典型病例引导式(CBL)教学模式在放射科临床实习生中的应用研究

Application Research of Case-Based Learning (CBL) Teaching Mode in Clinical Interns of Radiology Department

摘要: 目的：探讨典型病例引导式(CBL)教学法在临床医师放射科实习期间的教学效果。方法：对2024至2025年度在义乌市中心放射科实习的68名非影像临床实习医师进行为期2周的放射科实习学习培训；观察组(34人)采用CBL教学培训，对照组(34人)采用传统模式学习培训。实习结束后，分析两组实习生的理论、阅片考试成绩及问卷调查。结果：实习生开展CBL教学实践活动。基于典型病例、分层、分级进行教学，同时进行举一反三、拓展思路，并采用多维度的评价方法(师对生、生对师、自我评价、360˚评价)进行评价。本研究构建了以真实病例库为核心、5E教学流程为框架、AI技术为支撑的放射科临床教学模式，并通过随机对照试验验证其效果。该模式显著提升了实习生的OSCE技能成绩(94.2 ± 3.8 vs 87.6 ± 6.2, P < 0.001)、影像诊断逻辑性、临床决策信心(OR = 2.30)。创新性体现于动态病例知识图谱的构建、多角色模拟实践及虚拟现实阅片技术的整合，为破解医学教育中理论与实践脱节的问题提供了系统解决方案。

Abstract: Objective: To explore the teaching effectiveness of the case-based learning (CBL) teaching method guided by typical cases during the internship of radiologists in the radiology department. Methods: A 2-week radiology internship training was conducted for 68 non-imaging clinical interns who were interning in the Radiology Department of Yiwu Central Hospital from 2024 to 2025. The observation group (34 students) received CBL teaching training, while the control group (34 students) received traditional mode learning training. After the internship, the theoretical and radiographic examination scores and questionnaire surveys of the two groups of interns were analyzed. Results: The interns carried out CBL teaching practice activities. Teaching is carried out based on typical cases, stratification, and grading of the system, while drawing lessons from others and expanding thinking. Multi-dimensional evaluation methods (teacher to student, student to teacher, self-evaluation, 360˚ evaluation) are used for evaluation. This study constructed a clinical teaching mode for radiology with a real case library as the core, 5E teaching process as the framework, and AI technology as the support, and verified its effectiveness through randomized controlled trials. This mode significantly improved interns’ OSCE skill scores (94.2 ± 3.8 vs 87.6 ± 6.2, P < 0.001), imaging diagnostic logic, and clinical decision-making confidence (OR = 2.30). Innovation is reflected in the construction of dynamic case knowledge graphs, multi-role simulation practices, and the integration of virtual reality video reading technology, providing a systematic solution to the problem of the disconnect between theory and practice in medical education.