以问题为基础学习在内科学实习教学中的实践与评估

目的 在内科学实习教学中实施以问题为基础学习(problem-based learning,PBL)并评估其教学效果.方法 选择复旦大学2005级八年制临床医学专业59名实习生为研究对象,将其分为PBL组和非PBL组.PBL组进行为期6周、2个病例的教学,通过问卷调查了解该组学生在PBL教学前后的自我评价、学生对PBL课程和教师的评价以及教师对学生的评价.比较PBL组和非PBL组学生的实习成绩.结果 PBL组学生对于PBL教学持欢迎态度.从学生的自我评价来看,八年制实习生拥有较好的自我学习和协作实践能力,能够做好PBL的准备工作,主动参与PBL教学.学生对PBL教学的总体满意度为100%.他们认为,PBL教学能够提高其诊断与鉴别诊断的能力以及加深其对治疗的理解,指导教师能够引导学生自行寻找答案并进行表达.指导教师认为,学生临床推理等能力有待进一步提高.PBL组和非PBL组学生内科学实习总成绩差异无统计学意义.结论 PBL组学生对PBL教学有着较高的满意度,选择合适的临床问题、培养学生的临床思维、加深学生对疾病的理解是PBL教学的重点.

Practice and evaluation of problem-based learning in interns of internal medicine

Objective To improve the teaching effect, problem-based learning (PBL)was developed and evaluated for interns of internal medicine. Methods Fifty-nine eight-year program medical interns were divided into PBL group and non-PBL group. Six-week practice on two PBL cases was carried out for PBL group. Questionnaires were designed to investigate the self-evaluation of the interns of PBL group before and after PBL, the opinions on the PBL teaching, the tutors, and views of the tutors on the interns.Practice scores of the two groups were compared. Results PBL was welcomed by the interns. The interns enjoyed self-study and cooperation, and they prepared for and participated in the PBL teaching actively.They were satisfied with PBL teaching. PBL was helpful to diagnosis, differential diagnosis, understanding on therapy. The tutors thought that the students' ability of clinical reasoning needed to be improved. There was no significant difference on practice scores between the two groups. Conclusions The interns were satisfied with PBL. Raising proper clinical questions, cultivating the students' clinical thinking and improving the students' comprehension on diseases might be the emphases during PBL teaching.