Practice and Training Educational Office, School of Medicine, Nantong University, Nantong, 226000, China.
Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
BMC Med Educ. 2023 Jun 21;23(1):460. doi: 10.1186/s12909-023-04450-7.
Problem-based learning (PBL) is a widely adopted educational approach in medical education that aims to promote critical thinking and problem-solving in authentic learning situations. However, the impact of PBL educational mode on undergraduate medical students' clinical thinking ability has been limitedly investigated. This study aimed to assess the influence of an integrated PBL curriculum on clinical thinking ability of medical students prior to clinical practice.
Two hundred and sixty-seven third-year undergraduate medical students at Nantong University were recruited in this study and were independently assigned to either the PBL or control group. The Chinese version of the Clinical Thinking Ability Evaluation Scale was used to assess clinical thinking ability, and the students' performance in the PBL tutorials was assessed by tutors. All participants in both groups were required to complete the pre-test and post-test questionnaires to self-report their clinical thinking ability. A paired sample t-test, independent sample t-test and one-way analysis of variance test (ANOVA) were used to compare the difference in clinical thinking scores among different groups. Multiple linear regression was conducted to analyze the influencing factors correlated with clinical thinking ability.
The clinical thinking ability of most third-year undergraduate medical students at Nantong University was at a high level. The PBL group had a higher proportion of students with high-level clinical thinking ability in the post-test compared to the control group. The pre-test scores of clinical thinking ability were similar between the PBL and control groups, but the post-test scores of clinical thinking ability in the PBL group were significantly higher than those in the control group. Additionally, there was a significant difference in clinical thinking ability between the pre-test and post-test in the PBL group. The post-test scores of sub-scales of critical thinking ability were significantly higher than the pre-test in the PBL group. Furthermore, the frequency of reading literature, time of PBL self-directed learning, and PBL performance score ranking were influencing factors on the clinical thinking ability of medical students in the PBL group. Moreover, there was a positive correlation between clinical thinking ability and the frequency of reading literature, as well as the scores of the PBL performance.
The integrated PBL curriculum model has an active impact on improving undergraduate medical students' clinical thinking ability. This improvement in clinical thinking ability may be correlated with the frequency of reading literature, as well as the performance of the PBL curriculum.
基于问题的学习（PBL）是一种广泛应用于医学教育的教育方法，旨在促进真实学习情境中的批判性思维和问题解决能力。然而，PBL 教育模式对医学生临床思维能力的影响尚未得到充分研究。本研究旨在评估在临床实践之前，综合 PBL 课程对医学生临床思维能力的影响。
本研究招募了南通大学 267 名三年级医学生，将他们随机分为 PBL 组和对照组。采用中文版临床思维能力评价量表评估临床思维能力，导师评估学生在 PBL 教程中的表现。两组学生均需完成预测试和后测试问卷，以自我报告其临床思维能力。采用配对样本 t 检验、独立样本 t 检验和单因素方差分析（ANOVA）比较不同组间临床思维评分的差异。采用多元线性回归分析与临床思维能力相关的影响因素。
南通大学大多数三年级医学生的临床思维能力处于较高水平。与对照组相比，PBL 组在后测中具有更高比例的具有高水平临床思维能力的学生。PBL 组和对照组的临床思维能力预测试评分相似，但 PBL 组的后测临床思维能力评分明显高于对照组。此外，PBL 组在预测试和后测试之间的临床思维能力存在显著差异。PBL 组批判性思维能力的子量表后测评分明显高于前测。此外，阅读文献的频率、PBL 自主学习的时间以及 PBL 表现评分排名是影响 PBL 组医学生临床思维能力的因素。此外，临床思维能力与阅读文献的频率以及 PBL 表现评分呈正相关。
综合 PBL 课程模式对提高医学生临床思维能力具有积极影响。这种临床思维能力的提高可能与阅读文献的频率以及 PBL 课程的表现有关。
