khdng cd y nghTa thdng kd giu'a 3 nhdm cd tai lupng VI rut khdc nhau.
- Ndng do Bilimbin TP: Ndng dp Bilimbin todn phan tang cao >10 lan gap da so (54,5%) b nhdm cd tal lupng vi nit tmng binh (10^- <10* copies/ml) cao hon so vdi cdc nhom cdn lai. Su khac biet cd y nghTa thong ke vdi p<0.05.
- Ty le Prothrombin: Khdng ed sU khac bidt vd cac miic dd giam t j Id Prothrombin g\ija dc nhdm eo tai lupng vi nit khdc nhau
TAI Ll|U THAM K H A O
1. E)dng Thj Hodi An, Pham Thj Thu Hd vd cong su (2009)" Su lidn quan cia kiiu gan virus vidm gan B vdi cac dang lim sing cda vidm gan B " Tap chf gan mdt Viet Nam,'sd9-2009,tr.5-15,
2. VUOng Phiic Dudng (2009)" Nghidn ciru kiiu gen virus vidm gan B vi Sm hiiu mil Hdn quan cOa chung vdi mdt so chf si cin lim sing d binh nhin vidm gan B man hoat ddn^' Luan vdn bae sy chuydn khoa 2, Hoc vien quan y- Vien NCKH y duoc idm sang 108, Ha Noi.
3. Le Thj Ngoc Lan, Pham .iu hiiu md li&n quan giifa HBsAg va ciri.
Y hpc thanh pho Ho Chf Minh, tap 7, Ir i' 4. Binh Oilc Thang(2009)" Vm hiSu •'' ••.
lim sing, cin lim sing a bdnh nhin vidm y -, hoat ddng cd HBeAg(+) vi HBeAg(-y Luan v. . chuyen khoa 2, Hpc vien quan y- Vien NCKH y (JLKJ.
sang 108, Ha Ndi
5. Behnava B., Assari Set al (2005), -HBV-DNA viral load and chronic hepatitis infection In different slagu".
Hepatitis Monthly, 5(4), pp.123-127.
6 Chu C.J, Hussain M. Lok A.S.F, (2002),
"Quantitative serum HBV-DNA levels dunng different stage of chronic hepatitis B infection", J of hepal, 36 (6), pp.1408-1415
7. Dienstag J.L (2008), "Chronic viral hepatitis"
Hamson s principles of internal medicine, 17"" edition, pp.1955-1971.
8. Dusheiko G.M. (2007). "Hepatitis fl". Text book of hepatology, Third edilon, pp. 865 - 875
KET QUA AP DUNG PHiniNG PHAP GIANG DAY DUA TREN V A N DE (PBL)
VA P H U U N G P H A P G I A N G DAY DU'A T R I N TiNH HUONG (SBL)TAI TRUlCrNG DAI HOC Y TE CONG CONG
TOM T A T
Ning cao chit luang dio tao li mdt trong nhOng uu tien hang diu cda TrUdng DH Y te cdng cdng. Vdi su hd trd ky thuit vi til chinh cOa cic chuyen gia quoc ti, Trudng DH Y ti cdng cdng da triin khai thi diim phuang phip giang day PBL va SBL so mdn hgc trong chuong trinh dio tao tit nim 2008. Bii bio niy nhim md ti qui trinh triin khai vi dinh gii tinh phu hdp cOa viec ip dung phuang phip PBL vi SBL trong giang day tai TrUdng DH Y ti cdng cdng. Doi tuang va phuang phip: Bii bao niy trich tif kit qui cia 2 nghien citu dt ngang, sit dung kit hdp phliu tu didn vi thio luin nhim hpc viin, giing vien true tiep tham gia vio dc mdn hoc ip dung phuang phip PBL vi SBL tai tnJdng YTCC. Kit qui cho thay, tit nim 2008, TnJdng DH YTCC da ip dung phuang phap PBL cho 7 mdn hgc, trong dd cd 6 mdn tuchon cho ThS YTCC vi 1 mdn t)it budc cho cit nhan YTCC. Sau 1 nim triin khai, PBL bdc Id nhOng diim han chi khi ip dung trdn didn rdng vdi nguin luc hi$n cd cQa nhi trudng. Chinh vi viy, Trudng DH YTCC vin Up tuc duy tri triin khai PBL cho 6 mdn tu chgn cho ThS YTCC. nhimg da chuyin hudng ip dung phuang phip SBL trdn didn ring han. Da si hoc vidn va giing viin dinh gii la PBL vi SBL phi hop vi rit phd hdp, vi c^ hai phuang phap niy diu phit huy tinh chCi ddng cOa hpc vien, ting cudng ky ning lam viic nhdm, chia si kinh nghiem trong nhdm khien cho hgc vien hiiu bai ky hon. Kit luin vi khuyin nghi: Trong bii dnh nguin
NGUVeN THANH HA, BUI TH! THU HA, HA VAN NHU, L^ THj THANH HaONG Tru&ng dai hgc Y tecdng c0ng luc hidn cd cOa trudng YTCC. PBL tuang doi phii hdp hon vdi cac mdn tu chon trong chudng trinh dio tao thac sT, cdn SBL phii hdp hdn vdi chuang trinh dio tao cO nhin. Di tdng tinh hieu qui ciia hai phuang phap giang day niy, cac nha quan ly cin dn nhic nguin luc thuc ti cung nhu lua chon mdn hpc phu hop di ip dung.
