CBL教学法和PBL教学法在本科医学临床课程中应用效果的Meta分析  

Meta-Analysis of the Effect of CBL Teaching Method and PBL Teaching Method in the Clinical Course of Medical Undergraduates

作　　者：张黎[1] 杨光耀[1] 杨芬 ZHANG Li;YANG Guangyao;YANG Fen(Teaching Office,the First Clinical College of Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430022,China;Education and Research Office of Internal Medicine on Cardiovascular Disease,the First Clinical College of Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430022,China;Department of Cardiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430022,China)

机构地区：[1]华中科技大学同济医学院第一临床学院教学办公室,湖北武汉430022 [2]华中科技大学同济医学院第一临床学院心血管内科教研室,湖北武汉430022 [3]华中科技大学同济医学院附属协和医院心血管内科,湖北武汉430022

出　　处：《中国继续医学教育》2025年第5期49-55,共7页China Continuing Medical Education

基　　金：华中科技大学2023年教学研究项目(2023126)。

摘　　要：目的评价案例教学法(case-based learning,CBL)和以问题为基础的教学法(problem-based learning,PBL)在国内本科医学临床课程教学中的应用效果。方法计算机检索知网、万方和维普数据库中有关CBL和PBL教学法在我国本科医学临床课程教学中应用效果比较的随机对照试验(randomized controlled trial,RCT),检索时限设置为数据库建立至2023年1月。3名受到培训的研究者独立筛选文献、提取信息并评价偏倚,最后进行Meta分析。结果共纳入12项RCT进行Meta分析,包含了893例研究对象。结果显示CBL教学法和PBL教学法的本科医学临床课程教学的理论知识成绩,差异无统计学意义[标准化均数差(standardized mean difference,SMD)=0.376,95%CI-0.387~1.138,P>0.05],CBL教学法的病例分析成绩高于PBL教学法,差异有统计学意义(SMD=0.620,95%CI 0.003~1.237,P<0.05),CBL教学法的临床技能成绩高于PBL教学法,差异有统计学意义(SMD=1.120,95%CI 0.043~2.197,P<0.05),2种教学法的学习积极性比较,差异无统计学意义[相对危险度(relative risk,RR)=1.091,95%CI 0.969~1.228,P>0.05],CBL教学法的临床思维能力高于PBL教学法,差异有统计学意义(RR=1.149,95%CI 1.051~1.257,P<0.05),CBL教学法的整体满意度高于PBL教学法,差异有统计学意义(RR=1.195,95%CI 1.068~1.337,P<0.05)。结论当前证据表明,在提高本科医学临床课程教学效果及整体满意度方面,CBL教学法优于PBL教学法。Objective To assess the effect of the casebased learning(CBL)and problem-based learning(PBL)in clinical course teaching of medical undergraduates in China.Methods Computerized searches were conducted in the CNKI,Wanfang,and VIP databases for randomized controlled trials(RCT)comparing the application effects of the CBL and PBL teaching method in the teaching of undergraduate medical clinical courses in China.The search time limit was set from the establishment of the databases to January 2023.Three trained researchers independently screened the literatures,extracted the information,and evaluated the bias,and finally conducted a Meta-analysis.Results A total of 12 RCTs and 893 participants were included in the Meta-analysis.The results showed that there was no statistically significant difference in the theoretical knowledge scores of the undergraduate medical clinical course teaching between the CBL teaching mode and the PBL teaching mode(SMD=0.376,95%CI-0.387~1.138,P>0.05).The case analysis scores of the CBL teaching mode were higher than those of the PBL teaching mode,and the difference was statistically significant(SMD=0.620,95%CI 0.003~1.237,P<0.05).The clinical skill scores of the CBL teaching mode were higher than those of the PBL teaching mode,and the difference was statistically significant(SMD=1.120,95%CI 0.043~2.197,P<0.05).There was no statistically significant difference in learning enthusiasm between the two teaching modes(RR=1.091,95%CI 0.969~1.228,P>0.05).The clinical thinking ability of the CBL teaching mode was higher than that of the PBL teaching mode,and the difference was statistically significant(RR=1.149,95%CI 1.051~1.257,P<0.05).The overall satisfaction of the CBL teaching mode was higher than that of the PBL teaching mode,and the difference was statistically significant(RR=1.195,95%CI 1.068~1.337,P<0.05).Conclusion Current evidence shows that CBL teaching mode is superior to the PBL teaching mode in terms of improving the teaching effectiveness and satisfaction of the clinical course for me

关 键 词：案例教学法 以问题为基础的教学法 本科生 临床医学课程 荟萃分析 随机对照试验 

分 类 号：G642[文化科学—高等教育学]