摘要目的 病理生理学的教学目标是让医学生掌握重要疾病和病理过程的发病机制,为将来在临床工作中结合患者的实际情况分析和解决疾病的诊治奠定基础.为了更好地实现该目标,本研究尝试在病理生理学考试中增加临床情境式命题,以检测学生对所学理论知识的应用能力.方法 选取北京大学医学部2011级八年制基础医学专业和八年制临床医学专业共223名学生作为研究对象,在相同授课教师、相同班级学生和相同知识点的基础上,通过在试卷中设置相同选项而不同题干的情境式和非情境式单项选择题,比较学生答案的正确率,由此分析学生应用所学知识的能力.结果 与以考核知识记忆为主的传统式非情境题型相比,情境式考题的得分率低于非情境式单项选择题;进一步对不同分数段的学生成绩进行分析,亦呈相同的趋势.结论 在病理生理学考试中增加临床情境式考题对学生应用基础理论知识分析和解决临床问题的能力有着更高的要求,也增加了试题的难度,可以检测学生对所学理论知识的应用能力,有利于对学生综合素质的培养.

abstractsObjective The teaching aim of pathophysiology is to master the pathogenesis of the important disease and pathological process for the medical students,and to get the ability to analyze the actual situation of patients combined with what they learned in the class.In order to achieve this goal,we try to increase the questions containing the clinical situation in the examination.Methods 223 eightyear program students in Grade 2011 were selected from Peking University Health Science Center.These students were in the same one class and taught by the same pathophysiological instructors.This study set two type questions-stems that containing and not containing clinical situation for the same knowledge point in the examination paper and analyzed the students'comprehensive ability by comparing the score in different questions-stems.Results The score of traditional questions-stems that not containing clinical situation were higher than that of the questions-stems containing clinical situation in the different level of students.Conclusions Increasing the questions containing clinical situation in the examination of pathophysiology could strengthen the ability of medical students to analyze and solve clinical problems,enhance the difficulty of the examination and cultivate the students' comprehensive quality.