張孟賢 韓娜

[摘要] 目的 探討臨床醫(yī)學(xué)本科生臨床見習(xí)階段的教育模式，提高醫(yī)學(xué)生見習(xí)階段教學(xué)質(zhì)量。方法 2016級臨床醫(yī)學(xué)系本科生腫瘤科見習(xí)的學(xué)生隨機分為兩組，實驗組采用案例教學(xué)法（CBL）教學(xué)，對照組采用傳統(tǒng)教學(xué)法（LBL），教學(xué)結(jié)束后以臨床考核和問卷調(diào)查的形式進行教學(xué)效果質(zhì)量評估。結(jié)果 實驗組同學(xué)臨床考核成績明顯優(yōu)于對照組，其中認(rèn)為CBL教學(xué)激發(fā)學(xué)習(xí)興趣、加強學(xué)習(xí)參與感的比例為95%，有助于培養(yǎng)自主學(xué)習(xí)能力達(dá)到90%。結(jié)論 在本科生臨床見習(xí)階段采用CBL教學(xué)法可以有效激發(fā)同學(xué)學(xué)習(xí)興趣，提高學(xué)習(xí)參與意識，加強團隊協(xié)作能力，幫助同學(xué)適應(yīng)由基礎(chǔ)到臨床的角色轉(zhuǎn)換，優(yōu)化見習(xí)階段的教學(xué)成果。

[關(guān)鍵詞] CBL教學(xué)法；本科生；臨床見習(xí)

[中圖分類號] R73 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1672-5654（2018）07（c）-0008-03

Application of CBL Teaching Method in the Practice of Clinical Medical Undergraduates in the Department of Oncology

ZHANG Meng-xian， HAN Na

Department of Oncology， Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology， Wuhan， Hubei Province， 430000 China

[Abstract] Objective To study the education model of the clinical medical undergraduates in the clinical practice and improve the teaching quality of medical students in the practice phase. Methods The clinical medial undergraduates in the department of oncology in 2016 were randomly divided into two groups， the experimental group used the CBL， the control group used the LBL method， and the teaching effect was for quality evaluation in the clinical examination and questionnaire form at the end of teaching. Results The clinical examination score in the experimental group was obviously better than that in the control group， and the ratio of people supposed CBL teaching in motivating the learning interest and enhancing the learning participation sense was 95%， and the ratio of people who contributed to educating the automatic learning ability was 90%. Conclusion The CBL teaching for undergraduates in the clinical practice phase can effectively motivate the learning interest， improve the learning participation sense， enhance the team cooperation ability， help classmates adapt thechange from basic role to the clinical role， and optimize the teaching effect in the practice phase.

[Key words] CBL teaching； Undergraduate； Clinical practice

臨床見習(xí)是醫(yī)學(xué)生由基礎(chǔ)理論學(xué)習(xí)向臨床實踐過渡的橋梁，臨床醫(yī)學(xué)是實踐性很強的學(xué)科，早期接觸臨床是目前醫(yī)學(xué)教育課程改革的趨勢[1]。該院在臨床醫(yī)學(xué)本科二年級學(xué)生中開展了為期3個月的臨床見習(xí)，這些學(xué)生醫(yī)學(xué)理論知識尚且薄弱，缺乏建立良好臨床思維的基礎(chǔ)，單純的“看”和傳統(tǒng)的以授課為基礎(chǔ)的教學(xué)法（lecture based learning，LBL）都難以調(diào)動學(xué)生的學(xué)習(xí)興趣，不利于培養(yǎng)學(xué)生獨立思考的能力[2]。在臨床帶教中，探索應(yīng)用案例教學(xué)法（case-based learning，CBL），增加學(xué)生對臨床工作的感性認(rèn)識，有效激發(fā)學(xué)生的學(xué)習(xí)興趣，培養(yǎng)學(xué)生主動學(xué)習(xí)的能力，為學(xué)生完成后續(xù)理論課程的學(xué)習(xí)和實現(xiàn)基礎(chǔ)到臨床的角色轉(zhuǎn)換打下了良好的基礎(chǔ)。

1 對象與方法

1.1 研究對象

選擇華中科技大學(xué)同濟醫(yī)學(xué)院2016級臨床醫(yī)學(xué)系本科生在腫瘤科見習(xí)的學(xué)生作為研究對象，隨機分為兩組，每組20人，共40人。經(jīng)本人同意后，實驗組為CBL組，對照組為LBL組。兩組均由具有副高級且具有帶教經(jīng)驗的臨床醫(yī)師帶教。教學(xué)時間1次/周，2 h/次，共12次。

1.2 教學(xué)方法