PBL合并CBS在ICU临床教学中的应用

Application of problem-based learning combined with case-based study teaching mode in clini-cal teaching in intensive care unit

目的：观察以问题为基础的学习（problem-based learning， PBL）合并案例学习（case-based study， CBS）应用于重症加强护理病房（intensive care unit， ICU）临床教学的效果。方法将2011年3月至2012年2月在广东省中医院芳村医院ICU轮训的研究生按月分组，实验组31人采用PBL合并CBS教学，对照组34人采用传统讲授式教学。对比2组轮训后考试成绩差异，并对实验组进行问卷调查；数据采用SPSS 13.0处理，计量资料采用t检验，方差不齐的采用秩和检验。结果实验组考试成绩[理论考试（85.26±5.96）分，病例分析（80.59±7.33）分]优于对照组[理论考试（79.17±7.31）分，病例分析（76.02±9.27）分]，差异有统计学意义（P＆lt;0.05）。实验组问卷调查显示，PBL合并CBS教学增加了学生学习兴趣，但学习系统不足，且大部分学生不愿主动发言。结论 PBL合并CBS在ICU临床教学中应用有一定优势。

Objective To observe effects of problem-based learning（PBL） combined with case-based study （CBS）teaching mode in clinical teaching in intensive care unit（ICU）. Methods Students from ICU of Fangcun Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2011 to February 2012 were divided into treatment group （31 cases, with PBL combined with CBS teaching mode） and control group （34 cases, with the traditional teaching mode）. Scores of two groups were compared and analyzed and questionnaire survey was conducted in treatment group. Data were processed by SPSS 13.0 statistical software. Measurement data were compared by t-test and data of heterogeneous variance were compared by rank-sum test. Results Treatment group achieved better scores （（85.26 ＆#177;5.96） in theory examination and （80.59 ＆#177;7.33） in case-analyzing examination） compared with those of control group （（79.17 ＆#177;7.31） in theory examination and （76.02 ＆#177;9.27） in case-analyzing examination）（P＆lt;0.05）. PBL combined with CBS teaching mode can stimulate learning interests but it was lack of systematization; most students did not volunteer to speak. Conclusion PBL combined with CBS teaching mode has certain advantages in ICU clinical teaching.