摘要目的:探讨医学辩证法结合以教材为基础的问题导向教学在血液病实习教学中的应用。方法:以2022年至2023年于吉林大学第一医院血液科实习的100名本科学生为研究对象。将学生随机分为对照组和观察组，每组50人。对照组采用传统教学，观察组采用医学辩证法结合以教材为基础的问题导向教学。对两组学生的理论和操作成绩、课堂表现、综合能力及教学满意度进行考核。采用SPSS 22.0进行 t检验和卡方检验。 结果:观察组学生理论和操作考核成绩分别为（94.26±5.35）分、（92.68±4.72）分，对照组理论和操作考核成绩分别为（86.16±5.42）分、（81.52±5.28）分，两组比较差异有统计学意义（ P<0.001）。观察组学生认为在提高学习效率、提高自学能力、提高对疾病的理解和综合分析能力、提高分析解决问题能力、提高语言及组织表达能力、提高理论与实践结合能力、提高临床思维能力、提高独立思考能力等综合能力方面的认可率高于对照组，差异有统计学意义（ P<0.05）。观察组学生对教学态度、教学方式、教学安排、教学内容实用性、教学理论阐述清晰、教学目标突出等方面的教学满意度高于对照组，差异有统计学意义（ P<0.05）。 结论:医学辩证法结合以教材为基础的问题导向教学有助于提高医学生的考核成绩，同时有助于培养医学生的综合能力，养成良好的临床诊疗思维。

abstractsObjective:To explore the application of medical dialectics combined with problem-oriented teaching based on textbooks in hematology internship teaching.Methods:A total of 100 undergraduate students who practiced in the Department of Hematology of the First Hospital of Jilin University from 2022 to 2023 were selected as the research subjects. Students were randomly assigned to a control group and an observation group, with 50 students in each group. The control group received traditional teaching, while the observation group received medical dialectics combined with textbook-based problem-oriented teaching. We assessed the theoretical and operational scores, classroom performance, comprehensive abilities, and teaching satisfaction of two groups of students using t-test and χ 2 test in SPSS 22.0. Results:The theoretical and operational scores of the observation group were (94.26±5.35) points and (92.68±4.72) points, respectively. The theoretical and operational scores of the control group were (86.16±5.42) points and (81.52±5.28) points, respectively. The differences between the two groups were statistically significant ( P<0.001). The recognition rates were significantly higher by students in the observation group than in the control group ( P<0.05) in terms of improving learning efficiency, self-learning ability, understanding and comprehensive analysis of diseases, problem-solving ability, language and organizational expression ability, integration of theory and practice, clinical thinking ability, and independent thinking ability. The satisfaction with teaching was higher in the observation group than in the control group ( P<0.05) in terms of teaching attitudes, teaching methods, teaching arrangements, practicality of teaching content, clear explanation of teaching theories, and outstanding teaching objectives. Conclusions:The medical dialectics combined with textbook-based problem-oriented teaching can improve the assessment scores of medical students, while helping to cultivate their comprehensive abilities and develop good clinical diagnosis and treatment thinking.