CAJ | 학술논문

目的评价在普通外科学临床实习阶段教学中引入“以问题为基础学习”与“无标准答案”相结合教学模式对提高学生临床思维能力的作用。方法将学生随机分层分为实验组和对照组。实验组学生接受“以问题为基础学习”与“无标准答案”相结合教学模式，对照组学生接受传统教学模式，然后采用稿本一致性测试法测试两组学生临床思维能力，并采用医学教育环境量表进行问卷调查。结果两组学生临床思维能力测试成绩分别为75.1±5.7分和79.1±5.4分，实验组学生成绩明显高于对照组学生(t＝3.192,P＝O.002)。两组学生问卷调查量表总分分别为126.9±11.0分和142.2±8.3分，实验组学生总分明显高于对照组学生(t＝6.993,P＝0.000)。亚组分析结果显示，不同学制和年级学生中接受“以问题为基础学习”与“无标准答案”相结合教学模式者，其临床思维能力测试成绩和量表得分均高于接受传统教学模式者。结论在普通外科学临床实习中引入“以问题为基础学习”和“无标准答案”相结合教学模式，有助于提高学生的临床思维能力，有助于改善教学环境。
목적평개재보통외과학림상실습계단교학중인입“이문제위기출학습”여“무표준답안”상결합교학모식대제고학생림상사유능력적작용。방법장학생수궤분층분위실험조화대조조。실험조학생접수“이문제위기출학습”여“무표준답안”상결합교학모식，대조조학생접수전통교학모식，연후채용고본일치성측시법측시량조학생림상사유능력，병채용의학교육배경량표진행문권조사。결과량조학생림상사유능력측시성적분별위75.1±5.7분화79.1±5.4분，실험조학생성적명현고우대조조학생(t＝3.192,P＝O.002)。량조학생문권조사량표총분분별위126.9±11.0분화142.2±8.3분，실험조학생총분명현고우대조조학생(t＝6.993,P＝0.000)。아조분석결과현시，불동학제화년급학생중접수“이문제위기출학습”여“무표준답안”상결합교학모식자，기림상사유능력측시성적화량표득분균고우접수전통교학모식자。결론재보통외과학림상실습중인입“이문제위기출학습”화“무표준답안”상결합교학모식，유조우제고학생적림상사유능력，유조우개선교학배경。
Objective To evaluate the role of 'problem-based learning' and 'none-standardanswer' teaching model in improving interns' clinical thinking in general surgery.Methods Interns were divided into two groups by stratified random, test group receiving ' problem-based learning' and ' nonestandard-answer' teaching model, control group receiving conventional teaching model, then were tested clinical thinking by means of script concordance test and received a questionnaire survey by means of Dundee Ready Education Environment Measure (DREEM).Results The mean score of clinical thinking of test group, 79.1 ±5.4, was higher than that of control group, 75.1 ±5.7 (t ＝3.192, P＝0.002), and the mean score of DREEM of test group, 142.2 ± 8.3, was higher than that of control group , 126.9 ±11.0 (t ＝ 6.993, P ＝ 0.000).Subgroup analysis revealed that interns receiving ' problem-based learning'and 'none-standard-answer' teaching model got higher clinical thinking test scores and higher DREEM scores than those receiving conventional teaching model no matter of varied schooling-length programs and grades.Conclusions Application of ' problem-based learning' and ' none-standard-answer' teaching model into clinical clerkship in general surgery was helpful to improve the students' clinical thinking and to improve the education environment of problem-based learning.