ngā ākonga, ā, ka whiriwhiri te rōpū i tētahi kaiārahi rōpū hei kawenga mō te wehewehe i ngā mahi me te whakarite i te kaupapa. Ko te kaiārahi o mua i te tīma te kawenga mō te tohatoha i ngā kaupapa e whā: te whakataki take, te whakatinanatanga o ngā tukanga nēhi, te mātauranga hauora, me ngā mōhiotanga e pā ana ki te mate ki ia mema o te tīma. I te wā o te mahi tauira, ka whakamahia e ngā ākonga ō rātou wā waatea ki te rangahau i ngā papamuri ariā, i ngā rauemi rānei hei whakaoti rapanga take, hei whakahaere i ngā kōrero a te tīma, me te whakapai ake i ngā mahere kaupapa motuhake. I te whakawhanaketanga kaupapa, ka āwhina te kaiako i te kaiārahi tīma ki te tuku i ngā mema o te tīma ki te whakarite i ngā mōhiotanga e tika ana, ki te whakawhanake me te whakaputa kaupapa, ki te whakaatu me te whakarerekē i ngā hoahoa, me te āwhina i ngā ākonga nēhi ki te whakauru i ngā mōhiotanga e pā ana ki te mahi ki te hoahoa me te whakaputa. Whiwhi mōhiotanga mō ia kaupapa. I tātarihia, i whakawhanakehia hoki ngā wero me ngā kaupapa matua o tēnei rōpū rangahau, ā, i whakatinanahia te mahere whakatinanatanga mō te whakatauira horopaki o tēnei rōpū rangahau. I tēnei wāhanga, i whakarite hoki ngā kaiako i ngā whakaaturanga porowhita nēhi.
Ka mahi ngā ākonga i roto i ngā rōpū iti ki te whakaatu kaupapa. Whai muri i te pūrongo, ka kōrerohia, ka tukuna atu hoki he kōrero e ētahi atu mema o te rōpū me ngā kaiako mō te rōpū pūrongo hei whakapai ake i te mahere tiaki nēhi. Ka akiaki te kaiārahi o te tīma i ngā mema o te tīma ki te whakatauira i te tukanga tiaki katoa, ā, ka āwhina te kaiako i ngā ākonga ki te tūhura i ngā huringa hihiri o te mate mā te mahi whakatauira, te whakawhānui ake i ō rātou māramatanga me te hanga i ngā mōhiotanga ariā, me te whakawhanake i ngā pūkenga whakaaroaro arohaehae. Ko ngā ihirangi katoa me whakaoti i roto i te whanaketanga o ngā mate motuhake ka oti i raro i te arataki a ngā kaiako. Ka tukuna atu he kōrero, ka ārahi hoki ngā kaiako i ngā ākonga nēhi ki te mahi i ngā mahi whakaharatau i te taha o te moenga kia tutuki ai te whakakotahitanga o te mōhiotanga me te mahi haumanu.
I muri i te aromatawai i ia rōpū, ka kōrero te kaiako, ā, ka tuhia ngā kaha me ngā ngoikoretanga o ia mema o te rōpū i roto i te whakaritenga o ngā ihirangi me te tukanga pūkenga hei whakapai tonu i te māramatanga o ngā ākonga nēhi ki ngā ihirangi ako. Ka tātarihia e ngā kaiako te kounga whakaako, ka arotau hoki i ngā akoranga i runga i ngā aromatawai a ngā ākonga nēhi me ngā aromatawai whakaako.
Ka whai ngā ākonga nēhi i ngā whakamātautau ariā me ngā whakamātautau mahi ā-ringa i muri i te whakangungu mahi ā-ringa. Ka pātaihia ngā pātai ariā mō te wawaotanga e te kaiako. Ka wehea ngā pepa wawaotanga kia rua ngā rōpū (A me B), ā, ka whiriwhiria matapōkeretia tētahi rōpū mō te wawaotanga. Ka wehea ngā pātai wawaotanga kia rua ngā wāhanga: te mātauranga ariā ngaio me te tātari take, e 50 ngā tohu mō ia wāhanga, ā, ka whiwhi i te kaute katoa o te 100 ngā tohu. I te aromatawai i ngā pūkenga nēhi, ka whiriwhiria matapōkeretia e ngā ākonga tētahi o ēnei e whai ake nei, tae atu ki te tikanga hurihanga tuaka, te tikanga whakanoho pai o ngā peka mō ngā tūroro e whara ana te taurakiraki, te whakamahinga o te tikanga whakaora hau, te tikanga whakamahi i te mīhini whakaora hononga CPM, me ētahi atu. Ko te kaute katoa he 100 ngā tohu.
