案例联合问题引导在创伤骨科培训生临床思维能力提升中的应用  

Application of cases plus problem orientation in improving the clinical thinking skills for the trainees in trauma orthopedics department

作　　者：王林 杨民 左学良 WANG Lin;YANG Min;ZUO Xueliang(Department of Orthopedics,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院创伤骨科,安徽芜湖241001 [2]皖南医学院第一附属医院弋矶山医院普外科,安徽芜湖241001

出　　处：《皖南医学院学报》2025年第1期77-80,共4页Journal of Wannan Medical College

基　　金：安徽省高等学校省级质量工程项目(2022jyxm1733)。

摘　　要：目的:探究案例联合问题引导在临床医学创伤骨科学教学中的应用效果。方法:前瞻性选取2021年9月~2023年9月临床医学创伤骨科住院医师规范化培训学生40名为研究对象,按随机数字表法分为研究组20例与对照组20例,对照组予以传统教学方式,研究组接受以案例为中心联合以问题为中心教学,比较两组教学考核成绩、临床思维能力(CTDI-CV评分)、教学满意度的差异。结果:研究组学生病史采集得分、诊断及鉴别诊断得分、病情分析得分、治疗方案拟定得分、理论总成绩得分及骨牵引制动得分、体格检查得分、复位石膏固定得分均高于对照组(P<0.05)。两组教学后CTDI-CV各维度得分(信心、认知成熟度、求知欲、开放思想、分析能力、寻求真相、系统化能力)均较教学前升高(P<0.05);研究组CTDI-CV各维度得分上升幅度均高于对照组(P<0.05)。研究组解决问题、团队协作、沟通能力、自学能力、教学互动满意度均高于对照组(P<0.05)。结论:案例联合问题引导教学法应用于临床医学创伤骨科学教学中可有效提高创伤骨科住院医师规范化培训学生临床考核成绩,改善临床思维能力,提升教学满意度。Objective:To observe the effect of applying case-based learning combined with problem-based learning methods to teaching of traumatology and orthopaedics.Methods:Forty medical students undergoing standardized residency training were prospectively included from September 2021 to September 2023,and equally assigned to study group and control group by random number table.The students in the control group received traditional teaching,and those in the study group were taught with CBL plus PBL.The two groups were compared concerning the scores on the achievement test,scale of Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)and the trainees satisfaction with the teaching.Results:The scores on history taking,diagnosis and differential diagnosis,condition analysis,treatment plan development,total theoretical score,bone traction braking,physical examination and repositioning plaster fixation were higher in the study group than those of the control group(P<0.05).The scoring on each component of CTDI-CV(confidence,cognitive maturity,curiosity,open-mindedness,analytical ability,truth-seeking,and systematization ability)was higher in both groups after teaching(P<0.05),and the study group scored better on each component of the CTDI-CV and had higher satisfaction with the improved ability of problem solving,teamwork,communication,self-learning and teaching interaction than the control group(P<0.05).Conclusion:Combining case-based learning with problem-based learning can improve the clinical performance,clinical thinking skills and satisfaction with the teaching in medical students undergoing standardized residency training in traumatology and orthopedics.

关 键 词：创伤骨科学 临床医学 以案例为中心教学法 以问题为中心教学法 教学 应用效果 

分 类 号：G642[文化科学—高等教育学] R68-4[文化科学—教育学]