摘要目的 探讨以问题为基础的学习(problem-based learning,PBL)和案例教学(case based learning,CBL)相结合在临床肿瘤学教学中的应用价值.方法 将2013至2014年在肿瘤科临床学习的八年制临床医学专业学生和住院医师规范化培训学员(68人)分为两组,分别采用PBL和CBL相结合的双轨教学(30人)和常规教学(38人),PBL和CBL相结合教学主要基于病例和问题展开.采用结业考试和教学满意度调查比较两种教学方法的效果,应用SPSS 13.0对两组学生考试成绩行t检验、满意度结果行x2检验.结果 结业考试中非病例分析题平均得分,双轨教学组为(50.30±7.19),常规教学组为(52.04±8.01),差异无统计学意义(P=0.358);但病例分析题平均得分,双轨教学组的(35.76±5.28)优于传统教学组的(31.80±5.16),差异有统计学意义(P=0.003).教学满意度调查中,双轨型教学组学生相比常规教学组,对自学能力、医患沟通能力、交流表达能力的提升效果更认同,对教学总体满意度更高,并更愿意继续开展相应方式的教学(P＜0.05).结论 PBL和CBL相结合教学有利于提高教学质量和满意度,值得在肿瘤临床教学中推广应用.

abstractsObjective To explore the value of an innovative teaching model which combined problem based learning (PBL) method with case based learning (CBL) method in clinical oncology Teaching.Methods 68 students were divided into the combinational teaching group (30 cases) and the LBL group (38 cases).The combinational teaching group was taught by PBL method combined with CBL method, and this dual track teaching was based on cases and problems.The traditional teaching group was taught by LBL method.The teaching effect was evaluated by students' questionnaire survey and test score.SPSS 13.0 was used to two groups to do t test for statistical analysis in test score and x2 test for degree of satisfaction.Results In the final examination, the score of non-case test of combinational teaching group was similar to that of traditional teaching group (50.30 ± 7.19 vs.52.04 ± 8.01, P=0.358).The combinational teaching group had significant improvement in case analysis test (35.76 ± 5.28 vs.31.80 ± 5.16), and the difference was statistically significant (P=-0.003).In the course of teaching satisfaction survey, the dual track teaching group, compared with the conventional teaching group, has a better effect on self study ability, communication skills, communication skills, and higher satisfaction for teaching, and more willing to continue to carry out teaching (P＜0.05).Conclusion The PBL+CBL combinational teaching model can make a great contribution to improving the teaching quality and satisfaction, and worthy of being popularized and applied.