I te wiki tuawhā, ka aromatawaitia te Tauine Aromatawai Ako Motuhake e toru ngā rā i mua i te mutunga o te akoranga. I whakamahia te tauine aromatawai motuhake mō te kaha ako i whakawhanakehia e Zhang Xiyan [18], tae atu ki te hihiri ako (8 ngā tūemi), te whakahaere-ā-roto (11 ngā tūemi), te kaha ki te mahi tahi i roto i te ako (5 ngā tūemi), me te mātauranga mōhiohio (6 ngā tūemi). Ka aromatawaitia ia tūemi i runga i te tauine Likert 5-ira mai i te "kāore i te rite tonu" ki te "tino rite tonu," me ngā kaute mai i te 1 ki te 5. Ko te kaute katoa he 150. Ko te teitei ake o te kaute, ko te kaha ake o te kaha ki te ako takitahi. Ko te tauwehenga alpha a Cronbach o te tauine he 0.822.
I te wiki tuawhā, i aromatawaihia he tauine aromatawai kaha whakaaroaro arohaehae i ngā rā e toru i mua i te tukunga. I whakamahia te putanga Hainamana o te Tauine Aromatawai Kaha Whakaaro Arohaehae i whakamāoritia e Mercy Corps [19]. E whitu ngā taha: te kitenga pono, te whakaaro tuwhera, te kaha tātari me te kaha whakarite, me te 10 ngā tūemi i ia taha. Ka whakamahia he tauine 6-ira mai i te "tino whakahē" ki te "tino whakaae" mai i te 1 ki te 6. Ka tātaihia ngā kōrero kino ki muri, me te tapeke kaute mai i te 70 ki te 420. Ko te tapeke kaute ≤210 e tohu ana i te mahi kino, ko te 211–279 e tohu ana i te mahi koretake, ko te 280–349 e tohu ana i te mahi pai, ā, ko te ≥350 e tohu ana i te kaha whakaaroaro arohaehae. Ko te tauwehenga alpha a Cronbach o te tauine he 0.90.
I te wiki tuawhā, ka tū he aromatawai pūkenga haumanu i ngā rā e toru i mua i te tukunga. Ko te tauine mini-CEX i whakamahia i tēnei rangahau i ahu mai i te Medical Classic [20] i runga i te mini-CEX, ā, i whiwhihia te korenga mai i te 1 ki te 3 ngā tohu. E tutuki ana i ngā whakaritenga, 4-6 ngā tohu mō te tutuki i ngā whakaritenga, 7-9 ngā tohu mō te pai. Ka oti i ngā ākonga hauora ā rātou whakangungu i muri i te whakaoti i tētahi mahi tauira motuhake. Ko te tauine alpha a Cronbach o tēnei tauine ko te 0.780, ā, ko te tauine pono o te haurua-wehe ko te 0.842, e tohu ana i te pono pai.
I te wiki tuawhā, i te rā i mua i te wehenga atu i te tari, i tū he hui wānanga mō ngā kaiako me ngā ākonga, me te aromatawai i te kounga o te whakaako. Nā Zhou Tong [21] i whakawhanake te puka aromatawai kounga whakaako, ā, e rima ngā āhuatanga kei roto: te waiaro whakaako, te ihirangi whakaako, me te whakaako. Ngā tikanga, ngā pānga o te whakangungu me ngā āhuatanga o te whakangungu. I whakamahia he tauine Likert 5-ira. Ko te teitei ake o te kaute, ko te pai ake o te kounga o te whakaako. I oti i muri i te otinga o tētahi mahi whakangungu motuhake. He pai te pono o te pātai, ko te alpha a Cronbach o te tauine he 0.85.
I tātarihia ngā raraunga mā te whakamahi i te pūmanawa tatauranga SPSS 21.0. Ka whakaatuhia ngā raraunga ine hei toharite ± paerewa rerekētanga (\(\strike X \pm S\)) ā, ka whakamahia te rōpū wawaotanga t hei whakatairite i waenga i ngā rōpū. I whakaatuhia ngā raraunga tatau hei maha o ngā take (%), ā, ka whakatairitea mā te whakamahi i te chi-square, i te wawaotanga tika rānei a Fisher. Ko te uara p <0.05 e tohu ana i te rerekētanga nui ā-tatauranga.
