目的 探讨基础医学系统整合联合基于问题学习、基于案例学习教学(以下简称系统整合教学)对医学生批判性思维能力的影响。方法 2018年6月以大连医科大学五年制临床医学专业184名学生为研究对象,将其分为试验组和对照组,试验组89名学生实施“卓越医生新模式培养计划”,进行基础医学系统整合教学,对照组95名学生实施以学科为中心的传统教学。采用中文版批判性思维量表(Critical Thinking Disposition Inventory-Chinese Version,CTDI-CV)评价基础医学系统整合教学对医学生批判性思维能力的培养效果。 结果 试验组的批判性思维能力总分明显高于对照组,差异具有统计学意义 (P＜0.01) 。试验组的开放思想、分析能力、认知成熟度、求知欲4个维度评分高于对照组[(42.03±5.60)分比(39.98±5.47)分、(41.69±6.27)分比(39.43±5.89)分、(42.16±6.93)分比(39.61±8.13)分、(43.74±7.74)分比(40.32±5.63)分],差异均有统计学意义(均P＜0.05)。在70个题目中,17个题目两组间差异具有统计学意义(P＜0.05) 。结论 在临床医学专业学生基础医学教学中,系统整合教学能有效促进医学生批判性思维能力的提高。

Objective To discuss the effect of system-based integrated curriculum combined with problem-based learning, case-based learning (hereinafter referred to as system-based integrated teaching) in basic medical sciences in the cultivation of clinical medical students' critical thinking ability. Methods A total of 184 students from the 5-year clinical medicine scheme in Dalian Medical University were subjects, which include experiment group (n=89, system integrated teaching mode)and control group(n=95, traditional discipline-centered teaching mode). Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was used to evaluate the critical thinking ability of students. Results The total score of the experiment group was significantly higher than that of control group (P＜0.01). Open-mindedness, analyticity, inquisitiveness and cognitive maturity of the seven dispositions of experiment group were significantly higher than that of control group [(42.03±5.60)vs(39.98±5.47),(41.69±6.27)vs(39.43±5.89),(42.16±6.93)vs(39.61±8.13),(43.74±7.74)vs(40.32±5.63), all P＜0.05]. There were statistical differences in 17 of 70 items of critical thinking ability of two groups (P＜0.05). Conclusions System-based integrated course facilitates clinical medical students to improve their critical thinking abilities.