CAJ | 학술논문

目的：探讨以问题为基础的学习（Problem‐based Learning ，PBL ）结合循证医学（Evidence‐based M edicine ，EBM ）在儿科临床实习中的实施效果。方法将56名实习医师随机分为实验组（PBL 结合EB M教学组28人）和对照组（灌输式教学组28人），教学均围绕病房患儿病例展开。实验组由带组教师提出问题，实习医师查阅文献；在每周固定的全科教学查房时间结合该病例进行循证医学证据总结汇报，参与病例讨论和学习，带组教师进行总结。对照组采用传统的灌输式教学，以带教教师的临床经验指导实习医师作病例分析；实习医师有问题提出时，带教教师直接给予回答。教学效果评价分为问卷调查、理论试卷考试、临床技能考核三部分。结果实验组实习医师认为，自身所接受的培养方式在提高自学能力、文献检索查阅能力、医师团队合作精神、临床思维、幻灯片制作技术和语言表达能力方面更有优势。理论考试成绩显示，实验组平均成绩为（87．45±3．67）分，高于对照组的（73．28±4．35）分，差异有统计学意义（P＜0．05）。临床技能考核显示，实验组病例书写及临床思维成绩优于对照组。结论 PBL结合EB M 教学在提高实习医师的自学能力、培养临床思维能力及文献检索和语言表达等方面明显优于传统的灌输式教学，适用于儿科临床实习。
목적：탐토이문제위기출적학습（Problem‐based Learning ，PBL ）결합순증의학（Evidence‐based M edicine ，EBM ）재인과림상실습중적실시효과。방법장56명실습의사수궤분위실험조（PBL 결합EB M교학조28인）화대조조（관수식교학조28인），교학균위요병방환인병례전개。실험조유대조교사제출문제，실습의사사열문헌；재매주고정적전과교학사방시간결합해병례진행순증의학증거총결회보，삼여병례토론화학습，대조교사진행총결。대조조채용전통적관수식교학，이대교교사적림상경험지도실습의사작병례분석；실습의사유문제제출시，대교교사직접급여회답。교학효과평개분위문권조사、이론시권고시、림상기능고핵삼부분。결과실험조실습의사인위，자신소접수적배양방식재제고자학능력、문헌검색사열능력、의사단대합작정신、림상사유、환등편제작기술화어언표체능력방면경유우세。이론고시성적현시，실험조평균성적위（87．45±3．67）분，고우대조조적（73．28±4．35）분，차이유통계학의의（P＜0．05）。림상기능고핵현시，실험조병례서사급림상사유성적우우대조조。결론 PBL결합EB M 교학재제고실습의사적자학능력、배양림상사유능력급문헌검색화어언표체등방면명현우우전통적관수식교학，괄용우인과림상실습。
Objective Explore the implementation effect of method in pediatric clinical studying which is combined the problem‐based learning with the evidence‐based medicine .Methods Random allocation was taken to averagely divide 56 interns into two groups:the experiment group (28 students) and the control group (28 students) .The cases which should be used by teaching were in pediatric depart‐ment .The modality of experiment group like this in the teaching round weekly ,teacher asked ques‐tions .Then ,interns reviewed of the literature ,reported the case which is combine with evidence‐based and take part in case discussion ,finally teachers summarize .The modality of experiment group like that ,teacher guide interns analysis case and give answer to them directly ,what interns didn′t un‐derstand .Questionnaire survey ,theoretical test ,clinical skills examination were made up the teach‐ing quality evaluation .Results Interns in the experiment group thought that the training they accept improved their self‐learning ability ,information retrieval access ability ,teamwork spirit ,Clinical thinking ability ,slides making technology and language competence .The result of theoretical test showed that the score of experimental group(87 .45 ± 3 .67) is higher than the control group′s(73 .28 ± 4 .35);the difference was statistically significant between the 2 groups(P<0 .05) .The result of clinical skills examination show ed that cases clinical thinking and w riting performance of the experi‐mental group was better than the control group′s .Conclusion PBL combined with EBM teaching in improving self‐learning ability ,Clinical thinking ability ,information retrieval access ability ,and the literature search and language competence is superior to the traditional teaching of the non‐computer majors ,is suitable for the pediatric clinical practice .