Kei te Ripanga 2 te whakataurite i ngā kaute wawaotanga ariā me ngā kaute wawaotanga whakahaere o ngā rōpū nēhi tauira e rua.
Kei te Ripanga 3 te whakataurite i ngā pūkenga ako takitahi me te whakaaroaro arohaehae o ngā rōpū nēhi tauira e rua.
He whakatairite i ngā aromatawai pūkenga mahi haumanu i waenga i ngā rōpū nēhi tauira e rua. He pai ake te pūkenga mahi nēhi haumanu o ngā ākonga i roto i te rōpū wawaotanga i tērā i roto i te rōpū whakahaere, ā, he rerekētanga nui te tatauranga (p < 0.05) e whakaaturia ana i te Ripanga 4.
I whakaatuhia e ngā hua o te aromatawai i te kounga whakaako o ngā rōpū e rua ko te tapeke o te kaute kounga whakaako o te rōpū whakahaere he 90.08 ± 2.34 ngā tohu, ā, ko te tapeke o te kaute kounga whakaako o te rōpū wawaotanga he 96.34 ± 2.16 ngā tohu. He rerekētanga nui te tatauranga. (t = – 13.900, p < 0.001).
Ko te whanaketanga me te ahunga whakamua o te rongoā me nui te kohikohinga o ngā pūkenga hauora. Ahakoa he maha ngā tikanga whakangungu whakaata me te whakaata, kāore e taea te whakakapi i te mahi haumanu, e pā tika ana ki te kaha o ngā pūkenga hauora o muri mai ki te rongoā i ngā mate me te whakaora i ngā oranga. Mai i te mate urutā COVID-19, kua aro nui te whenua ki te mahi whakaako haumanu o ngā hōhipera whare wānanga [22]. Ko te whakapakari i te whakaurunga o te rongoā me te mātauranga me te whakapai ake i te kounga me te whai huatanga o te whakaako haumanu he wero nui kei mua i te mātauranga hauora. Ko te uaua o te whakaako i ngā orthopedic kei roto i te whānuitanga o ngā mate, te ngaiotanga teitei me ngā āhuatanga tino uaua, e pā ana ki te kaupapa, te hihiri me te kaha ako o ngā ākonga hauora [23].
Ko te tikanga whakaako akomanga hurihuri i roto i te ariā whakaako CDIO ka whakauru i ngā ihirangi ako ki te tukanga whakaako, ako me te mahi. Ka huri tēnei i te hanganga o ngā akomanga, ā, ka whakanoho i ngā ākonga nēhi ki te kaupapa matua o te whakaako. I roto i te tukanga ako, ka āwhina ngā kaiako i ngā ākonga nēhi ki te uru motuhake ki ngā mōhiohio e tika ana mō ngā take nēhi uaua i roto i ngā take noa [24]. E whakaatu ana ngā rangahau kei roto i te CDIO te whakawhanaketanga mahi me ngā mahi whakaako haumanu. Ka whakaratohia e te kaupapa he aratohu taipitopito, ka hono tata i te whakakotahitanga o te mātauranga ngaio me te whakawhanaketanga o ngā pūkenga mahi mahi, ā, ka tautuhi i ngā raruraru i te wā whakatauira, he mea whai hua mō ngā ākonga nēhi ki te whakapai ake i ā rātou pūkenga ako motuhake me te whakaaroaro arohaehae, tae atu ki te ārahi i te wā ako motuhake. -rangahau. E whakaatu ana ngā hua o tēnei rangahau i muri i te 4 wiki o te whakangungu, he nui ake ngā kaute ako motuhake me te whakaaroaro arohaehae o ngā ākonga nēhi i roto i te rōpū wawaotanga i ērā i roto i te rōpū whakahaere (e rua p < 0.001). He rite tēnei ki ngā hua o te rangahau a Fan Xiaoying mō te pānga o te CDIO me te tikanga whakaako CBL i roto i te mātauranga nēhi [25]. Ka taea e tēnei tikanga whakangungu te whakapai ake i ngā pūkenga whakaaroaro arohaehae me te ako motuhake o ngā ākonga. I te wā o te whakaaro, ka whakapuaki tuatahi te kaiako i ngā āhuatanga uaua ki ngā ākonga nēhi i roto i te akomanga. Kātahi ka ako takitahi ngā ākonga nēhi i ngā mōhiohio e tika ana mā roto i ngā ataata kōrero poto, ā, ka rapu kaha i ngā rauemi e tika ana hei whakarei ake i tō rātou māramatanga ki te umanga nēhi wheua. I te wā o te