CAJ | 학술논문

目的探讨以病例为基础的学习（case-based learning，CBL）在血管外科临床带教中的应用及效果。方法将37名住院医师随机划分为CBL教学组（21人）和传统带教组（16人）。CBL教学通过典型病例的选择---典型病例库的建立与应用---自主学习---定期举办学术讲座等步骤开展教学。传统带教以基础理论学习、参与临床实践、参加科室病例讨论等方式开展教学。以出科考试（笔试和临床操作技能）、住院医师对教学法的反馈进行效果评价，对数据进行描述性统计分析和独立样本t检验。结果 CBL教学组的笔试成绩和临床技能考核后测成绩均高于传统带教组[笔试成绩（85.53±1.75）vs.（79.94±2.29）；临床技能成绩（85.10±1.64）vs.（80.31±1.82）]。在提高学习效率、培养临床思维、促进知识的掌握与应用、拓宽知识面、增进交流与表达能力、提高学习积极性等方面，CBL教学组也有较大优势。结论 CBL教学能有效提高教学质量，并获得更高的评价，但必须不断完善典型病例库，加强对血管外科基础理论的教育更有利于CBL的开展。
목적탐토이병례위기출적학습（case-based learning，CBL）재혈관외과림상대교중적응용급효과。방법장37명주원의사수궤화분위CBL교학조（21인）화전통대교조（16인）。CBL교학통과전형병례적선택---전형병례고적건립여응용---자주학습---정기거판학술강좌등보취개전교학。전통대교이기출이론학습、삼여림상실천、삼가과실병례토론등방식개전교학。이출과고시（필시화림상조작기능）、주원의사대교학법적반궤진행효과평개，대수거진행묘술성통계분석화독립양본t검험。결과 CBL교학조적필시성적화림상기능고핵후측성적균고우전통대교조[필시성적（85.53±1.75）vs.（79.94±2.29）；림상기능성적（85.10±1.64）vs.（80.31±1.82）]。재제고학습효솔、배양림상사유、촉진지식적장악여응용、탁관지식면、증진교류여표체능력、제고학습적겁성등방면，CBL교학조야유교대우세。결론 CBL교학능유효제고교학질량，병획득경고적평개，단필수불단완선전형병례고，가강대혈관외과기출이론적교육경유리우CBL적개전。
Objective To explore the application and effect of case-based learning(CBL)in vas-cular surgery clinical teaching. Methods Totally 37 resident doctors were randomly divided into 2 groups respectively: CBL teaching group (n=21)and traditional teaching group (n=16). CBL teaching was con-ducted through the following procedures:selecting typical cases-establishing and applying typical case library-autonomous learning-holding regular seminars. Traditional teaching was conducted through the following procedures: basic theory studying-participating in clinical practice-participating in case discus-sion. Evaluation was conducted based on test socre (written test and clinical operational skill test)and res-idents' feedback of teaching effect. Data were statistically described and independent sample t test was performed. Results Theoretical exam score and clinical skill test score were high in CBL group than in traditional group ((thoretical score:(85.53 ±1.75) vs. (79.94 ±2.29);clinical skill test score:(85.10±1.64)vs.(80.31±1.82)). CBL teaching group had advantages in improving learning efficiency, cultivat-ing clinical thinking,promoting mastery and application of knowledge,broadening knowledge, promoting communication and expression ability and improving study enthusiasm ,et al . Conclusion CBL teaching can effectively improve the teaching quality and obtain higher evaluation. Typical case li-brary should be constantly improved and education of vascular surgical basic theory should be strength-ened to promote CBL.