“以问题为基础学习＂与“无标准答案＂相结合教学模式在普通外科学临床实习中的应用  

Application of ＇ problem-based learning＇ and ＇ none-standard-answer＇ teaching model into clinicalclerkship in general surgery

作　　者：刘晓[1] 秦安[1] 吴鸣宇[1] 沈伟[1] 王彤[1] 陶国清[1] 蔡兵[1] 

机构地区：[1]江苏省无锡市人民医院普通外科,214023

出　　处：《中华医学教育杂志》2011年第4期558-561,共4页Chinese Journal of Medical Education

摘　　要：目的评价在普通外科学临床实习阶段教学中引入“以问题为基础学习”与“无标准答案”相结合教学模式对提高学生临床思维能力的作用。方法将学生随机分层分为实验组和对照组。实验组学生接受“以问题为基础学习”与“无标准答案”相结合教学模式，对照组学生接受传统教学模式，然后采用稿本一致性测试法测试两组学生临床思维能力，并采用医学教育环境量表进行问卷调查。结果两组学生临床思维能力测试成绩分别为75．1±5．7分和79．1±5．4分，实验组学生成绩明显高于对照组学生（t：3．192，P=0．002）。两组学生问卷调查量表总分分别为126．9±11．0分和142．2±8．3分，实验组学生总分明显高于对照组学生（t=6．993，P：0．000）。亚组分析结果显示，不同学制和年级学生中接受“以问题为基础学习”与“无标准答案”相结合教学模式者，其临床思维能力测试成绩和量表得分均高于接受传统教学模式者。结论在普通外科学临床实习中引入“以问题为基础学习”和“无标准答案”相结合教学模式，有助于提高学生的临床思维能力，有助于改善教学环境。Objective To evaluate the role of ＇problem-based learning＇ and ＇none-standard- answer＇ teaching model in improving interns＇ clinical thinking in general surgery. Methods Interns were divided into two groups by stratified random, test group receiving ＇problem-based learning＇ and ＇none- standard-answer＇ teaching model, control group receiving conventional teaching model, then were tested clinical thinking by means of script concordance test and received a questionnaire survey by means of Dundee Ready Education Environment Measure （DREEM）. Results The mean score of clinical thinking of test group, 79. 1 ＋ 5.4, was higher than that of control group, 75.1 -＋ 5.7 （ t = 3. 192, P = O. 002） , and the mean score of DREEM of test group, 142. 2 ＋ 8. 3, was higher than that of control group , 126. 9 -＋ 11.0 （ t = 6. 993, P = 0. 000 ）. Subgroup analysis revealed that interns receiving ＇ problem-based learning＇ and ＇none-standard-answer＇ teaching model got higher clinical thinking test scores and higher DREEM scores than those receiving conventional teaching model no matter of varied schooling-length programs and grades. Conclusions Application of ＇problem-based learning＇ and ＇none-standard-answer＇ teaching model into clinical clerkship in general surgery was helpful to improve the students＇ clinical thinking and to improve the education environment of problem-based learning.

关 键 词：以问题为基础学习 “无标准答案” 教学模式 稿本一致性测试法 临床思维能 力 教育环境 

分 类 号：R-4[医药卫生]