hoahoa, i whakaharatau ngā ākonga nēhi i ngā pūkenga mahi tahi me te whakaaroaro arohaehae mā roto i ngā kōrero ā-rōpū, me te ārahi a ngā kaiako me te whakamahi i ngā rangahau take. I te wā whakatinanatanga, ka titiro ngā kaiako ki te tiaki i ngā mate tūturu i te wā e pokanga ana hei whai wāhitanga, ā, ka whakamahi i ngā tikanga whakaako whakatauira take hei whakaako i ngā ākonga nēhi ki te whakahaere i ngā mahi take i roto i te mahi tahi a te rōpū kia mōhio ai rātou ki ngā raruraru o te mahi nēhi me te kite. I taua wā anō, mā te whakaako i ngā take tūturu, ka taea e ngā ākonga nēhi te ako i ngā āhuatanga matua o te tiaki i mua i te pokanga me muri i te pokanga kia mārama ai rātou he mea nui ngā āhuatanga katoa o te tiaki i muri i te pokanga ki te whakaora i te tūroro i muri i te pokanga. I te taumata whakahaere, ka āwhina ngā kaiako i ngā ākonga hauora ki te ako i ngā ariā me ngā pūkenga i roto i te mahi. I te mahi pera, ka ako rātou ki te mātakitaki i ngā huringa o ngā āhuatanga i roto i ngā take tūturu, ki te whakaaro mō ngā raruraru ka taea, kaua hoki e maumahara ki ngā tikanga nēhi rerekē hei āwhina i ngā ākonga hauora. Ko te tukanga hanga me te whakatinanatanga e whakakotahi ana i ngā ihirangi o te whakangungu. I roto i tēnei tukanga ako mahi tahi, taunekeneke, me te wheako, ka tino whakaohokia te kaha ako whaiaro me te hihiri o ngā ākonga nēhi ki te ako, ā, ka whakapaitia hoki ō rātou pūkenga whakaaroaro arohaehae. I whakamahia e ngā kairangahau te Whakaaro Hoahoa (DT)-Whakaaro-Hoahoa-Whakatinana-Whakahaere (CDIO)) hei whakauru i tētahi anga hoahoa hangarau ki ngā akoranga hōtaka tukutuku e tukuna ana hei whakapai ake i te mahi mātauranga me ngā pūkenga whakaaro rorohiko (CT) a ngā ākonga, ā, e whakaatu ana ngā hua, kua tino pai ake te mahi mātauranga me ngā pūkenga whakaaro rorohiko a ngā ākonga [26].
Mā tēnei rangahau ka āwhina i ngā ākonga nēhi ki te whai wāhi atu ki te tukanga katoa e ai ki te tukanga Pātai-Ariā-Hoahoa-Whakatinanatanga-Mahi-Whakamārama. Kua whakawhanakehia ngā āhuatanga haumanu. Ko te arotahi ko te mahi tahi a te rōpū me te whakaaro motuhake, me te tautoko a te kaiako i ngā pātai, ngā ākonga e whakaaro ana i ngā otinga ki ngā raruraru, te kohikohi raraunga, ngā mahi whakaari, ā, i te mutunga ko ngā mahi moenga. I whakaatu ngā hua o te rangahau he pai ake ngā kaute o ngā ākonga hauora i roto i te rōpū wawaotanga mō te aromatawai i te mōhiotanga ariā me ngā pūkenga whakahaere i ērā o ngā ākonga i roto i te rōpū whakahaere, ā, he rerekētanga nui te tatauranga (p < 0.001). He rite tēnei ki te meka he pai ake ngā hua o ngā ākonga hauora i roto i te rōpū wawaotanga mō te aromatawai i te mōhiotanga ariā me ngā pūkenga whakahaere. Ki te whakatauritea ki te rōpū whakahaere, he rerekētanga nui te tatauranga (p <0.001). I honoa ki ngā hua rangahau e tika ana [27, 28]. Ko te take o te tātaritanga ko te tauira CDIO e tīpako tuatahi ana i ngā tohu mōhiotanga mate me ngā reiti tūponotanga teitei ake, ā, tuarua, ko te uaua o ngā tautuhinga kaupapa e ōrite ana ki te turanga. I tēnei tauira, i muri i te whakaotinga a ngā ākonga i ngā kaupapa mahi, ka whakaotihia e rātou te pukapuka mahi kaupapa ina hiahiatia, ka whakahoutia ngā kaupapa e tika ana, ā, ka matapakihia ngā mahi me ngā mema o te rōpū hei keri me te whakauru i ngā kaupapa ako me te whakakotahi i ngā mātauranga me ngā akoranga hou. Ka pai ake te whakauru mātauranga.
