PBL在急诊临床实训教学中的应用及评价

目的 探讨以问题为基础的学习（problem-based learning,PBL）在急诊临床实训教学中的效果.方法 选择在上海交通大学医学院附属第九人民医院临床医学院参加急诊临床实训的2008、2009级5年制临床医学专业学生65人为研究对象.2008级学生33人作为对照组,采用传统方法进行急诊实训授课;2009级学生32人作为实验组,采用PBL教学.实训结束后,通过出科考试（包括理论考核、病例分析、急救操作考核）及问卷调查比较2组学生的教学效果.采用SPSS 13.0软件进行数据分析,数据用x±s表示,计数资料组间比较采用x2检验,计量资料采用t检验,以P＜0.05为差异具有统计学意义.结果 实验组和对照组出科考试中理论考核成绩差异无统计学意义（P=0.212）,实验组病例分析和急救操作考核成绩明显高于对照组（P＜0.05）.问卷调查结果显示,在激发学习兴趣、促进知识理解、培养临床综合思维、增加沟通能力、培养团队合作能力、提高临床操作能力6个方面的考查中,实验组学生对PBL教学的满意度明显高于对照组学生对传统教学的满意度（P＜0.05）.结论 在急诊临床实训中PBL教学优于传统教学,较好地培养了学生的临床综合分析能力,并使他们的急救操作技能在典型病例中得到较好运用.

Application of PBL teaching method in emergency clinical skill training and its evaluation

Objective To explore the effecr of problem-based leaming（PBL） in emergency clinic skill training.Methods Totally 65 students participating in emergency clinical skill training in The Ninth People＇s Hospital of Shanghai Jiao Tong University were enrolled.Thirty-three 2008 grade five-year clinic majors as control group were taught by traditional teaching method while Thirty-two 2009 grade five-year clinic majors as experimental group were taught by PBL.After the courses,final examinations （theoretical exam,case analysis and skill appraisal） and questionnaire smvey were used to evaluate the teaching effectiveness between the two groups.Data were managed by SPSS 13.0 software package.Quantitative data between two groups were compared by t-test.Enumeration data between two groups were compared by chi-square test.Results There was no difference in theoretical score between two groups（P=0.212）.Scores of case analysis and skill appraisal in experimental group were higher than those in control group （P〈0.05）.There were significant differences between experimental group and control group in arousing students＇ learning interest,promoting understanding of knowledge,cultivating clinical comprehensive ability,increasing communication skills,improving team cooperation ability and clinical operating ability（P〈0.05）.Conclusions PBL mode is better than traditional teaching methods in emergency clinical skill training.PBL can improve students＇ clinical comprehensive ability and emergency operations can be perfectly applied in clinic typical cases.