肖正华 李晓梅 李静

摘 要 目的：初步探讨PBL结合CBL教学在妇产科专业基地住院医师规范化培训教学中的应用效果。方法：选择妇产科专业基地住培医师为研究对象，随机分成对照组和实验组，实验组采取PBL+CBL教学模式， 对照组采取常规专科责任导师“跟班学习”的模式进行， 通过出科理论考核、技能考核以及问卷调查的方式评价教学效果。结果：实验组与对照组在临床思维、理论知识考核方面，前者明显高于后者，差异有统计学意义（P> 0.05），但在技能操作比较，差异没有统计学意义（P<0.05），同时住培医师对PBL+CBL教学模式更加满意。结论：PBL结合CBL教学模式在提高妇产科住培医师临床思维、基本理论知识等方面更加有效，是一种在住院医师规范化培训教学中值得推广的教学方法。

关键词 PBL+CBL教学法 住院医师 规范化培训 教学效果

中图分类号：G424 文献标识码：A DOI：10.16400/j.cnki.kjdkz.2018.08.050

Abstract Objective：To explore the application effect of PBL combined with CBL teaching in the standardized training of residents in obstetrics and gynecology professional base. Methods：The doctors of obstetrics and gynecology were selected as the research subjects. They were randomly divided into the control group and the experimental group. The experimental group adopted the PBL+CBL teaching mode， while the control group adopted the regular specialist responsible tutor "follow-class learning" mode. Assessment， skill assessment， and questionnaire surveys evaluate teaching outcomes. Results： In the experimental group and the control group， the former was significantly higher than the latter in the clinical thinking and theoretical knowledge assessment. The difference was statistically significant （P>0.05）， but the difference was not statistically significant （P<0.05）. At the same time， the doctors were more satisfied with the PBL+CBL teaching model. Conclusion：PBL combined with CBL teaching mode is more effective in improving the clinical thinking and basic theoretical knowledge of obstetrics and gynecology physicians. It is a teaching method worthy of promotion in the standardized training of residents.

Keywords PBL + CBL teaching method； resident doctors； standardized training； teaching effect

住院医师规范化培训是毕业后医学教育的重要组成部分，目的是为各级医疗机构培养具有良好的職业道德、扎实的医学理论知识和娴熟的临床技能，能独立、规范地承担本专业常见病、多发病的诊治工作。众所周知，妇产科是一门专科性质较强的临床学科，它既有外科性质的普遍性，又具有专科性质的特殊性，那么如何培养住院医师具备良好的临床思维和操作技能，是一个值得妇产科带教老师去深入探讨的问题。[1]笔者作为国家级基地第一责任导师和专科责任导师的双重身份，剖析了近5年来妇产科基地住院医师的现状，首次尝试了将PBL结合CBL联合应用在住院医师的日常教学活动中，以培养学生的综合素质能力。

1 对象与方法

选择重庆医科大学附属永川医院妇产科专业基地同期每月……