CAJ | 학술논문

目的：探讨以问题为基础的学习（problem-based learning，PBL）在神经外科临床见习教学中的应用效果。方法针对在我院神经外科见习的600名2011级临床医学专业学生，随机将其分为实验组（300人，教学中分为15个学习小组，20人/组）及对照组（300人，教学中分为15个学习小组，20人/组）。实验组采用PBL，实施以问题为基础、学生为主体、带教教师为导向的小组讨论式教学；对照组采用案例教学（case-based learning，CBL）联合课堂讲授（lecture-based learning，LBL）。见习结束后，针对两组学生开展统一测试和评价自身所受教学方法的问卷调查，同时针对实验组学生开展PBL对其各方面影响情况的问卷调查。应用SPSS 15.0处理数据，组间比较行t检验、曼-惠特尼u检验。结果实验组学生理论考试与综合能力考核成绩[（40.57±3.24）分，（41.23±4.56）分]均优于对照组[（37.21±4.05）分，（36.51±4.11）分]，差异有统计学意义（P＜0.05）。问卷调查显示，实验组学生在教学方式满意度、见习兴趣、教学参与度以及知识掌握度方面的评价均优于对照组，差异有统计学意义（P＜0.05）。实验组学生认为PBL教学有助于，提高教学满意度（97.0%，291人）、增强团队协作能力（96.7%，290人）、提升自学能力（92.7%，278人）等。结论 PBL在神经外科见习教学中取得较好效果，有助于提升学生参与意识及学习积极性，促进学生综合能力培养。
목적：탐토이문제위기출적학습（problem-based learning，PBL）재신경외과림상견습교학중적응용효과。방법침대재아원신경외과견습적600명2011급림상의학전업학생，수궤장기분위실험조（300인，교학중분위15개학습소조，20인/조）급대조조（300인，교학중분위15개학습소조，20인/조）。실험조채용PBL，실시이문제위기출、학생위주체、대교교사위도향적소조토론식교학；대조조채용안례교학（case-based learning，CBL）연합과당강수（lecture-based learning，LBL）。견습결속후，침대량조학생개전통일측시화평개자신소수교학방법적문권조사，동시침대실험조학생개전PBL대기각방면영향정황적문권조사。응용SPSS 15.0처리수거，조간비교행t검험、만-혜특니u검험。결과실험조학생이론고시여종합능력고핵성적[（40.57±3.24）분，（41.23±4.56）분]균우우대조조[（37.21±4.05）분，（36.51±4.11）분]，차이유통계학의의（P＜0.05）。문권조사현시，실험조학생재교학방식만의도、견습흥취、교학삼여도이급지식장악도방면적평개균우우대조조，차이유통계학의의（P＜0.05）。실험조학생인위PBL교학유조우，제고교학만의도（97.0%，291인）、증강단대협작능력（96.7%，290인）、제승자학능력（92.7%，278인）등。결론 PBL재신경외과견습교학중취득교호효과，유조우제승학생삼여의식급학습적겁성，촉진학생종합능력배양。
Objective To explore the effect and experience of problem-based (PBL) teaching in neurosurgical clinical training and improve the quality of the neurosurgical clinical training. Methods 600 clinical medical students of Grade 2011 in their probation in our department of neurosurgery were chosen as the subjects of study and were randomly divided into the experimental (PBL, 15 groups, 20 people/group, over 300 people) and control groups (CBL+ LBL, 15 groups, 20 people/group, over 300 people). In experimental group, PBL which is a problem-based, student-centered and teacher-directed pedagogy was adopted. In control group, CBL (case-based learning) + LBL (lecture-based learning) were adopted. After probation, two groups of students had the unified test and assessed their teaching methods by questionnaire survey and at the same time, the questionnaire survey about PBL' impact on the various aspects was done only to experimental group students. SPSS 15.0 software was used to do statistical analysis and data were processed by description analysis, t test, Mann-Whitney U test and correlation analysis. Results The scores of theoretical knowledge and general ability in PBL group [(40.57 ±3.24), (41.23 ±4.56) individually] were higher than these in control group [(37.21 ±4.05), (36.51±4.11) individually]. The differences demonstrated statistically meanings. Through the surveys, the students in experimental group showed the high satisfaction (97.0%, n=291) in PBL teaching. Most of the students considered that their abilities of team cooperation (96.7%, n=290), and self-directed learning (92.7%, n=278) were improved by PBL teaching. The students in experimental group illustrated their attitudes in satisfaction of teaching; interests of clinical training, participation of teaching and understanding of knowledge were superior to the control group. The differences demonstrated statisti-cally meanings. Conclusion PBL teaching got a good effect in neurosurgical clinical training. This method, which improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities, is suitable for modern neurosurgical clinical training.