Tirkhda: Phuang phip giang day dua trin vin di (PBL), phuang phip giang day dua tren tinh huing (SBL), chuang trinh dio tao y ticdng cdng.
SUMMARY
Improve the quality of education is the first priority at Ha Noi school of Public health (HSPH). PBL and SBL teaching method has been applied as a pilc^ in a number of subjects in HSPH since 2009 with technical and financial support of intemational experts.
Objective: This paper brief describes the implementation process and assess the suitat^lity of PBL and SLB in training programs of HSPH. Sttudy subject and methodology: A cross-sec^onal study, txjmbining self-administrative questionnaire and focus group discussion was conducted with students and /ecftjrers who participate in subjects applied PBL and SBL at HSPH. Results: PBL method has been applied for seven subjects which includes six selective subjet^s ofMPH and one compulsory subjects of BPH training program at HSPH since 2008. After one year Implementing. PBL has shown some limitation when applied in larger s(x>pe with existing resources of HSPH. Therefore, PBL has been continuously applied
Y HOC THVC HANH (843) - S6 10/2012
for 6 selective subjects and parallel with shift to SLB in extension number of other subjects. Most of students and lecturers agreed that PBL and SBL method is suitable with applied subjects, because these methods helps students more positive and initiative in studying, strengthen team-work skills, share rxpimonces and help them cleariy understand the studying contents.
Conclusion: PBL seem to be more appropriate for selective subjects of MPH program and SBL is more appQpiate for in existing HSPH resoumes. To Increase effect of these methods, the education managers should concern the reality resources as well as select suitable subjects to apply.
Keywords: Problem based learning (PBL), Scenario based learning (SBL). public health training program.
D A T VAN 0 ^
Trong xu thd ddi mdi phuong phdp gl^ng day dai hoc theo hudng Idy ngudi hoe lam trung tdm, phuong phap day hoe dua trdn van dd (PBL) vd phuong phdp giang day dUa tren tinh hudng (SBL) dang dupe cdc ndn gido due dai hoc b nhidu nude quan tam nghiSn cUu vd Ung dung. Kha ndng hoe tdp chu ddng, tu hoc tap vd tu nghidn cUu cua sd ddng sinh vidn Vidt Nam cdn han chd Id mdt thdeh thUc ddi vdi ddo tao dai hpc ciia Viet Nam nen vide nghidn eUu dp dung cdc phuong phap hoc tdp tich cue Id mdt ydu edu quan trong hien nay, "PBL li mdt phuang phip day-hgc cd ddc diim la sOdung vin di lim bii dnh cho vide hoc tip liy sinh viin lim trung tim" [1] cdn "SBL li phuang phap giup ngudi hpc duac tUp xuc vdi m^t tinh huing trdn thuc ti va yiu du ngudi hoc thuc hinh dc ky ndng liin quan di giii quyit tinh huing dd" [2]. Nhldu bao edo nghien cUu ddnh gid eao hieu qua ctia phuong phdp hoc tap ndy, ddc biet Id hidu qua trong viee giup cho sinh vien thuc sii tdng cudng kha nang tu hpc vd lam viee nhom,
Ddi mdi phuong phap giang day la mdt trong nhOng ndi dung trong tdm trong chidn lupc ndng eao chdt lupng ddo tao cOa TmPng DH YTCC trong nhieu ndm qua, ddc bidt Id giai doan 2005 - 2010. Chinh vi vdy, Trudng OH YTCC da tang cudng dp dung cdc phuong phdp giang day tieh cue. trong dd phi/Ong phap PBL dupc dp dung tit ndm 2008 vd phuong phdp SBL dupe dp dung t u ndm 2009.
Bdi bdo nay nham md tS lai qud trinh xdy dung vd dp dung phuong phap giSng day PBL vd SBL tai trudng DH YTCC cQng nhu ddnh gia tinh phii hpp cOa hai phuong phdp ndy vdi cdc chuong trinh ddo tao ciia DH YTCC.
D 6 | Tl/pNG vA PHUONG P H A P
Bdi t)ao nay dupc trich tit kdt qua cLja 2 nghidn cCru eat ngang tai TruOng D H Y T C C n d m 5/2008 va 6/2010 trdn tdt ca hoc vidn va giang vidn/trp giang tham gia cdc mdn hpc ed dp dung PBL v d SBL. Cdc nghidn cUu ndy da sCT dung phuong phdp nghidn citu dinh luong ket hpp vdi ^ n h tinh.
