基于“PBL-CBL-MOOC-临床见习”四位一体教学模式在临床医学生教育中的应用探索

Based on the Application of the Four-in-One Teaching Model of “PBL-CBL-MOOC-Clinical Clerkship” in the Education of Clinical Medical Students

摘要: 目的：探索“PBL-CBL-MOOC-临床见习”四位一体教学模式在临床医学生教育中的应用效果。方法：2023年5月至2025年5月在吉首大学附属湘西州人民医院2021级见习生50名为实验组，另选2020级见习生50名为对照组。对照组学生按照医学院现有教学大纲正常参与课程学习，实践等，不做任何其他干预，试验组接受“PBL-CBL-MOOC-临床见习”四位一体教学模式。通过岗位胜任能力评估结果、临床操作测试结果和临床理论测试结果，对本次教学改革成果作出评价。结果：试验组教学后总分及实践知识成绩明显高于对照组，差异有统计学意义(t = 4.11, t = 2.26, P < 0.05)。试验组在病史采集、典型案例分析、临床操作、总分方面得分均高于对照组，差异均有统计学意义(t分别 = 2.12，2.69，2.64，4.11，P均<0.05)。岗位胜任能力评估实验组满意度高于对照组。结论：基于“PBL-CBL-MOOC-临床见习”四位一体教学模式能显著提高学生的技能成绩及实践知识分数，提升医学生的岗位胜任能力。

Abstract: Objective: To explore the application effect of the integrated “PBL-CBL-MOOC-Clinical Internship” teaching model in clinical medical education. Methods: From May 2023 to May 2025, 50 clinical interns from the 2021 cohort at Xiangxi People’s Hospital affiliated with Jishou University were enrolled as the experimental group, while 50 interns from the 2020 cohort served as the control group. The control group followed the standard curriculum and practical sessions based on the existing syllabus without additional interventions, whereas the experimental group received instruction through the “PBL-CBL-MOOC-Clinical Internship” integrated teaching model. The outcomes of this teaching reform were evaluated by assessing competency scores, clinical skills test results, and clinical theoretical test results. Results: After the intervention, the experimental group showed significantly higher total scores and practical knowledge scores compared with the control group, with statistically significant differences (t = 4.11, t = 2.26, P < 0.05). The experimental group also outperformed the control group in history taking, typical case analysis, clinical operations, and overall scores, with all differences being statistically significant (t = 2.12, 2.69, 2.64, 4.11, P < 0.05). In the competency evaluation, the satisfaction rate in the experimental group was higher than in the control group. Conclusion: The “PBL-CBL-MOOC-Clinical Internship” integrated teaching model can significantly enhance students’ practical skills and knowledge, thereby improving the clinical competency of medical students.