王丽娟 葛睿 周艳

[摘要] 目的 对比皮肤科临床见习教学过程中基于案例的协作学习的教学模式（CBCL）与基于问题的教学模式（PBL）的教学效果。 方法 选取2018年1～12月在西安交通大学第一附属医院皮肤科进行临床见习的临床专业本科学生32名，采用随机数字表法将其分为CBCL教学组（16）和PBL教学组（16）。临床见习结束后，根据理论考试成绩、临床技能掌握程度、授课效果调查问卷得分，综合评价两种教学模式在皮肤科临床见习中的教学效果。结果 两组的理论考试成绩与临床技能掌握熟练程度比较，差异无统计学意义（P > 0.05）。但对于既往考试成绩低于平均分的学生而言，CBCL组的理论考试成绩高于PBL组，差异有统计学意义（P < 0.05）。调查问卷显示更多的CBCL组学生认为教学中所应用的教学模式有趣、参与度高。 结论 在皮肤科临床见习教学中，CBCL教学模式更有助于调动学业成绩较低的学生学习理论知识的积极性与主动性。

[关键词] 基于案例的协作学习教学模式;基于问题的教学模式;临床见习;效果比较

[中图分类号] G642.4          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0051-04

[Abstract] Objective To compare the educational effectiveness of case-based collaborative learning （CBCL） and problem-based learning （PBL） in the clinical noviciate teaching of dermatology. Methods From January to December 2018， 32 undergraduate students of clinical majors were selected for clinical probation in the Department of Dermatology of the First Affiliated Hospital of Xi′an Jiaotong University， which was divided into CBCL teaching group （16 cases） and PBL teaching group （16 cases） by random number table method. After the end of clinical probation， the teaching effect of the two teaching modes in clinical probation of dermatology was evaluated comprehensively according to the theoretical examination results， the degree of clinical skill mastery and the teaching effect questionnaire scores. Results There were no significant differences in theoretical test scores and clinical skill proficiency between two group （P > 0.05）. However， for students with lower than average scores in previous exams， the theoretical exam scores of CBCL group were higher than those of PBL group， with statistically significant differences （P < 0.05）. The questionnaire showed that more students in CBCL group thought the teaching mode applied in teaching was interesting and highly engaged. Conclusion In clinical probation teaching of dermatology， CBCL teaching mode is more helpful to mobilize the enthusiasm and initiative of students with low academic performance in learning theoretical knowledge.

[Key words] Case-based collaborative learning; Problem-based learning; Clinical noviciate; Effects comparison

临床见习课程的授课质量直接决定着学生掌握临床知识的熟练程度及应用基础知识解决临床问题的能力[1-4]。越来越多的新式教学模式被应用到医学基础课程及临床见习教学课程当中，如基于小组的教学模式（team-based learning，TBL）[5-7]、基于问题的教学模式（problem-based learning，PBL）[8-10]、基于案例的教学模式（case-based learning，CBL）[11-13]。在全球医学教育领域，教学模式的改进与创新一直在进行当中。基于案例的协作学习的教学模式（case-based collaborative learning，CBCL）于2016年由哈佛大学医学院的Sch-wartzstein教授首次报道，该教学模式整合了TBL、PBL和CBL教学模式的相关成分[14]。在西安交通大学第一附属医院（以下简称“我院”）多项教学改革的基础上[15-18]，本研究探討了在临床见习授课中应用CBCL教学模式的可行性。