Nghien cUu ^ n h lupng dupc tidn hanh trdn todn b d SV da ^ a m gia cac mdn hpc ap dung PBL v d S B L bSng cdeh trS Idi b d cdu h6i tui\6n.'Cac cdu h6i chU trpng vdo cac v d n d d sau: (1) q u d trinh c h u l n bi v d
tridn khai cCia phuong phdp; (2)mijrc d d phu hpp ciia phuong phdp ( s u thich thd vdi mdn hpc. tich cub tham gia thlio ludn, tfnh chCi d d n g hpc tap, vd Idm vide nhdm); (3) khuydn nghj mO rdng phUOng phdp giirig day ndy. Tdt c d cdc edu trd Idi dupc s^ dung thang do LIkert tU 1-5, vdi mUc d d dao ddng tU rdt tdt tdi rSt khdng tdt.
Nghidn c i ^ dmh tinh dupe dp d y n g vdi cdc cudc thSo ludn nhdm vdi hoc vidn vd gidng vidn cQng dupc tidn hanh v d cdc chQ d d n h U q u d trinh chudn bi ctio mdn hpc, tai lidu, q u d trinh giang day ciing nhu nhin nhdn ciia hpc vidn vd vide m d rdng hinh thUc ddo tao ndy.
Chi tidt v d ddi tupng tham gia trong 2 nghien c(lu dupc trinh bdy trong b^ng dudi ddy:
Bdng 1. Ddi tupng tham gia nghidn cijfu Dditugnfl
Phidu phat vdn 11/difin (viitsinhvien/hocvifin) ThSoluannh6mslnhvien Thjki lufln nii6m gi^ng vifin Cdc tdi Wfyi Ii6n quan ddn qud Irinh chuln ii
va tri^n khai
390/454'
• Ting si phliu nhin dupc trin ting si phliu gSI tf Sd lidu dinh lupng dupe nhdp bang Epi-data va phdn tfcti bSng phdn mdm SPSS. Bdng ghi am cac cudc thSo ludn nhdm vdi hpc vidn dupc gd vd phan ticii, tdng hpp theo cac ehu de nghidn ciru. Tat ca cac ddi tupng tham gia nghien cUu tren t'nh thdn tu nguydn vd duoc giiJr bf mat danh tinh de dam bao b'nh khach quan ciia thdng tin.
K^'T QUA VA BAN LUAN
1. Qud trinh chuan bj, trien khai PBL va SBL 01 theo xu the ddi mdi phuong phdp giang day, Idy ngudi hoc lam tmng tdm, TmPng OH Y te cdng cdng vdi su h6 tro ky thudt tUcdc chuyen gia nuOc ngodi (Ha Lan, Indonexia, ue) vd hd trO tdi chinh tUDai SCf quan Hodng gia Hd Lan da trien khai cdc phut^g phap giang day tich cue mdi.
Thdng 5, ndm 2007. bat dau tU viec ct!r mot nhdm giang vidn dai dien cho cdc bd mdn ciia nhd tnJdng tham du khda tdp hudn dUdc thidt kd rieng cho tnJdng DH YTCC vd PBL tai DH Gadja Ivlada (Yog Jakarta, Indonesia) - Id noi dp dung ri5ng rai phUOng phdp PBL vdi su h6 trp ciia 2 giang vidn ddn til OH Matrix (Ha Lan)- Id nOi PBL Idn ddu tidn dupc ra ddi. Sau khi ^ vd, cdc giang vidn da bien soan tdi hdu vd md Idp ddo tao cho tdt ca giang vien, trp giang ciia Tmdng. Tiep theo dd, trudng cung da mdi chuydn gia tuvdn co nhidu kinh nghidm tU Hd Lan vd Indonesia tdi giang day nhCmg khda ddo tao ngdn han cung nhu tU vdn tnic tidp cho cdc bd mdn nhSm giiip cac bd mdn xay dung dd cuong mdn hpc, tdi lidu hpc tap cQng nhir cdc ky ndng giang day. Cdc bp mdn da thud hi§n xay dung tdi lidu hpc tap theo diing qui trinh vd tuan thii diing nhCmg qui djnh ciia Tmdng vd tai lidu giang day.
Tat oil tdi lidu giang day deu dupc giJrt tcri cdc giang vien cd nhidu kinh ngliiem de xin y kien phan bidn sau d6 gili tdi Hdi ddng khoa hoc vd dao tao (HDKHOT) ciia TrUdng.
