目的 探讨基于案例学习(case-based learning,CBL)教学方法联合KWL方法在内分泌代谢科临床实习中的应用效果。方法 采用试验对照方法。2021年6月至2022年6月,采用整群抽样方法,选取在空军军医大学西京医院实习的2016级和2017级五年制临床医学专业80名学生作为研究对象,采用随机数字表将其分为试验组和对照组,每组40人。试验组采用CBL联合KWL方法进行实习带教,对照组采用传统教学方法进行实习带教。通过模拟临床执业医师理论知识和实践技能考试及问卷调查进行教学效果评价。采用t检验分析相关数据。结果 试验组学生在理论知识考试和实践技能考试的得分均高于对照组[(95.22±2.84)分比(85.58±2.96)分,(94.28±2.64)分比(83.19±2.39)分],差异均具有统计学意义(均P＜0.001)。问卷调查结果显示,试验组学生在提高学习兴趣、提高学习能力、增强逻辑思维能力、提高解决问题能力、增进师生沟通、增进医患沟通等方面的评分均高于对照组[(9.51±0.05)分比(6.83±0.96)分,(9.47±0.54)分比(6.18±0.37)分,(9.62±0.14)分比(6.51±0.25)分,(9.23±1.65)分比(6.55±3.46)分,(9.72±0.09)分比(7.41±1.98)分,(9.38±1.67)分比(6.72±2.87)分],差异均具有统计学意义(均P＜0.001)。结论 在内分泌代谢科临床实习带教中应用CBL教学方法联合KWL方法有助于提高学生理论知识和实践技能考试成绩,有助于提高学生学习兴趣及临床逻辑思维能力,促进师生沟通、增进医患沟通效果。

Objective To explore the effect of case-based learning (CBL) combined with KWL method in clinical internship teaching of endocrinology and metabolism. Methods The experimental control method was used. From June 2021 to June 2022, a cluster sampling method was adopted to select 80 five-year clinical medicine students enrolled from 2016 to 2017 who interned in Xijing Hospital of Air Force Military Medical University as research participants, and they were divided into experimental group and control group by random number table, with 40 people in each group. The experimental group used CBL and KWL method for internship teaching, whereas the control group used traditional teaching methods. The learning effect was evaluated by simulated clinical practitioner theory and practical skill examination and questionnaire survey, t-test was used to analyze the relevant data. Results The scores of experimental group students in theoretical knowledge test (95.22±2.84 vs. 85.58±2.96) and practical skill test (94.28±2.64 vs. 83.19±2.39) were higher than those in the control group, and the differences were statistically significant (all P <0.001). The results of the questionnaire showed that the students in the experimental group reported improvement in their learning interest (9.51±0.05 vs. 6.83±0.96), learning ability (9.47±0.54 vs. 6.18±0.37), logical thinking ability (9.62±0.14 vs. 6.51±0.25), problem solving ability (9.23±1.65 vs. 6.55±3.46), teacher-student communication (9.72±0.09 vs.7.41±1.98) and doctor-patient communication (9.38±1.67 vs. 6.72±2.87) in comparision with the control group, and the differences were statistically significant (all P<0.001). Conclusions The application of CBL teaching method combined with KWL method in clinical internship teaching of endocrinology and metabolism can help improve students' theoretical knowledge and practical skills test scores, effectively improve students' learning interest and clinical logical thinking ability, promote teacher-student communication and improve the effect of doctor-patient communication.