以问题为基础教学法在颅内动脉瘤外科治疗临床教学中的应用

Application of Problem-based Learning in Clinical Teaching of Intracranial Aneurysms Management

目的探究以问题为基础教学法(probl em-based learning,PBL)在颅内动脉瘤外科治疗中的应用价值。方法将2018年8月-2019年8月在南京大学医学院附属鼓楼医院神经外科进行住院医师规范化培训的医师随机分为两组,分别采用PBL教学法和以授课为基础教学法(lecture-based learning,LBL)进行1个月的基础知识、临床实践和手术策略教学。教学完成后统一组织考核,比较两组学员以上3门课程的平均成绩。结果共纳入32名规培生,PBL组和LBL组各16人。PBL组与LBL组的基础知识考核成绩无显著差异(77.3±1.2分vs.76.9±1.0分,P=0.310);PBL组临床实践(84.7±3.1分vs.81.8±2.9分,P=0.011)和手术策略(73.0±2.6分vs.70.5±2.9分,P=0.015)的考核成绩较LBL组增高。结论对于颅内动脉瘤外科治疗的临床教学,PBL教学法更有利于提高规培生的临床实践能力和培养手术策略选择的辩证思维能力。

Objective To explore the application value of problem-based learning(PBL)in clinical teaching of intracranial aneurysms management.Methods The standardized training students in Department of Neurosurgery of Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from August 2018 to August 2019 were randomly assigned to the observation group and control group,and the PBL teaching method was used in observation group and lecture-based learning(LBL)teaching method in control group.A one-month teaching course included basic theoretical knowledge,clinical practice and surgical strategy.After completing all the teaching courses,the two groups were tested by examination,and the scores of the two groups were compared.Results A total of 32 students were included,with 16 ones in each group.The test results showed that there was no statistical difference in score of basic theoretical knowledge between the two groups(77.3±1.20 vs.76.9±0.98,P=0.310),the scores of clinical practice(84.7±3.11 vs.81.8±2.93,P=0.011)and surgical strategy(73.0±2.58 vs.70.5±2.88,P=0.015)in PBL group were higher than that in LBL group.Conclusions For the clinical teaching of surgical treatment of intracranial aneurysms,the PBL teaching method is more conducive to improving the clinical practice ability and cultivating dialectical thinking ability of surgical strategy for standardized training students.