PBL结合LBL教学模式在甲状腺外科临床实习教学中的临床应用效果

Clinical application effect of PBL combined with LBL teaching mode in clinical practice teaching of thyroid surgery

目的探讨以问题为基础教学法(PBL)结合传统的讲授教学法(LBL)教学模式在甲状腺外科临床实习教学中的临床应用效果。方法选取2018年3月统一来四川大学华西医院甲状腺外科实习的临床医学本科生100名为研究对象,按随机数字表法分为对照组(n=50,LBL教学方法)和实验组(n=50,PBL结合LBL教学模式),实习时间3个月。学习结束后,分别考核学生的理论成绩及操作技能以评定教学效果,比较学生对教学满意度的主观评价及专家对教学效果的评定。结果实验组本科生考核后专业理论知识、临床操作技能、病历书写及病历分析讨论评分均高于对照组,差异有统计学意义(P<0.05)。实验组本科生学习兴趣、临床思维能力、知识点掌握程度、学习效率、课程安排、自学能力、创新性评分均高于对照组,差异有统计学意义(P<0.05)。实验组专家对教师教案设计、病历书写分析、问题讨论、临床实践及教学效果的评定均优于对照组,差异有统计学意义(P<0.05)。结论PBL结合LBL教学模式在甲状腺外科临床实习教学中临床应用效果较好,可提高学生出科考试成绩,培养学生集体讨论解决问题能力及学生综合素质,获得专家、学生较高的满意度,值得在临床实习教学中进一步推广。

Objective To explore the clinical application effect of problem-based learning (PBL) combined with lecture-based learning (LBL) in clinical practice teaching of thyroid surgery.Methods One hundred clinical undergraduates who came to West China Hospital of Sichuan University for thyroid surgery practice in March 2018 were selected as the subjects of study.They were divided into control group (n = 50,LBL teaching method) and experimental group (n = 50,PBL combined with LBL teaching mode) according to random number table method,the internship lasted for 3 months.At the end of the study,the students′ theoretical achievements and operational skills were assessed to evaluate the teaching effect.The subjective evaluation of students′ satisfaction with teaching and experts′ evaluation of teaching effect was compared.Results The scores of professional theory knowledge,clinical operation skills,medical record writing and medical record analysis and discussion of undergraduates in experimental group were higher than those in control group,and the difference was statistically significant (P < 0.05).The experimental group undergraduates′ interest in learning,clinical thinking ability,mastery of knowledge points,learning efficiency,curriculum arrangement,self-study ability and innovation scores were higher than those of control group,with statistical significance (P < 0.05).Experts′ evaluation results on teacher′s teaching plan design,medical record writing and analysis,problem discussion,clinical practice and teaching effect in experimental group were better than those in control group,and the difference was statistically significant (P < 0.05).Conclusion PBL combined with LBL teaching mode has a good clinical application effect in clinical practice teaching of thyroid surgery.It can improve students′ examination results,cultivate students′ ability to discuss and solve problems collectively and students′ comprehensive quality.It has obtained higher satisfaction from experts and students.It is worthy of further promotion in clinical practice teaching.