LBL—PBL—CBL—LBL与LBL—CBL教学模式在关节外科见习教学中的对比研究

王波+许超+范秋平+何世杰+季卫平

[摘要] 目的 比较LBL-PBL-CBL-LBL与LBL-CBL两种不同的教学模式在关节外科临床见习教学工作中的效果，探索更加适合关节外科见习教学的方法，指导临床教学。 方法 将研究对象随机分为LBL-PBL-CBL-LBL组（即实验组，n=28）和LBL-CBL组（即对照组，n=28），两组分别采用不同的教学模式，通过基础知识、临床操作和分析能力、病例书写、文献检索与阅读、创新思维等方面来综合评估。 结果 实验组在基础知识、病例书写方面与对照组无显著差异（P>0.05）；实验组在临床操作和分析能力、文献检索与阅读、创新思维方面与对照组存在显著差异，实验组明显优于对照组（P<0.05）。 结论 LBL-PBL-CBL-LBL教学模式在关节外科临床见习教学中临床操作和分析能力、文献检索与阅读、创新思维方面明显优于LBL-CBL教学模式，实验组在基础知识、病历书写方面与对照组无差别。

[关键词] 关节外科；LBL-PBL-CBL-LBL；LBL-CBL；见习教学；医学教育

[中图分类号] R5-4；G642.4 [文献标识码] B [文章编号] 1673-9701（2017）22-0124-05

[Abstract] Objective To compare the effect of the two different teaching modes of LBL-PBL-CBL-LBL and LBL-CBL on the clinical internship teaching of joint surgery， so as to explore a teaching method more suitable for joint surgery and to guide clinical teaching. Methods The subjects were randomly divided into LBL-PBL-CBL-LBL experimental group （n=28） and LBL-CBL control group （n=28）. Different corresponding teaching modes were applied in both group. Through the basic knowledge， clinical operation and analysis ability， medical report writing， literature retrieval and reading， innovative thinking and other aspects， comprehensive evaluation was performed. Results There was no significant difference between the experimental group and the control group in the basic knowledge and medical report writing （P>0.05）. There were significant differences between the experimental group and the control group in the clinical operation and analysis ability， literature retrieval and reading， and innovative thinking， and the experimental group was significantly better than the control group（P<0.05）. Conclusion LBL-PBL-CBL-LBL teaching mode is superior to LBL-CBL teaching mode in the clinical internship teaching of joint surgery in terms of the clinical operation and analysis ability， literature retrieval and reading， and innovative thinking. There are no differences with the control group in terms of the basic knowledge and medical records writing.

[Key words] Joint surgery； LBL-PBL-CBL-LBL； LBL-CBL； Internship teaching； Medical teaching

临床见习是本科临床医学专业的一个特殊教学环节，是纯粹理论学习向临床医生过度的桥梁，是培养临床意识和临床思维的重要一环。关节外科作为骨科的一个重要亚专科，具有相对独立的知识体系，对MRI等影像学知识、解剖学知识及空间思维能力要求较高。且相关知识和理论日新月异，发展迅速，而临床见习时间短，任务繁重，如何在短期见习临床教学过程中将关节外科的相关知识让学生得以轻松掌握，一直都是我们积极追求和探索的目标。目前对于临床见习的教学方面的研究主要包括早期的LBL（lecture based learning），以及后来的CBL（case based learning），PBL（problem based learning）[1-3]。在臨床医学专业见习阶段教学过程中应用比较广泛的是LBL-CBL教学模式，或单独的PBL教学模式等[4-6]。我们在临床教学过程中，尝……