Y HOC THUC HANH (843) - S610/2012
Sau hon mdt nam chuan bi tich cue vdi su dau tu thieh ddng vd tlidi gian, nhan lUc va kinh phi, 7 bp mdn dupc lua chpn da xdy dung dupe bd tdi tieu hoe tap dUa tren van de cho 7 mdn hoe: Dinh du9ng-An todn ve sinh thUC pham; SUc khoe nghe nghiep; Phdng chdng HIV/AIDS; Tidp thi xa hpi; Chdm sdc sUc khoe ba me tre em (CSSKBMTE); Phdng chdng chd'n thuong vd mdn Benh thdng thudng,
Phuong phap PBL ddi hoi sinh vidn phai dupc chia thdnh eae nhdm nho (10-12 SV/nhdm) vdi sU hudng ddn eCia 1 giang vien vd 1 trp giang trong cac phdng hpc rieng, VI vay, nha truOng nhdn thdy PBL chua thuc sU phu hpp vdi bdi eanh ngudn lUC iiidn cd cua nha tnjPng, nen trong nam hpc 2008-2000, chi cd 6 mdn
hoe tu chon trong chuong trinh d.
lan dau tien da ap dung.
Khdng dUng lai b do, nham tiep tu.
mdl phuong phap ddo tao, duOc su hd no gia Oc, nha tnJdng lai ddu tu cho viec ap i;i trong eac chUdng trinh dao Iao ciia nha trUdm] -J. •/.
tiep tuc duy tri PBL cho 6 mon hoc da tnen klini irisdt.
36. Do ddc thu ciia phuong phap SBL linh hoat hOn, cho phep 1 giang vidn cd the lam viec vdi nhieu nhom SV Cling mot liic nen sau 1 ndm chuan bi, nSm hoc 2009-2010, 15 mdn hoc da ap dung phUdng phap SBL. Ndm tidp theo, da co tdng cdng 22 mon hoc ap dung phuong phap ndy vd tiep tue duy tri cho den nay Tdm tat qua trinh chuan bj vd tnen khai PBL va SBL dupe tdm tat trong hinh dUdi ddy:
T$p 111)in. hOi thdo cho c ^ bO cia cfic b(f m6n vfl PBL, SBL
Xdy di/ng tinh hu6ng vA tdi li^u ddnh cho gidng v\&r\ vd
ng\r&\ hoc
Chinh si>a tdi li$u, phifoing phdp dp dgng
Ap dgng chinh thCpc Ddnh gid
1
HOi t h i o chia se kinh nghi$m
i
Chinh sira tdi li^u, phu-crng phdp dp dgng
Hinh 1. T6m t ^ qui trinh chu^n bj v i triln khai ip dung PBL vd SBL tai tnAng DH YTCC Sau 3 nam trien khai, hien tai da cd 6 mdn hpc
trong chuOng trinh thac sT YTCC dp dung phuong phap PBL; 22 mdn hpc trong ehuOng trinh cCf nhdn. thac sT YTCC vd Quan ly bdnh vidn dp dung phuong phdp SBL. Tat ca cdc mdn hpc dp dung hai phuong phdp giang day ndy ddu xuat ban dUOc cdc cudn tai lidu hudng ddn giang vidn vd hudng d i n sinh vidn tao dieu kidn thuan I d trang qua trinh hoc tdp. Nhd truOng cQng da td chCtc hdi thao cQng nhu eliia se kinh nghidm cQng nhu chia se cac tdi lieu giang day vdi hd thdng cac Trudng Dai hpc Y tren cS nudc. Trong nhiing ndm hpc
tidp theo. Tmdng Dai hpe Y te cdng cdng se tidp tuc ap dung va hoan thidn phuong phdp l=BL vd SBL, sSn sang chia se vdi cae eo sd ddo tao trang vd ngodi nudc kinh nghiem ciia Tnidng nham gdp phin tfch c u t vdo vide ndng eao chdt lupng ddo tao nhdn lUC y td ndi Chung vd Y te cdng cdng ndi ridng.
2. Ddnh gia sir phu hpp cua phuong phdp PBL va SBL vdi cac chuong trinh ddo t^o cua nha trudng:
2.1. Si/phO hpp cua PBL vi SBL t§l TrUdng DH YTCC
Y HOG THirc H A N H (843) - s610/2012
Viec dp dung PBL v.: i J.i lam phong phU thdm phuong phap giang il.iy ' • ' 'hum lUa chpn cho gi^ng vien va da c6 tac dnim • • i nlian dupc nhiing ph^n hoi tich cue tu phia giatiuvK ii cung nhUnguOihoe, Kdt qua bieu do 1 cho IhJy da so hoc vidn ddnh gid phuong phdp PBL v.i SBL la "rat phu hop" vd "phu hop" vdi mon hoc (lan ludt la 78,1% vd 72,0%),
SBL
PBL
_ 1 ^ 1 20.5 \ E^HH^^H
7.A
21.9 1
20% 40% 60%
• R^t phu hqrp n luong dAi phu hiyp
• Phu hffp O Khftng phij hgfp Bleu 661. Ddnh gii cua sinh vl6n v6 sUphii hop ciia 2 phUtfng
phip PBL v4 SBL
Ddi vdi ngudi hpc, tac dung ndi bdt Id PBL vd SBL Id kich thich sU chii ddng hpc tap cua sinh vidn, tang cudng kha nang hpc tap, nghien cUu doc lap. Nhieu smh vien vd giang vien danh gia cao phuong phap hpc tap nay. Ket q u i tU thao luan nhdm cho thdy"P/iuan0 phap PBL ri't li khuyen khich moi ngudi chCi ddng hoc va di thithai nua li nd giup cho ngudi ta nhd dupc liu dc van de. Titc la tu tim tii lieu, tu doc thi minh se nhd liu dupc hdn"; SBL da giup cho sinh vien chii ddng vd hoe tap tich cue hon "Day la phuang phip giing day hay, tao cho hpc vidn tinh chu ddng trong hpc tip han rit nhidu so vdi phuang phap hpc truyin thing..."