E whakaatu ana tēnei rangahau, mā te whakamahi i te tauira ako haumanu CDIO, he pai ake ngā ākonga nēhi i roto i te rōpū wawaotanga i ngā ākonga nēhi i roto i te rōpū whakahaere i te whakahaere i ngā kōrerorero nēhi, ngā whakamātautau tinana, te whakatau i ngā tātaritanga nēhi, te whakatinana i ngā wawaotanga nēhi, me te tiaki nēhi. ngā hua. me te tiaki tangata. Hei tāpiri, he rerekētanga nui te tatauranga i roto i ia tawhā i waenga i ngā rōpū e rua (p < 0.05), he rite ki ngā hua o Hongyun [29]. I ako a Zhou Tong [21] i te pānga o te whakamahi i te tauira whakaako Ariā-Hoahoa-Whakatinana-Whakahaere (CDIO) i roto i te mahi haumanu o te whakaako nēhi ngakau, ā, i kitea e waru ngā tawhā, pērā i te kaha nēhi me te ngākau pono, he pai ake i ērā o ngā ākonga nēhi e whakamahi ana i ngā tikanga whakaako tuku iho. Tērā pea nā te mea i roto i te tukanga ako, kāore ngā ākonga nēhi e whakaae noa ki te mātauranga, engari e whakamahi ana i ō rātou ake pūkenga. Ka whiwhi mātauranga ngā mema o te tīma i roto i ngā huarahi rerekē. Ka tukuna katoatia e ngā mema o te tīma ō rātou wairua tīma, ka whakauruhia ngā rauemi ako, ā, ka ripoata tonu, ka mahi, ka tātari, ka matapaki hoki i ngā take nēhi haumanu o nāianei. Ka whanake ō rātou mātauranga mai i te papaku ki te hōhonu, ka aro nui atu ki ngā kaupapa motuhake o te tātari take. ngā raruraru hauora, te whakatakoto whāinga nēhi me te whaihua o ngā wawaotanga nēhi. Ka whakaratohia e ngā kaiako he aratohu me te whakaaturanga i roto i ngā kōrero hei hanga i tētahi whakaoho huringa o te tirohanga-mahi-urupare, hei āwhina i ngā ākonga nēhi ki te whakaoti i tētahi tukanga ako whai tikanga, hei whakapai ake i ngā pūkenga mahi haumanu a ngā ākonga nēhi, hei whakarei ake i te hiahia ako me te whai huatanga, me te whakapai tonu i te mahi haumanu ākonga – ngā nēhi. . te pūkenga. Te kaha ki te ako mai i te ariā ki te mahi, hei whakaoti i te whakauru i te mātauranga.
