目的 探讨基于问题学习(problem-based learning, PBL)教学中医学生、教师和案例3个因素对医学生批判性思维的影响。方法 以北京大学2013级八年制临床医学专业114名学生为研究对象,汇总PBL教学过程中针对医学生、教师和案例3个因素的评估分数。课程结束后,应用批判性思维倾向测试量表对医学生批判性思维进行评价。以批判性思维倾向测试总分为因变量,以PBL教学中的3个因素得分为自变量,进行多因素逐步回归分析。以PBL教学中3个因素的得分与医学生批判性思维倾向测试总分及7项特质得分进行相关性分析。应用SPSS 16.0进行统计学分析。结果 医学生批判性思维总得分为303.5分,7项特质的平均分均超过40分。多因素逐步回归分析显示,PBL教学中医学生和案例2个因素进入回归方程。相关性分析显示,案例和医学生的得分与批判性思维总分及部分特质得分呈正相关,尤其是自信心和求知欲特质。结论 PBL教学中,医学生自身的表现和案例的质量是影响医学生批判性思维的关键因素,需要在教学管理中加强。
Objective To investigate the influence of 3 components in problem-based learning system, that is students, tutors and learning cases, on the critical thinking ability of undergraduate medical students. Methods A total of 114 medical students of grade 2013 in Peking University were involved in this study. The scores of student performance, tutor performance and case quality were collected after PBL teaching. The Chinese version of the critical thinking disposition inventory (CTDI-CV) was used to assess the critical thinking ability. Multiple linear regression analysis was used with the CTDI-CV scores as dependent variable, and the scores of student performance, tutor performance and case quality as independent variable. Correlation was analyzed between the 3 components in PBL system and the critical thinking ability. The analysis of numerical data was conducted by using SPSS 16.0. Results Critical thinking disposition of third-year undergraduate medical students in Peking University was at a positive level, the average total score was 303.5 and all subscale scores were over 40. Multiple linear regression analysis results showed 2 factors were of significance, that were students and case quality. Positive correlation was found between the scores of students and case quality with the scores of critical thinking ability, especially with the self-confidence subscale and the inquisitiveness subscale. Conclusions The performance of students and the case quality in PBL system are the key components which exert a significant influence on critical thinking ability and should be improved in medical education.
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