改良TBL在八年制临床医学专业学生内科实习教学中的应用

Application of the modified team-based learning in internal medicine practice teaching for eight-year clinical students

为针对性提高实习生的临床思维和实践能力，以实习阶段的八年制临床医学专业学生为教学对象，开展基于诊治真实病人实战训练考核的基于团队的学习（team-based learning， TBL）。教师在教学前准备相应病例素材、制作教具等，动员与指导学生以小组为单位自学。课堂上除实施传统TBL教学的个人预习效果测试、团队自学效果测试外，新增诊治真实病人的实战训练考核，包括抽签确定诊疗任务、学生完成诊疗任务并回答主讲教师的提问，并组织评委点评学生表现与综合评分。教学完成后，从学生表现、课堂考核成绩及学生评教等方面评价教学效果。实践表明，这种改良TBL不仅保证了学生的参与度，而且有助于培养其临床思维和实践能力，并可增强其人际关系能力。

Targeting to improve clinical thinking and practice skill of interns, modified Team-based learning （TBL） based on seeing real patient was performed for interns from eight-year clinical medicine program. Teachers prepared the corresponding case material before the teaching and made teaching aids. And interns were mobilized and guided to preview and self-study in teams. During modified TBL, in-class application of seeing real patient was performed to assess the effect of self-study in teams, besides individual test and team test deriving from traditional TBL. All teams were assigned one task of seeing real patient by drawing lots, and then finished the task, answered teachers＇ questions. And the students＇ performance was given comments and comprehensive scores by the judges. After the completion of teaching, the teaching effectiveness of the modified TBL was assessed from students＇ performance, their scores and their teaching evaluation. Practice shows that the modified TBL can not only attract students to engage in it, but also elevate their abilities of clinical thinking and practical skill. It can also cultivate their interpersonal ability.