Application value of PBL combined with CBL in clinical teaching of emergency medicine
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摘要:
目的 探讨以问题为基础的教学(problem-based learning，PBL)联合以案例为基础的教学(case-based learning, CBL)模式在急诊医学临床教学中的应用效果。 方法 选取2018年7月—2019年5月蚌埠医学院第一附属医院2015级临床医学专业实习医生84名作为研究对象，采用随机数字表法随机分成2组，其中对照组42例，采用PBL结合传统模式教学，观察组42例，采用PBL结合CBL教学。通过2组理论考试成绩、病例分析成绩以及教学满意度问卷调查来评价2种教学方法在急诊医学临床教学中的应用价值。 结果 2组学生在性别、年龄和入科理论考试成绩方面差异无统计学意义(均P>0.05)，观察组理论知识成绩(34.18±3.13)分和对照组(33.45±3.21)分相比较差异无统计学意义(P>0.05), 而观察组病例分析成绩(35.51±4.07)分和临床技能成绩(34.78±3.04)分明显高于对照组(32.57±4.11)分和(30.44±3.22)分，差异有统计学意义(均P < 0.01)，同时观察组学生对教学满意度评价较高(P < 0.01)。 结论 PBL联合CBL教学法在急诊医学临床教学中保证理论知识水平的同时显著提升了学生解决实际临床问题的能力，并获得了学生的认可。 Abstract:Objective To explore the effect of the problem-based teaching (PBL) combined with case-based teaching (CBL) model in clinical teaching of emergency medicine. Methods Total 84 clinical medical interns of grade 2015 in the First Affiliated Hospital of Bengbu Medical College from July 2018 to May 2019 were selected as the research subjects. The random digital table method was used to divide the subjects into two groups: 42 in the control group (PBL combined with the traditional mode of teaching) and 42 in the observation group (PBL combined CBL teaching). Theoretical test results, case analysis results and teaching satisfaction questionnaire of two groups were used to evaluate the value of the two teaching methods in emergency medical clinical teaching. Results There was no significant difference between the two groups in gender, age and academic entrance examination scores (all P>0.05) There was no significant difference in theoretical knowledge score between the observation group and the control group (34.18±3.13) and (33.45±3.21, P>0.05). However, the case analysis score (35.51±4.07) and clinical skill score (34.78±3.04) in the observation group were significantly higher than those in the control group (32.57±4.11 and 30.44±3.22, respectively), the difference was statistically significant (all P < 0.01). Furthermore, the students in the observation group had a high evaluation of teaching satisfaction (P < 0.01). Conclusion PBL combined with CBL teaching ensure the level of theoretical knowledge in emergency medical clinical teaching, whilst significantly improving students' ability to solve practical clinical problems, which has been recognised by students. -
表 1 2组学生一般情况比较(x ±s)
组别 例数 性别(例) 年龄(岁) 入科理论成绩(分) 男性 女性 对照组 42 23 19 22.03±1.27 30.95±2.97 观察组 42 25 17 22.17±1.31 30.73±3.19 统计量 0.194a 0.497b 0.327b P值 0.659 0.620 0.744 注：a为χ2值，b为t值。 
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表 2 2组学生考试得分比较(x ±s，分)
组别 例数 理论知识 病例分析 临床技能 对照组 42 33.45±3.21 32.57±4.11 30.44±3.22 观察组 42 34.18±3.13 35.51±4.07 34.78±3.04 t值 1.055 3.294 6.352 P值 0.294 0.002 < 0.001
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表 3 2组学生问卷调查得分比较(x ±s，分)
组别 例数 学习兴趣激发 理论知识掌握 临床能力提高 总体满意度 对照组 42 1.53±0.29 1.67±0.37 1.38±0.22 1.52±0.29 观察组 42 1.72±0.31 1.71±0.36 1.78±0.25 1.73±0.31 t值 2.901 0.502 7.784 3.206 P值 0.005 0.617 < 0.001 0.002
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