以问题为基础学习教学法在八年制学员眼科临床实习中的应用

Application of problem- based learning method in clinical internship of eight- year program medical students in department of ophthalmology

目的:探讨以问题为基础学习(problem-based learning,PBL)教学法在临床医学专业八年制学员眼科学临床实习过程中的教学效果。方法:以2013-01/2014-03在第四军医大学西京医院眼科实习的40名临床医学专业八年制学员为研究对象,随机分为PBL教学组(PBL组)和传统教学组(对照组),每组20名。PBL组采用PBL教学法引导实习学员主动参与实习过程,以实习学员为主体;对照组采用传统教学法以教师为主导引导学员完成临床实习。最后通过问卷调查、出科考试成绩分析等综合评价不同教学方法的实习效果。结果:出科考试成绩分析中,PBL组的问答题、病例分析题和总成绩的分数均明显高于对照组(P<0.05);选择题和名词解释的得分与对照组无显著差异(P>0.05)。实习学员对教学效果的自评指标中,在提高学员综合分析能力、学习主动性和实习效果等方面PBL组均明显优于对照组(P<0.05);在激发学员兴趣和对教学法满意度方面PBL组略强于对照组,但统计学差异不显著(P>0.05)。教员对实习生的评价指标中,PBL组在实习前充分积极准备、实习中全面准确表达观点、临床思维逻辑性等方面均明显好于对照组(P<0.05);在与患者沟通能力方面两组间差异不显著(P>0.05)。结论:PBL教学法适用于临床医学专业八年制学员在眼科的实习教学,PBL教学法能够较好训练学员的临床综合分析能力,有助于其主动解决临床实际问题能力的培养。

AIM： To investigate the efficacy of applying problem- based learning （PBL） method in clinical internship of eight-year program medical students in Department of ophthalmology. METHODS： Totally 40 medical students of eight- year program, who were clinical interns from January 2013 to March 2014 in Department of Ophthalmology, Xij^ng Hospital, the Fourth Military Medical University, were randomly divided into PBL teaching group （PBL group） and traditional teaching group （control group）, 20 students in each group. In PBL group, students positively participated in clinical internship leading by PBL teaching, whereas in control group, students were guided by teachers in pattern of traditional teaching. Practical effects of different teaching methods were comprehensively evaluated by questionnaire and examination results. RESULTS： In analysis of final examination, PBL group had higher scores than control groups in the quiz, case analysis and overall performance with statistical significance between the two groups （ P〈 0.05）, as for score of multiple- choice and glossary questions, differences between the two groups were not statistically significant （P〉 0. 05）. From the data of intern self- assessment questionnaire, PBL group was superior to control group in comprehensive analysis capabilities, motivation to learn, and learning outcomes with statistically significant differences （ P〈 0. 05）. Whereas concerning stimulating interest of students and satisfaction of teaching mode, the difference between the two groups was not statistically significant （P〉 0. 05）. From the intern evaluation by teachers, PBL group was superior to control group in pre-intern preparation, full and accurate expression of views in class and clinical logic （P 〈 0. 05 ）, however, there was no difference in communicative abilities with patients between the two groups （P〉0.05）. CONCLUSION： PBL teaching is suitable for internship learning in Department of Ophthalmology for eight-year program medical students. PBL method can improve student＇s capabilities of clinical comprehensive analysis and contribute to develop the ability to solve clinical problems positively.