问题导向教学法联合案例教学法在临床实践教学中的应用研究

Research on the Application of Problem-Based Learning Combined with Case-Based Learning in Clinical Practical Teaching of Oncology

摘要: 目的：探讨医教融合背景下问题导向教学法(Problem-Based Learning, PBL)联合案例教学法(Case-Based Learning, CBL)在肿瘤科临床实践教学中的应用效果，为肿瘤科临床实习教学模式改革提供实证依据。方法：选取2025年1月至2025年12月在山东第二医科大学附属医院肿瘤相关科室实习的150名五年制临床医学专业医学生，采用随机数字表法分为观察组和对照组各75名。对照组在常规临床教学基础上实施单一CBL教学法；观察组在常规临床教学基础上实施PBL联合CBL教学法，围绕真实肿瘤病例开展以问题驱动与案例分析为核心的整合式教学干预。比较两组临床实践教学质量、医学生临床能力及教学满意度。结果：观察组临床实践教学质量总分(88.62 ± 4.53)分高于对照组(82.41 ± 5.28)分(t = 7.732, P < 0.05)；临床能力总分(88.35 ± 4.62)分高于对照组(80.16 ± 5.74)分(t = 9.626, P < 0.05)；教学总满意率 97.33% (73/75)高于对照组的84.00% (63/75) (χ² = 7.163, P < 0.05)。结论：医教融合背景下PBL联合CBL教学法相较于单一CBL教学法，能进一步提升肿瘤科实习医学生临床思维能力、操作技能及综合临床能力，教学满意度高。

Abstract: Objective: To investigate the application of problem-based learning (PBL) combined with case-based learning (CBL) in oncology clinical practice teaching under medical-education integration. Methods: A total of 150 fifth-year medical students interning at the Affiliated Hospital of Shandong Second Medical University from January to December 2025 were randomly assigned to observation (n = 75) and control (n = 75) groups. The control group received CBL-based teaching in addition to routine clinical teaching; the observation group received PBL combined with CBL based on real oncology cases. Teaching quality, clinical competency, and teaching satisfaction were compared. Results: The observation group scored higher in teaching quality (88.62 ± 4.53 vs 82.41 ± 5.28, t = 7.732, P < 0.05) and clinical competency (88.35 ± 4.62 vs 80.16 ± 5.74, t = 9.626, P < 0.05); the overall teaching satisfaction rate was significantly higher in the observation group [97.33% (73/75)] than in the control group [84.00% (63/75)] (χ² = 7.163, P < 0.05). Conclusion: Compared with CBL alone, PBL combined with CBL more effectively improves oncology interns’ clinical thinking, operative skills, and overall competency with high satisfaction.