Odi vdi giang vidn, vide ap dung PBL va SBL Id cO hdi hpc tdp ndng eao kidn thUc vd ky ndng dp dung phuong phdp giang day tich cue ddng thdi ciing ddi hdi giang vien phai vdn ddng, sang tao trong lua chpn dp dung phuong phdp giang day khdc nhau phii hpp vdi mdn hpc va vdi tUng ddi tupng ngudi hpc. Giang vien cung cd nhdn xdt la ho cd nhidu ddng luc giang day hon khi md nhieu hoc vidn cd hUng thu vdi phuong phap PBL "... Chung tdi cung thiy hUng khdi han khi ma hpc dc hpc viin thi ho cung diu nil li hp rit hOng thu vdi phuang phip niy"
Mae du PBL va SBL la 2 phuOng phdp gidng day cd cdeh tidp cdn khdc nhau nhurig ddu h6 trp ngudi hpc rdn luydn nhidu ky nang. Bidu dd 2 du6i ddy eho thay, da sd hpc vidn khJing <^nh phuOng phdp PBL vd SBL hd trp b mile tdt vd rdt tot cho mdt sd ky ndng hpe tap nhu tdng cudng kha ndng hpc cliii ddng, tao didu kien tdt eho thao ludn nhdm, tdng cudng ky ndng Idm viec nhdm vd hidu ro npi dung hpc hdn.
Bl^u dd 2, Dinh gii ciia hi?c vlSn v l sir h6 tr? "rft tdt vi tfif" cda PBL vi SBL trong mdt sd hoat d6ng hpc tip Kdt qud thdo ludn nhdm eijng cho thdy phurnig phdp PBL ed tdc dung tich cue trong vide phat huy tinh chii ddng eua hpe vidn trong doe tdi lidu vd phan licii vdn dd. Ben eanh do giup cho hoc vidn rdn luydn ky ndng Idm vide nhdm, dae bidt la ky nang dieu hdnhcila trudng nhdm vd thu kf,
"Thuc ra thi di niy (phuong phip PBL) rit la khuyin khich mpl ngudi chu ddng hpc vi cii thif iiai nOa li nd giup cho ngudi ta nhd dUOc liu dc vir] dS.
TOC li tu tim tii lidu, tu doc thi minh si nhd liu duoc hdn" (M_TLNSKNN).
Ben eanh tae dung tdng cudng tinh chii ddng, viec giang day PBL edn phat huy tinh than Idm vide nhdm tdt hon. Hoc vidn phai eung chia se nhiem vu hoctdpd budc 6 khi tim kidm tdi hdu tra Idi cho cac muc tieu hoc tap vd chia se kinh nghiem giCfa cdc hpc vien,
".. .hoc theo phuang phap PBL niy ndi chung li rS tit tai vi li nhitng cii muc tidu cOa bii hpc lido cac hpc vidn tudi ra.... Cai thit hai nOa li di min nay thi nd trao dSi duac di kinh nghidm giOa dc hpc viin vdi nhau, mdi ngtk^ cd mdt kinh nghidm khic nhau vi mOt di dch lam viic khac nhau. kiin thdc khic nhau niit trao dii duac nhiJng y kiin giOa dc hpc win WHC n/iau.''(M_fLNSKNN)
Hoc tap bang phuong phdp SBL mang lai cho hoc vien vd sinh vidn su tu tin, bao quat vd tdng t'nh diii ddng trong hpc tdp vd trang cong \nec. Cdc tinh hu5ng SBL dupc xdy dung gdn rdt ehdt vdi thuc ben cdng tac cung nhu chUc ndng. nhidm vu ciia hpc vien va sinh vien khi ra tnJdng, do vdy da giup eho hp, ddc biet 1^
cdc smh vidn ei> nhdn mudng tupng dupc cdng viec ho se phai tndn khai trong tuong lai, chudn bj cho ho nhijfng kidn thCiC vd ky ndng can thidt dd cd flii flng phd dupe vdi thuc td cdng viec sau ndy. Rat nhieu 1^
ndng quan trpng ciia nganh y te edng cdng cd cd t ^ dupc cdc hpc vien vd sinh vien ren rua va phat trien trang qua trinh Idm vide nhdm va trinh t>ay, vidt bao edo SBL,
'Em cung cd y kiin la hinh thOC hpc SBL nay se ting cho chitng em hgc chO ddng han a. Bpn em se difi trin vin di diy bon em si tim hiiu nhOng virt de xung quanh 9. TOC li giing mit vin di, bo em cd the tim hiiu dc thing tin vi nd. tir diy thi bai em cdm xiy dung ra mH di bin di bpn em bio do iy ?• ^ ' em thiy khi ning hgc chO ding cda bpn em se dtfiX khuyin khich han ^. Thi theo em li ndn hgc theo SBL
Y HOC THlJC HANH (843) - s 6 10/2012
han li hpc thu d^ng nhutnJdc diy a" (Thio luan nhdm c&nhin - mdn Tiip thi xi hpi).
