Zhao Wanjun, He Linye, Deng Wenyi, Zhu Jingqiang, Su Anping, Zhang Yong
Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
West China School of Medicine, Sichuan University, Chengdu, 610041, China.
BMC Med Educ. 2020 Oct 22;20(1):381. doi: 10.1186/s12909-020-02306-y.
This study aimed to evaluate the effectiveness and efficiency of PBL-CBL combined teaching in thyroid surgery and make observations from the students' perspectives, based on their satisfaction with the learning process.
We prospectively enrolled 354 fourth-year students majoring in clinical medicine, along with 232 residents, from September 2014 to June 2019. These participants were randomly allocated into either the combined PBL-CBL teaching group or the traditional lecture-based classroom group to attend a course about thyroid nodules. Both pre- and post-class quizzes were conducted. An anonymous questionnaire was also administered to both groups to evaluate the students' perceptions and experiences. We compared the two teaching methods among all the students as well as with the fourth-year students and residents in subgroups.
The traditional group's pre-class quiz scores were significantly higher than the PBL-CBL group's (as determined by a two-tailed t-test at a 95% confidence interval, T = 16.483, P < 0.001). After class, in the PBL-CBL group, the mean total quiz score and the basic knowledge and case analysis scores increased significantly (P < 0.001). The PBL-CBL group's performance improvement was significantly higher than the traditional group's (increasing from 52.76 to 70.51 vs. from 67.03 to 71.97). Furthermore, the scores for learning motivation, understanding, student-teacher interaction, the final examination, communication skills, clinical thinking skills, self-learning skills, teamwork skills, and knowledge absorption, as measured by the survey, were significantly higher in the PBL-CBL group than in the traditional group (P < 0.001). Meanwhile, the survey scores representing the amount of students' free time the course consumed were significantly lower in the PBL-CBL group than in the traditional group (P < 0.001).
PBL combined with CBL may be an effective method for improving medical students' and residents' performance and enhancing their clinical skills.
本研究旨在评估以问题为基础的学习（PBL）与以案例为基础的学习（CBL）相结合的教学方法在甲状腺手术教学中的有效性和效率，并基于学生对学习过程的满意度，从学生的角度进行观察。
我们前瞻性地招募了2014年9月至2019年6月期间的354名临床医学专业四年级学生以及232名住院医师。这些参与者被随机分配到PBL-CBL联合教学组或传统课堂讲授组，参加一门关于甲状腺结节的课程。课前和课后均进行了测试。还向两组发放了匿名问卷，以评估学生的看法和体验。我们在所有学生中以及在四年级学生和住院医师的亚组中比较了这两种教学方法。
传统组的课前测试成绩显著高于PBL-CBL组（通过95%置信区间的双尾t检验确定，T = 16.483，P < 0.001）。课后，PBL-CBL组的平均总测试成绩以及基础知识和病例分析成绩显著提高（P < 0.001）。PBL-CBL组的成绩提高显著高于传统组（从52.76提高到70.51，而传统组从67.03提高到71.97）。此外，通过调查衡量，PBL-CBL组在学习动机、理解、师生互动、期末考试、沟通技巧、临床思维能力、自主学习能力、团队合作能力和知识吸收等方面的得分显著高于传统组（P < 0.001）。同时，代表该课程消耗学生自由时间量的调查得分，PBL-CBL组显著低于传统组（P < 0.001）。
PBL与CBL相结合可能是提高医学生和住院医师成绩以及增强其临床技能的有效方法。
