Abstract: Objective To explore the teaching effect of problem-based learning (PBL) combined with students as standardized patients (SSP) in clinical skill training. Methods The total 183 students of five-year clinical medicine in Shanxi Medical University were selected as research subjects. A group of 62 students in class 1 was used as experimental group with PBL combined with SSP, A group of 60 students in class 2 was used as control group 1 with PBL, A group of 61 students in class 3 was used as control group 2 with lecture-based learning (LBL) according to their routine classes. The students in the three groups were evaluated on learning outcomes through theoretical and practical test scores and questionnaires. Results The scores of theoretical examination and practical operation in experimental group are (86.1±8.9) and (80.3±11.9); which in control group 1 are (81.7±8.7) and (75.7±10.4); which in control group 2 are (79.7±11.8) and (74.7±8.3).The scores of theoretical and practical examination in experimental group is significantly better than those of control group 1 and control group 2 (all P＜0.05). The teaching method combined with PBL and SSP can improve medical students' interest in learning and students' autonomous learning and students' clinical thinking ability and doctor-patient communication ability. The identification ratio of experinmental group are91.9%(57/62),91.9%(57/62),90.3%(56/62),88.7%(55/62); which in control group 1 are76.7%(46/60),78.3%(47/60),71.7%(43/60),53.3%(32/60); which in control group 2 are75.4%(46/61),73.8%(45/61),67.2%(41/61),50.8%(31/61). There was statistical difference (all P＜0.05). Conclusions Compared with LBL teaching method and PBL teaching method, the teaching method combining PBL with SSP can better improve students' clinical practice ability.

Key words: Problem-based learning, Student as standardized patient, Clinical teaching, Practical ability