案例式PBL教学法在普通外科教学中对学生批判性思维能力培养的探索研究

Exploratory Research on Case-based PBL Teaching Method in Training Students' Critical Thinking Ability in General Surgery Teaching

目的探讨在普通外科教学中案例式PBL对昆明医科大学2013级临床医学本科生批判性思维能力的影响。方法选取昆明医科大学2013级临床医学本科生36人作为研究对象,在普通外科教学中案例式PBL教学前、后进行问卷发放填写。结果案例式PBL教学前调查对象的CTDI-CV平均总分为(238.56±14.39)分,其中高达97.22%受试者的批判性思维倾向处于矛盾范围,2.78%受试者的批判性思维倾向是负性批判性思维,本组没有正性批判性思维的受试者。7个维度中只有寻找真理平均得分达到40分以上,其他方面能力均欠佳。案例式PBL教学后调查对象的CTDI-CV平均总分上升至(279.17±12.08)分。调查对象中处于矛盾范围及负性批判性思维的受试者比例明显下降,为41.67%;正性批判性思维的受试者比例明显上升,为58.33%。7个维度中寻找真理、开放思想、求知欲和认知成熟度这4个维度得分达到40分以上。除寻找真理维度外,其他维度得分在PBL前后均有所上升,差异有统计学意义(P<0.01)。结论在普通外科教学中,案例式PBL教学法有助于提升受试学生的批判性思维能力,有望提高普通外科的教学质量。

Objective To explore the influence of problem-based learning （PBL） combined with case-based learning （CBL） on critical thinking capability in general surgery clinical learning of Grade 2013 medical undergraduates in Kunming Medical University. Methods 36 medical undergraduates of Grade 2013 in Kunming Medical University were selected as study subjects. Questionnaires were conducted among the subjects before and after PBL combined with CBL in general surgery clinical learning. Results Before PBL combined with CBL, the average total CTDI-CV score of subjects was （238.56±14.39）. The critical thinkingdisposition of 97.22% of the subjects was in contradiction, 2.78% of the subjects showed negative critical thinking disposition and no subject of positive critical thinking existed in the group. In 7 dimensions, only the score of truth seeking was〉40, while other aspects were poor. After PBL combined with CBL, the average total CTDI-CV score of subjects rose to （279.17±12.08） . The proportion of subjects in contradiction and negative critical thinking decreased to 41.67%, and the proportion in positive critical thinking increased significantly to 58.33%. The score of 4 in 7 dimensions such as truth seeking, open-mindedness, inquisitiveness and cognitive maturity were〉40. Except the dimension of truth seeking, the score of other dimensions after PBL combined with CBL were higher obviously compared with before. Before and alter comparison, the difference was statistically significant （P〈0.01）. Conclusion During the learning of general surgery, PBL combined with CBL is instrumental to enhance the critical thinking capabilities of the students, which is promising to improve the teaching quality of general surgery.