基于胸部高分辨率CT的三维重建联合PBL教学法在胸外科临床教学中的应用

  目的  探讨基于胸部高分辨率CT(HRCT)的三维重建联合基于问题的教学法(PBL)在胸外科临床带教中的应用经验和效果。  方法  选取2019年12月—2020年10月在蚌埠医学院第一附属医院胸外科实习的60名临床医学专业的本科实习生为研究对象，按随机数字表法分为实验组和对照组，每组各30人。对照组采用常规教学模式进行临床教学, 实验组采用基于胸部HRCT的三维重建联合PBL教学法的教学模式进行临床教学。比较2种教学模式在临床教学中的应用效果。  结果  实验组理论知识成绩为(80.17±8.43)分，高于对照组的(77.33±13.33)分，差异无统计学意义(P＞0.05)；实验组学生的临床技能考试成绩(82.90±7.86)分]明显高于对照组(74.30±4.45)分，P＜0.05]。实验组学生临床思维能力增强(9.12±0.56)分]、实践能力提升(9.04±0.52)分]、学习兴趣及满意度(8.62±1.65)分]、教学模式的认可度(8.67±1.03)分]等项目评分均高于对照组(6.72±1.26)分、(7.18±1.24)分、(7.33±1.84)分、(6.10±1.64)分，均P＜0.05]。  结论  基于胸部HRCT的三维重建联合PBL的教学模式，不仅增加了实习学生的学习兴趣和学习热情，也进一步提升其临床操作技能和综合分析问题的能力，教学效果满意。 

The application of 3D reconstruction technology based on high-resolution CT and PBL teaching model in thoracic surgery clinical teaching

  Objective  To explore the application experience and effect of 3D reconstruction technology based on chest high resolution CT (HRCT) combined with problem-based learning (PBL) in clinical teaching in thoracic surgery.  Methods  Sixty undergraduate interns in clinical medicine who were interns in the Thoracic Surgery Department at the First Affiliated Hospital of Bengbu Medical College from December 2019 to October 2020 were selected as the research objects. With the informed consent of the students, they were randomly divided into the experimental group and the control group, with 30 persons in each group. The control group was subjected to the conventional teaching mode for clinical teaching, whereas the experimental group adopted the 3D reconstruction technology based on chest HRCT combined with PBL teaching method. The application effects of the two teaching modes in clinical teaching were compared.  Results  The theoretical knowledge score of the experimental group was (80.17±8.43) points, whereas that of the control group was (77.33±13.33) points, there was no significant difference between the two groups (P>0.05). The clinical skill test scores of the students in the experimental group (82.90±7.86) points] were significantly higher than those in the control group (74.30±4.45) points], and the difference was statistically significant (P < 0.05). The students in the experimental group had improved clinical thinking ability (9.12±0.56) points], improved practical ability (9.04±0.52) points], improved learning interest and satisfaction (8.62±1.65) points] and improved recognition degree of the teaching mode (8.67±1.03) points] than those in the control group. The scores of the items mentioned above were higher than those of the control group (6.72±1.26) points, (7.18±1.24) points, (7.33±1.84) points and (6.10±1.64) points, all P < 0.05].  Conclusion  The 3D reconstruction of chest HRCT combined with PBL teaching mode not only increases the learning interest and enthusiasm of intern students but also improves their clinical operation skills and comprehensive analysis of problems. The teaching mode effect is satisfactory.