案例和问题为导向相结合的教学查房模式与传统教学查房模式对照研究

目的探讨案例和问题为导向相结合的教学查房模式在精神科实习中的效果，优化精神科教学查房模式。方法将2010年3月～2012年2月到上海交通大学医学院附属精神卫生中心实习的上海交通大学医学院五年制本科生、七年制本硕连读生及八年制本硕博连读生共365人分为A组（181人）和B组（184人），分别参加案例和问题为导向相结合的教学查房模式和传统讲座式查房模式的临床教学查房。通过自制调查问卷评定两组教学查房效果，并对实习成绩进行考核。结果A组总体满意度（4．56±0．39）分比（4．13±0．52）分]、准备工作（4．57±0．21）分比（4．26±0．43）分1、上课效果（4．65±0．38）分比（4．26±0．34）分]、参与性f（4．64±0．33）分比（4．08±0．45）分1、处理问题能力（4．62±0．27）分比（4．42±0．43）分]显著高于B组（P〈0．05或P〈0．01）；A组临床实习生成绩高于B组实习生成绩，但差异无统计学意义（P〉0．05）。结论案例和问题为导向相结合的教学查房模式可能有助于提高实习生的学习兴趣和积极性，增加实习生自学能力，更好地培养了实习生分析和解决临床问题的能力．

Controlled study of problem-based learning combined with case-based learning teaching mode and traditional teaching mode

Objective To investigate the value of problem-based learning combined with case-based learning on psychiatric practice, optimized psychiatric teaching mode. Methods A total of 365 five-year undergraduate, seven-year graduate students and doctoral students who came from Shanghai Jiao Tong University School of Medicine and took practice in Shanghai Mental Health Center of Shanghai Jiao Tong University School of Medicine from March 2010 to February 2013 were divided into group A （n = 181） and group B （n = 184）. Probem-based learning combined with case-based learning and traditional teaching were respectively used in the group A and B. A self-made questionnaire and clinical scores was employed to assess the effect of two teaching modes. Results The overall satisfaction （4.56± 0.39） points vs （4.13±0.52） points], preparatory work （4.57±0.21） points vs （4.26±0.43） points], class effects （4.65± 0.38） points vs （4.26±0.34） points], participatory （4.64±0.33） points vs （4.08±.45） points], problem solving ability 0.62±.27） points vs （4.42±0.43） points] of group A were significantly higher than those in group B （P 〈 0.05 or P 〈 0.01）. Though clinical score of group A was higher than that in group B, there was no significant difference between the two groups （P 〉 0.05）. Conclusion Problem-based learning combined with ease-based learning can improve the interns＂ enthusiasm and initiative in learning, and enhance self-study ability, and bring up the intern＇s ability to analyze and solve clinical problems.