Mā te whakatinanatanga o ngā kaupapa mātauranga haumanu e ahu mai ana i te CDIO ka whakapai ake i te kounga o te mātauranga haumanu. E whakaatu ana ngā hua rangahau a Ding Jinxia [30] me ētahi atu he hononga kei waenganui i ngā āhuatanga maha pēnei i te hihiri ako, te kaha ako takitahi, me te whanonga whakaako whai hua a ngā kaiako haumanu. I roto i tēnei rangahau, me te whanaketanga o te whakaako haumanu CDIO, i whiwhi ngā kaiako haumanu i te whakangungu ngaio kua whakarei ake, ngā ariā whakaako hou, me ngā pūkenga whakaako kua whakapai ake. Tuarua, ka whakarei ake i ngā tauira whakaako haumanu me ngā ihirangi mātauranga nēhi ngakau, ka whakaata i te raupapa me te mahi o te tauira whakaako mai i te tirohanga whānui, ā, ka whakatairanga i te māramatanga me te pupuri a ngā ākonga i ngā ihirangi akoranga. Ka taea e ngā urupare i muri i ia kauhau te whakatairanga i te mōhiotanga ki a rātou anō o ngā kaiako haumanu, te whakatenatena i ngā kaiako haumanu ki te whakaaroaro ki ō rātou ake pūkenga, taumata ngaio me ngā āhuatanga tangata, te tino mohio ki te ako a ngā hoa, me te whakapai ake i te kounga o te whakaako haumanu. I whakaatuhia e ngā hua he pai ake te kounga whakaako a ngā kaiako haumanu i roto i te rōpū wawaotanga i tērā i roto i te rōpū whakahaere, he rite ki ngā hua o te rangahau a Xiong Haiyang [31].
Ahakoa he mea nui ngā hua o tēnei rangahau mō te whakaakoranga haumanu, he maha tonu ngā herenga o tā mātou rangahau. Tuatahi, ko te whakamahinga o te tauira watea ka whakawhāiti pea i te whānui o ēnei kitenga, ā, i whakawhāitihia tā mātou tauira ki tētahi hōhipera tiaki tuatoru. Tuarua, e 4 wiki noa iho te roa o te whakangungu, ā, me nui ake te wā e hiahiatia ana e ngā nēhi mahi whakangungu hei whakawhanake i ngā pūkenga whakaaroaro arohaehae. Tuatoru, i roto i tēnei rangahau, ko ngā tūroro i whakamahia i roto i te Mini-CEX he tūroro tūturu kāore i te whakangungu, ā, ko te kounga o te mahi akoranga a ngā nēhi whakangungu ka rerekē pea i ia tūroro ki ia tūroro. Koinei ngā take matua e whakawhāiti ana i ngā hua o tēnei rangahau. Me whakawhānui ake ngā rangahau ā muri ake nei i te rahi o te tauira, me whakanui ake i te whakangungu o ngā kaiwhakaako haumanu, me te whakakotahi i ngā paerewa mō te whakawhanake i ngā rangahau take. Me whai rangahau roa hoki hei tirotiro mēnā ka taea e te akomanga hurihuri i runga i te ariā CDIO te whakawhanake i ngā pūkenga whānui o ngā ākonga hauora i roto i te wā roa.
I whakawhanakehia e tēnei rangahau te tauira CDIO i roto i te hoahoa akoranga mō ngā ākonga nēhi wheua, i hangaia he akomanga hurihuri i runga i te ariā CDIO, ā, i whakakotahihia ki te tauira aromatawai mini-CEX. E whakaatu ana ngā hua kāore te akomanga hurihuri i runga i te ariā CDIO i te whakapai ake i te kounga o te whakaakoranga haumanu anake, engari ka whakapai ake hoki i te kaha ako motuhake a ngā ākonga, te whakaaro nui, me te kaha mahi haumanu. He pono ake, he whai hua ake hoki tēnei tikanga whakaako i ngā kauhau tuku iho. Ka taea te whakatau ko ngā hua ka pā ki te mātauranga hauora. Ko te akomanga hurihuri, i runga i te ariā CDIO, e arotahi ana ki te whakaako, te ako me ngā mahi mahi, ā, e hono tata ana i te whakakotahitanga o te mātauranga ngaio me te whakawhanaketanga o ngā pūkenga mahi hei whakarite i ngā ākonga mō te mahi haumanu. I te mea he mea nui te whakarato i te whai wāhitanga ki ngā ākonga ki te whai wāhi kaha ki te ako me te mahi, me te whakaaro ki ngā āhuatanga katoa, e whakaarohia ana kia whakamahia he tauira ako haumanu i runga i te CDIO i roto i te mātauranga hauora. Ka taea hoki te taunaki i tēnei huarahi hei huarahi auaha, e aro ana ki te ākonga ki te whakaakoranga haumanu. Hei tāpiri, ka tino whai hua ngā kitenga ki ngā kaihanga kaupapa here me ngā kaipūtaiao i te wā e whakawhanake ana i ngā rautaki hei whakapai ake i te mātauranga hauora.
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