Hoic: "Niu mi minh cd tinh huing minh lim thi nd s§ nhd vi sau dd minh vi bdnh vidn cd thi vin dung se lit hdn. Diy li cii uu diim" (Thio lu$n nhdm cao hgc Quin ty bdnh vidn - mdn Quin ly chit luang b$nh vi^n).
Khi dupc hoi ed ndn md rdng dp dung phuong phap PBL va SBL hay khdng, cdc kdt qua djnh luong vd dinh tinh kha tuong ddng Id nen md rpng ca 2 phuong phdp ndy. Vdi phuong phdp PBL, hoc vidn cho rdng cho rang nen md rdng ap dung PBL cho cdc mdn hoc khae ciia chuong trinh dao tao thac sy Y td cdng cdng (YTCC) ndu so lupng giang viSn cQa cae mdn hoc eung nhU cO sd vdt chdt nha tnJdng eho phep, nhung chi chpn vdi nhiing mdn hpc phii hop, Mdt sd If do duoc hoc vien ndu Idn Id 'dc mdn hpc ca bin rit khd ip dung": "Md si min cd kiin thOc chuydn siu thi phuang phip PBL khd dat dugc"^. 'Thu viin chua cd nhiiu tii liiu tham khio"; °Thi^ gian dinh cho mdn hpc
Bllu d6 3. Khi ning md r$ng ip dung phuong phip PBL v i SBL Cdn vdi phuong phap SBL, kdt qua thao ludn nhdm vdi sinh vien cho thay tat ca smh vien ddu cho rang phuong phdp SBL ed nhieu uu diem va nen dupc dp dung cl nhidu mdn hoc khac nhau. "TTieo (6/ thi phuang phip SBL niy ip dung cho dupc nhi4u mdn khic van dung thuc ti" 'nhu kinh ti y ti, chinh sich y te"
(FGD_MS_QLBV). Tuy nhien smh vidn eho rang khdng ndn dp dung phuong phap ndy ddi vdi mdt sd mdn hpc nhu Djch td. Thdng ke, Phuong phdp nghien cUu khoa hoc. "Em nghT dc mdn xa hdi nin cho vao, djch te thing kd khdng ndn"(FGD_MS_QLYT).
2.2. Nh&ig han chi khi ip dyng PBL vi SBL tai Trtrdng DH Y ticdng c^ng:
Nguin luc cda nhi tnJbng con han chi Vdi phuong phdp PBL, cd sd vdt chat cda Trudng, chii yeu td sd phdng hpc chi ddp itng dupe sd luong han chd cdc nhdm hpc tdp trong khi hpc tdp theo phuong phdp ndy Id hpc tap theo nhdm nho nen can sd lupng phdng hoc ntiidu hdn. Trong khi nhu cdu vd sd lupng phdng hpc cao nhung kha nang dap Ung hidn nay cda Tmdng han che vd dieu ndy khd cd ^ e khac phuc bong thdi gian ngan.
Odng thdi. dpi ngQ giang vien vd trp giang chUa dO ca ve sd lupng va chat lupng cung Idm anh hudng den viec md rdng dp dung P B L tai tmdng DH YTCC. Ba sd giang vidn ddu cho rang ndn md rpng dp dung phuong phap PBL vl nhiJng uu didm cOa nd vd cac giSng vien
eho rang dp dung PBL cho doi • se cd nhidu uu diem hon vi "Nha ' - em thiy sinh vidn c(t nhin nghiei • nhiSu cai ddng luc, cai khi ndng doc • han, han nOa la background cua hp i.g;j- dii vdi hoc vidn thac sT thi ho cd backgi ngang bing nhau, nen ho rit la khd. con vi u thi ngang bing nhau" (F_TLNGV) Tuy nhien .'••
thii eua phuong phap nay, vdi sd lupng sinh vit^n ^ny ddng, khoang 150 SV/khoa vd so vdi dieu kien thuc te ciia nha trudng thi ap dung PBL cho ddi tUOng cCr nhan Id mdt thach thUc Idn, nen trong nhieu nam vUa qua.
nha trudng vdn ehi duy tri phuong phap nay vdi ddi tupng cao hpc.
