PBL教学对提高医学生毕业后临床实践技能效果的系统评价

目的对PBL教学提高医学生毕业后临床实践技能的效果进行系统评价。方法计算机检索PubMed、EMbase、Cochrane图书馆、CBM、CNKI和VIP等数据库,纳入国内外有关PBL教学法对比传统教学法提高医学生毕业后临床实践技能的对照研究,检索时间截至2010年1月。对研究结果进行定性分析。结果最终纳入16个对照研究,其中仅1个为RCT。结果显示：4个研究的客观评价和2个研究的自我评价结果均显示PBL教学组医生的综合能力优于传统教学组医生。在卫生保健法律伦理道德、研究及表达技巧和解决问题的能力方面,无论自我评价还是客观评价均显示了PBL教学法的优势。但在其他方面,PBL教学方法对医学生毕业后临床实践技能的影响尚存在一定争议。结论相对于传统教学法,PBL教学法可较好地提高医学生毕业后的临床实践技能,但由于纳入分析的研究质量较低,上述结论尚有待设计更为严谨的试验进一步验证。

Effectiveness of Problem-Based Learning to Improve Clinical Practice Skills for Clinical Students after Graduation: A Systematic Review

Objective To assess the effect of problem-based learning（PBL）to improve clinical practice skills for clinical students after graduation.Methods Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL.The quality of the included studies was critically evaluated and data were analyzed.Results A total of 16 articles were included.The results showed that in integrated capabilities,PBL teaching was superior to traditional teaching methods.Whether in self-evaluation or objective evaluation,in terms of legal and ethical aspects of health care,research and presentation skills and ability to solve problem,PBL teaching was superior to non-PBL-learning methods.But in other aspects,it was yet controversial whether PBL-learning was better than non-PBL-learning.Conclusion Problem-based learning could improve clinical practice skills for clinical students after graduation.However,most trials included are of low quality,so large-scale randomized controlled trials of higher quality are needed to confirm this.