以问题为基础的学习结合计算机辅助技术在乳腺外科临床见习教学中的应用

目的 探讨以问题为基础学习（problem—based learning，PBL）结合计算机辅助技术在乳腺外科临床见习教学中的应用效果。方法 采用随机抽样法将见习生分为两组。对照组24名学生采用课堂讲授（1ecture，based learning，LBL），试验组24名学生采用PBL结合计算机辅助技术教学。向试验组学生发放调查问卷，调查其对PBL结合计算机辅助技术教学的认可程度。向试验组和对照组教学中各5名参与示教的患者发放调查问卷，调查患者是否感觉隐私权受到侵犯。比较两组学生理论考试成绩（满分50）、综合技能考核成绩（满分50）。两组间均数比较采用t检验。结果 91．7％（22人）的实验组学生认同PBL结合计算机辅助技术教学。参与试验组示教的患者20．0％（1人）感觉隐私权受到侵犯，参与对照组示教的患者60．0％（3人）感觉隐私权受到侵犯。试验组及对照组学生理论考试成绩分别（46．23±2．45）分和（45．52±3．29）分，差异无统计学意义（t=1．230，P=0．225）；综合技能考核成绩分别为（47．23±2．45）分和（36．52±3．29）分，差异有统计学意义（t=12．791，P=0．000）。结论 PBL结合计算机辅助技术教学能够激发学生的学习积极性，有助于培养其临床思维，并可保护患者隐私权，避免医患纠纷。

The application of problem-based learning with computer aided technology in teaching of breast surgery clinical practice

Objective To probe the teaching method of application of problem-based leaming （PBL）with computer aided technology in teaching of breast surgery clinical practice. Methods 48 students were randomly divided into two groups： control group（n=24） were taught by lecture-based learning （LBL）, experimental group （n=24） were taught by method of application of problem-based learning （PBL）with computer aided technology. Questionnaire was provided to the students of experimental group to investigate the degree of recognition to the teaching method of problem-based learning （PBL）with computer aided technology, 5 patients from experimental group and 5 patients from control group participating in teaching were given questionnaires to investigate if their fight of privacy were violated. The theory examination score（out of 50） and comprehensive skills assessment score （out of 50） were compared between the two groups; the mean differences between the two groups were compared by t test. Result The teaching method of application of problem-based learning（PBL） with computer aided technology was recognition by 91.7 %（22 persons） of students. 20 percent（one person） of the experimental group patients felt their fight of privacy violated; 60 percent（three persons） of the control group patients felt their right of privacy violated. The theory test scores of the experimental group and control group were （46.23 ± 2.45） and （45.52 ± 3.29）. There was no statistical significance （t=1.230,P=0.225）. The skill test scores of the experimental group and control group were （47.23± 2.45） and （36.52 ± 3.29）. There was statistical significance（t=12.791,P=0.000）. Conclusion The teaching method of application of problem-based learning（PBL） with computer aided technology can help encourage the study interest of students, and cultivate their clinical thinking method and capacity, and protect the right of privacy of the patients, avoiding patient-hospital disputes.