Ket qua dmh lupng trong danh gia phuong phap SBL eung eho thay. 36,9% tong sd sinh vien, hoe vien tra ldi thdi gian ddnh cho sinh vidn trinh bdy kdt qua thao ludn nhdm la "Qua i f (10%) va "it" (26,9%). Kdt qua thao luan nhom giang vien cung cho thay rd sd lupng giang vien va Iro giang cua cac bp mdn it so vdi sd nhdm cCia mot Idp cU nhan, ed khi chi cd 1 giang vien phu trach cho ca 4 nhdm trong ciing mdt thdi gian.
"Bd mdn em cd khi chi cd mdt giing vidn phu trach ludn ci 4 nhdm" (FGD_GV_F2). Didu ndy dupc ly giai do sd lupng giang vien edn it nen trong mdt budi trinh bdy, thdi gian ddnh cho trinh bay va ddng gdp y kidn cdn han chd, Neu sd lUOng giang vien day dLJ, ed the chia Idp ra nhieu nhom nhd hdn va nhu vay sinh vien se tang co hoi va tang thdi gian trinh bay ket qua bai tap eCia minh, ddng thdi ciing dupc nghe cac y kidn dong gop eua eae nhom khdc va giang vien nhidu hOn, Viec thidu giang vien cung se Idm anh hudng den kha nang bao quat eae nhom trong qud trinh Idm vide nhdm ciia smh vidn.
Tinh than vi thai dd hpc tap ci)a ngUdi hgc Mae du da so hoc vien ndi rang hp hUng thii vdi phuong phap PBL va Ong hd vide md rdng ap dung cho cdc mdn hpe khac nhung trong thut td vide tham gia cda nhieu hpc vidn trong cae mdn hpc vUa qua chua the hien dupe nhung gi ho ndi. Hien tupng hpe vien chUa that chd ddng hoc tap, ehua cd thdi quen dpc tai lieu da dupe nhldu giang vien nhac den 'Hpc vien chua d thdi quen dpc tii lidu vi d phuang phip doc tii lieu t&, chi dpc vi trich din nhOng ndi dung trong tii lieu duac cung dp. Chua dua ra nguin thdng tin khic va minh chiing cho thio /uan." Didu nay anh hudng rat Idn den qua trinh vd hieu qua hpc tap. Hoc vien cao hpe ludn ed ly do Id ho thieu thdi gian de dpc tdi jieu. tuy vay chdng tdi nghT tliidu thdi gian chi Id mdt phan ma ly do dung hon la hp khdng danh thdi gian thich ddng de nghien cUu tdi lieu vl nhieu hpc vidn vCra di hoc vUa phai lam viec cda eo quan. B^ng chdng Id trong khi nhidu hpc vien cho rang then gian ddnh cho nghien cdu tdi lieu qua it ndn hpc khdng thd nghien cUu tdi lieu dupc trong Khi dd mdt sd hpc vidn lai nghien cdu dupc het tai lieu do bp mdn cung cdp vd ttidm chi cdn tim kiem thdm tdi lieu
Ben canh dd, mot bong nhOtig UU diem ndi bdt cda SBL Id hinh thdc Idm vide nhdm, hjy nhidn, theo y kidn
Y HOC THVC H A N H (843) • S610/2012
cua ngudi hoc, day i.i.i-; '.. v^u diem ciia SBL vi sp thidu tu giac ciia mot :.0 ili.inli vien trong nhom,
"Thuc ra d<vKj lo l,ii < n cac thanh vidn cung phii tim, nhidu khi uu di<)rn i ihi no li khuyin khich mpl ngUdi tim tai lidu vii tim loi. nhi/iig mi nhidu khi li lim cho sinh vidn y Im Minh lam cii nay li ci nhdm Cd ma". (Thao ludn nhom cur nhan - mdn Tiep thi xd hdi).
Chinh vi vSy, trong thdi gian qua, cdc mdn hoe dp dung phUdng phap nay da xay dung cdc bang kidm danh gia "sU Iham gia cua cae thdnh vidn". Bang kidm ndy duoc thuc hiSn bdi ca giang vidn phu trdch nhdm va cac thanh vien trong nhdm, nhdm cd gang ddnh gid mdt each khach quan vd trung Ihuc nhdt vd sU ddng gop ciia tUng thanh vien Irong nhdm.
