张孟贤 韩娜

[摘要] 目的 探讨临床医学本科生临床见习阶段的教育模式，提高医学生见习阶段教学质量。方法 2016级临床医学系本科生肿瘤科见习的学生随机分为两组，实验组采用案例教学法（CBL）教学，对照组采用传统教学法（LBL），教学结束后以临床考核和问卷调查的形式进行教学效果质量评估。结果 实验组同学临床考核成绩明显优于对照组，其中认为CBL教学激发学习兴趣、加强学习参与感的比例为95%，有助于培养自主学习能力达到90%。结论 在本科生临床见习阶段采用CBL教学法可以有效激发同学学习兴趣，提高学习参与意识，加强团队协作能力，帮助同学适应由基础到临床的角色转换，优化见习阶段的教学成果。

[关键词] CBL教学法；本科生；临床见习

[中图分类号] R73 [文献标识码] A [文章编号] 1672-5654（2018）07（c）-0008-03

Application of CBL Teaching Method in the Practice of Clinical Medical Undergraduates in the Department of Oncology

ZHANG Meng-xian， HAN Na

Department of Oncology， Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology， Wuhan， Hubei Province， 430000 China

[Abstract] Objective To study the education model of the clinical medical undergraduates in the clinical practice and improve the teaching quality of medical students in the practice phase. Methods The clinical medial undergraduates in the department of oncology in 2016 were randomly divided into two groups， the experimental group used the CBL， the control group used the LBL method， and the teaching effect was for quality evaluation in the clinical examination and questionnaire form at the end of teaching. Results The clinical examination score in the experimental group was obviously better than that in the control group， and the ratio of people supposed CBL teaching in motivating the learning interest and enhancing the learning participation sense was 95%， and the ratio of people who contributed to educating the automatic learning ability was 90%. Conclusion The CBL teaching for undergraduates in the clinical practice phase can effectively motivate the learning interest， improve the learning participation sense， enhance the team cooperation ability， help classmates adapt thechange from basic role to the clinical role， and optimize the teaching effect in the practice phase.

[Key words] CBL teaching； Undergraduate； Clinical practice

臨床见习是医学生由基础理论学习向临床实践过渡的桥梁，临床医学是实践性很强的学科，早期接触临床是目前医学教育课程改革的趋势[1]。该院在临床医学本科二年级学生中开展了为期3个月的临床见习，这些学生医学理论知识尚且薄弱，缺乏建立良好临床思维的基础，单纯的“看”和传统的以授课为基础的教学法（lecture based learning，LBL）都难以调动学生的学习兴趣，不利于培养学生独立思考的能力[2]。在临床带教中，探索应用案例教学法（case-based learning，CBL），增加学生对临床工作的感性认识，有效激发学生的学习兴趣，培养学生主动学习的能力，为学生完成后续理论课程的学习和实现基础到临床的角色转换打下了良好的基础。

1 对象与方法

1.1 研究对象

选择华中科技大学同济医学院2016级临床医学系本科生在肿瘤科见习的学生作为研究对象，随机分为两组，每组20人，共40人。经本人同意后，实验组为CBL组，对照组为LBL组。两组均由具有副高级且具有带教经验的临床医师带教。教学时间1次/周，2 h/次，共12次。

1.2 教学方法