CBL联合PBL教学法在神经外科临床教学中的应用研究

Application research of CBL combining with PBL in clinical teaching of neurosurgery

目的探讨CBL联合PBL教学方法在神经外科临床教学中的效果。方法选取2013年2月-2014年10月在本院神经外科实习的临床医学生64名,将其随机分为实验组（22名）、CBL组（21名）和PBL组（21名）。实验组采用CBL联合PBL教学法,CBL组和PBL组分别采取CBL和PBL教学法,授课结束后进行专业知识、基本临床操作技能考试和问卷调查,评价三种教学模式的教学效果。结果实验组学生专业知识考试和基本临床操作技能成绩优于CBL组和PBL组（P〈0.05）,同时在提高临床思维能力和理论联系临床实践能力方面优于CBL组和PBL组（P〈0.05）,但三组学生在文献阅读能力、实习兴趣、知识理解力和教学方法选择方面差异无统计学意义（P〉0.05）;实验组和PBL组在发病机制及诊断分析、治疗方案拟定方面优于CBL组（P〈0.05）,其他方面无明显差异性（P〉0.05）。结论 CBL联合PBL教学法可提高神经外科的临床教学效果,是临床实习中值得推广的教学模式。

Objective To explore the effect of piloting case-based learning（CBL） combining with problem-based learning（PBL） in clinical teaching of neurosurgery. Methods 64 clinical medical students in neurosurgery of our hospital from February 2013 to October 2014 were selected and randomly divided into experimental group（22 cases）,CBL group（21 cases） and PBL group（21 cases）.In the experimental group,teaching method of CBL and PBL was used.In the CBL group and PBL group,teaching methods of CBL and PBL were adopted respectively.After the course finished,professional knowledge and basic clinical operating skills and questionnaire were used to evaluate the teaching effects by these three teaching modes. Results The scores of students′ professional knowledge examinations and basic clinical operating skills in experimental group were better than those of CBL group and PBL group（P〈0.05）.Meanwhile,ability of clinical thinking and putting theory into practice were better than those in CBL and PBL group（P〈0.05）,but there was no significant difference in three groups of reading literature,internship interest,knowledge understanding and selection of teaching methods（P〉0.05）.Aspects of pathogenesis,diagnosis and analysis and therapeutic regimen drafting in experimental group and PBL group were better than those of CBL group（P〈0.05）.Except that,there were no other significant differences（P〉0.05）. Conclusion Combination of CBL and PBL can improves teaching effect,and is worthy of promotion in clinical internship.