K^T LUAN VA KHUYDN NGHj
PBL vi SBL la phudng phap hoc tdp da dupc tridn khai lU lau va dUdc danh gia Id co hieu qua b cic InJong dai hoc y |31,[4]. Kel qua danh gid vide thd nghiem tai Tn/ong Dai hoc Y Id cdng cdng cho thdy, nhin chung sinh vien cho rSng vide dp dung phuOng phap PBL va SBL Id phii hpp vdi mdt sd mfin hoc dd duoc lua chon Ca 2 phuong phdp ndy Od tridn khai
ehuong trinh trdn mdt didn rdng, bdn canh nnuTig uu didm ndi bdt ciia PBL vd SBL, cdc nhd quan ly p ^ due edn phdi tinh ddn nhldu ydu td khdc Hdn quan d&
ngudn lUc (phai dd sd lupng phdng hpc cho nhi&j nhdm nhb 8-12 hoc vidn, dd giao vidn hudng dSn th&i ludn nhdm vd tai lidu hpc tdp), Ddy Id mdt thach thUfc Idn ddi vdi Trudng Dai hpc y td edng cdng ndi ridng va cdc trudng dai hoc khdc d Vidt Nam ndi ehung khi mS rdng phUOng phdp nay
TAI LI$U THAM K H A O
1. Moust J H C et al. (2007) Introduction to Problem- based learning, A guide for students, Wolters-Noordhofi Groninggen/Houten,
2. Arie Roterm, Hudng d i n phuOng phdp giang day dua trdn tinh hudng (SBL), Tdi lieu tdp hudn cho TrUSiig DH Y Id cfing cdng, Vidl Nam, thdng 1/2009.
3. Hamilton JD. (1976) The MeMaster curriculum: a critique. Brilis Medical Joumal 1, 1191-1196,
4. Trevena L. (2007) Problem-based teaming in pubfic health workforce training: a discussion of educational principles and evidence. NSW Public Health Bulletin 18 (1-2).
DANH GlA Dir A N PHONG CHdNG SUY DINH D U S N G THE EM TREN DjA B A N TINH KON TUM GIAI DOAN 2006 - 2008
PHAN VAN Ti;dNG N G U Y i N N G U Y S N N G Q C , L S T R I K H A I
TOM T A T
Muc dich: Dinh gia vide triin khai thuc hidn vi kit qua dat duac cQa Duin phdng ching suy dinh dudng tre em (PCSDDTE) trin dia bin tinh Kon Tum giai doan 2006-2008; ding thdi md ti kiin thUc vi thuc hanh cOa bi me cd con dudi 5 tuii vi PCSDDTE nim 2008.
Phuang phip nghidn cdu: Md ti dt ngang kit hpp dinh tinh, dinh lugng vi thu thip s6 lidu thit dp.
Kiim dinh ^ vi cic tinh toin tin si, t^ 1$ %, OR duac sit dung.
Kit qui: Qua trinh thi/c hidn vi kit qui d^t duac:
Ca ciu ti chCic, cdng tic giim sit vi bio do thijc hiin dOng quy dinh vi cd si/ phii hpp liin nginh trong khi thuc hidn; Nhin luc d cic tuyin cdn mdng.
trinh dd chuydn min han chi; Ngin sich cho chuang trinh hing nim diu ting vi dupc phin bi diu; Cic hoat ddng cOa Du in di dip Cmg duac nhu ciu CSSK cOa ngudi din. Kiin thdc PCSDDTE cda bi me: T} Id bi me cd kiin thiic dOng vi thdi diim cho tri bCi lin diu sau sinh li 82,4%, bu me hoin toin li 88,8%. 78,0% bi me biit duac ci 4 rihdm TPCT.
Thuc hinh PCSDDTE ci)a bi me: 80,0% bi me thuc hanh dOng vi thdi gian cho tri bii hoin toin; 99,1%
bi me cd theo doi cin n$ng cQa tri; chi cd 46,8%
bi mp sU dung ci 4 nhim TPCT trong bCta in tiing ngiy cOa tri.
Tirkhda: Suy dinh dudng tri em.
SUMMARY
Targets: Evaluate the imf^ementation and outcomes of the project 'Prevention of mainouri^ted children" In Kon Tum province from 2006 to 2<X)S; mi describes the knovriedge and practice ofmothasmib children under 5 years of age about ma/noorfsherf children.
Method: The cross-sectional study combine wffli quantitive and qualitative approach was caried ai- The secondary data was also cc^ieded in tfifs research. ^ test, OR and descriptive statistics was used.
Results: Implementation process and resute-' Organizational structure, supervision and repoiSng was taken under penmision and rule of MOH; Hurnan Resounxs were still limited both quantity and qua^.
Budget for prevenion of malnourished chUdf&i increased every years; advities of the prpjed met (/le health care needs of people. Knowledge ofprevet^
of malnourished children: The pnspotion of m^i^
who have the right knowledge on how and when fte babies had first feeding after birth is 82.4%; 88.8% d mothers have the right knowledge about exc/us/Ve breastfeeding. Rate of mothers who can iistgroi^^
4 main type of food is 78.0%. Practice ofprevenSonnf malnourished children: 80.0% of mothers feed itie baby in the right way; 99.1% of mothers folkmei^
child's weight; -^
Keyword: malnourished r^ikiren.
Y HOC THUC HANH (843) - S610/2012
