神经病学见习中以问题为基础学习与床边学习两种教学方法的比较研究

Comparison of the effect of clinical neurologic thinking training between the problem-based learning and the bedside-based learning during neurologic probation

目的 比较以问题为基础学习（problem-based learning,PBL）和床边学习（bedsidebased learning,BBL）两种教学方法在神经病学见习中培养医学生临床思维能力的效果.方法 选择2009年9月~2009年10月在广州医学院第一附属医院见习神经病学并由专人带教的2006级临床医学专业70名本科学生为研究对象,将其随机分为PBL组（34人）和BBL组（36人）,分别采用PBL教学方法和BBL教学方法进行带教,并在1个月后进行临床思维能力和理论知识的考核.结果 PBL组和BBL组学生见习时答题正确率的差异无统计学意义;见习1个月后,PBL组学生临床思维能力考核成绩（t=2.346,P=0.022）及总成绩（t：2.329,P=0.023）均高于BBL组学生,其差异均具有统计学意义;两组学生理论考试成绩之间的差异无统计学意义（t=1.164,P=0.248）.结论 本研究发现,PBL教学方法对于学生神经病学临床思维能力培养的效果优于BBL教学方法,能够从多方面提高学生的素质,是一种值得推广的教学方法.

Objective To compare the effect of clinical neurologic thinking training between the problem-based learning （PBL） and the bedside-based learning （BBL） during neurologic probation. Methods From September 2009 to October 2009, 70 forth-year medical probation undergraduates of Guangzhou Medical College undergoing the neruologic teaching of a special doctor were randomly divided into PBL group （34 students） and BBL group （36 students）. The PBL and BBL approachs were respectively used to teach the students. A month later, the clinical and theoretic examinations were performed to compare the effect Results No statistically significance about the answers＇ accuracy was found during probation between PBL and BBL groups. A month after probation, both clinical exam record and total record of PBL group were higher than those of BBL group. However, no statistically difference was found in the theoretic examinartion record between PBL and BBL groups. Conclusions Our study suggests that the effect of clinical neurologic thinking training of PBL approach is more effective than that of BBL approach during neurologic probation. The PBL approach can also improve the students＇ quality in many aspects, and deserves to be popularized.