PBL 联合CBL 教学法在脊柱外科生产实习教学中的应用

目的 探讨以问题为基础的教学法（problem-based learning, PBL）与案例教学法（case-based learning,CBL）相结合在脊柱外科临床见习中的应用及其优越性。方法 选取首都医科大学附属北京友谊医院在脊柱外科进行生产实习的七年制临床医学生，共40 人，随机分为传统教学组和PBL+CBL 联合教学组进行生产实习，每组20 人。实习结束时采取专业知识小测验的方式评价专业知识掌握情况，同时派发调查问卷，调查学生各方面能力提高情况。结果 PBL+CBL 组实习结束时专业测验得分要高于传统教学组，特别是病例分析方面，两组学生间差异具有统计学意义。PBL+CBL 组学生同样在临床思维能力、重点难点掌握能力、患者沟通能力、解决问题能力等能力提升上优于传统教学组，并增加了对骨科学习的兴趣。结论 在脊柱外科临床实习教学中应用PBL 联合CBL 教学法，学生掌握知识更加牢固系统，学习能力提高显著，值得推广这一新型的教学方式。

Application of PBL combined with CBL teaching method in clinical probation in spine Surgery

Objective To explore the effect and strength of problem based learning (PBL) combined with case based learning(CBL) in clinical practice of spine surgery. Methods 40 interns of Beijing Friendship Hospital who are seven-year clinical medical students of Capital Medical University were selected as subjects who were randomly subdivided into two groups, one was traditional group and the other was PBL combined CBL group (each group 20 students). After the course was finished, each student of these two groups underwent a test on the professional knowledge and filled in a questionnaire on the assessment of students' capacities. Results The scores of professional test in PBL+CBL group were significantly higher than those in traditional group, especially more difference between them in cases analysis. Meanwhile, the data showed that students' ability of PBL+CBL group in clinical thinking, mastering key points and difficulties and communication skills were significant improved more than those in traditional group. Conclusion PBL combined with CBL is a useful teaching method in clinical practice of spine surgery and should be promoted.