CBL联合Seminar教学模式在重症医学专业临床教学中的应用效果

目的 探索以病例为基础的教学(case-based learning，CBL)与研讨会(Seminar)教学相结合的教学模式在重症医学临床教学中的应用效果。 方法 选取2018年10月—2019年3月期间在蚌埠医学院第一附属医院重症医学科临床专业型研究生，每月随机选取8名学生入组，为期1个月，每月底进行教学效果测评。前3个月采用单一的CBL教学(共24名，对照组)，后3个月采用CBL联合Seminar教学(共24名，观察组)。 结果 在总成绩和病例分析题成绩方面:观察组明显高于对照组(81.9±4.0)分vs.(77.4±5.3)分和(31.0±2.6)分vs.(24.5±2.1)分]，差异有统计学意义(P＜0.01)；选择题和名词解释题成绩方面:观察组稍高于对照组，差异无统计学意义(均P＞0.05)。在重症医学学习兴趣、资料文献查阅积极性和重症医学思维方式3个方面成绩:观察组明显高于对照组(6.0 vs.4.0、6.0 vs.4.0和6.5 vs.4.0)，差异有统计学意义(均P＜0.01)；自主学习积极性和临床应用能力重视程度成绩方面:2组差异无统计学意义(P＞0.05)。对科室带教模式的评价方面，观察组优于对照组，差异有统计学意义(P＜0.05)；教学模式的不足之处:①一次教学时间偏长；②动手操作机会不足；③知识点理解深度不够，2组之间差异无统计学意义(均P＞0.05)。 结论 在重症医学临床教学中，使用CBL联合Seminar教学方法有利于提高专业型研究生的教学效果，值得在该领域中推广。 

Application effect of CBL combined with seminar teaching mode in clinical teaching of critical medicine

Objective To explore the application effect of case-based learning (CBL) combined with seminar teaching in clinical teaching of critical medicine. Methods From October 2018 to March 2019, clinical graduate students in the Department of critical medicine of the First Affiliated Hospital of Bengbu Medical College were selected.Eight students were randomly selected to join the group for one month, and the teaching effect was evaluated at the end of each month. In the first three months, a single CBL teaching was used (24 students in the control group). In the last three months, CBL combined with seminar teaching was used (24 students in the experimental group). Results In terms of total score and case analysis,the scores of group D were significantly higher than group S(81.9±4.0 vs. 77.4±5.3 and 31.0±2.6 vs. 24.5±2.1),had a statistically significant difference (P<0.01);In terms of choice questions and noun explanation questions,the scores of group D was slightly higher than group S,had no statistically difference(P>0.05).In terms of interest in learning critical medicine,enthusiasm for literature review and thinking mode of critical medicine in the practice assessment, the scores of group D were significantly higher than group S(6.0 vs. 4.0、6.0 vs. 4.0 and 6.5 vs. 4.0),had a statistically significant difference (P<0.01). The evaluation of teaching mode in department:Group D was better than Group S,with statistical difference (P<0.05).Disadvantages of teaching mode:①a long teaching time;②inadequate opportunities for hands-on operation; ③ inadequate understanding of knowledge points,there was no statistical difference between the two groups (P>0.05). Conclusion In clinical teaching of critical medicine, CBL combined with Seminar teaching method is helpful to improve the teaching effect of professional postgraduates, and it is worth popularizing in this field.