李红　孟帅++孔祥赟

[摘要] 临床见习是医学学习过程中由理论到临床实践的转折点，是通过临床实践促进理论知识融会贯通、提高学习兴趣、培养逻辑思维的重要阶段。理论与临床实践脱节时，面对实际临床问题就会手足无措，不利于急危重症的快速鉴别诊断与针对性治疗。胸痛、腹痛、呼吸困难是急诊科常见症状，北京安贞医院急诊科尤以心血管疾病见长。近年来，基于问题学习的教学模式（PBL）在临床教学中取得了良好的教学效果。在急诊见习中PBL教学具有特殊意义，有助于医学生系统性认识、分析疾病，提高逻辑思维能力。笔者总结了PBL教学在典型急诊病例中应用的经验和体会，以期为急诊医学教学提供经验与帮助。

[关键词] 基于问题学习的教学模式；临床见习；急诊科

[中图分类号] G642.0 [文献标识码] A [文章编号] 1673-7210（2016）12（a）-0151-03

Application of problem-based learning in emergency clinical probation

LI Hong MENG Shuai KONG Xiangyun

Emergency Department， Beijing Anzhen Hospital， Capital Medical University， Beijing 100029， China

[Abstract] Clinical probation is the turn point from medical theories towards clinical practice for medical students. During clinical probation， practice will increase the integration of theories， improve study interest and develop clinical logical thinking. Once theory is divorced from clinical practice， students will be confused in the diagnosis and treatment， miss the best opportunity of disease control， especially for acute and critical diseases. Cardiovascular diseases are the specialty of Beijing Anzhen Hospital. Emergency department are experienced with rapid diagnosis and treatment of acute chest pain， abdominal pain and dyspnea. In recent years， problem-based learning （PBL） has been widely used in clinical teaching and has obtained favorable effects. PBL is more important in emergency clinical probation. Medical students can improve the ability of systemic analysis of disease and make rapid diagnosis through PBL training. The authors summarize the experiences and understandings of PBL in emergency cases， so as to provide experience and help for the teaching of emergency medicine.

[Key words] Problem-based learning； Clinical probation； Emergency Department

見习是医学生初涉临床、由理论到实践的转折点。学生对临床问题产生兴趣，会有效激发学习积极性，培养临床思维能力，为实际诊治患者打下良好基础。急诊科急危重症患者多，病情复杂，快速诊断和治疗可挽救生命。在见习中，教师对病例以传统方式进行疾病诊治的授教，不利于启发学生进行自主诊治的积极性和主动性。基于问题学习的教学模式（problem-based learning，PBL）是以问题为基础、以学生为主体、以教师为导向的教学模式[1]。近年来笔者在急诊科见习教学中结合急诊科室的特色，积极采用PBL模式，更好地调动了医学生的学习积极性，培养了他们的思维能力。……