从“临床疑云”到“实验求真”：PBL分幕式教学在实验机能学课程中的独特运用与特点分析——以“头孢就酒”案例为例

From “Clinical Uncertainty” to “Experimental Inquiry”: The Distinctive Application and Characteristics Analysis of Scene-Based PBL in Medical Functional Experiment Education—A Case Study of the “Cephalosporins and Alcohol” Scenario

摘要: 实验机能学课程作为基础医学与临床医学之间的桥梁课程，传统教学模式以验证性实验为主，难以有效培养学生的临床思维能力和科学探究精神。本研究以“头孢就酒”这一兼具临床争议性与科学探究价值的真实案例为载体，构建了“临床疑云→风云突变→科学之辩→实验求真”四幕递进式PBL教学模式，并将其融入实验机能学课程教学实践。该模式突破了传统PBL“单一问题驱动”的局限，实现了临床情境模拟、科学争议思辨与动物实验验证的三维融合；在知识维度上贯通药理学机制、病理生理学改变与临床诊疗决策，在能力维度上整合鉴别诊断思维、循证医学素养与实验设计能力，在价值维度上渗透科学精神培育与医学人文教育。教学实践表明，该模式有效提升了学生的自主学习能力、批判性思维水平和临床决策意识，为实验机能学课程的教学改革提供了可复制的范式参考。

Abstract: Medical functional experiment courses serve as a bridge between basic and clinical medicine. However, conventional teaching, which relies predominantly on verification-based experiments, may be insufficient to effectively cultivate students’ clinical reasoning and scientific inquiry skills. In this study, the authentic clinical case of “cephalosporin-alcohol interaction”, which combines clinical controversy with substantial potential for scientific inquiry, was used as the central teaching scenario. A four-stage, progressive problem-based learning (PBL) model—“Clinical Uncertainty → Dramatic Turn → Scientific Debate → Experimental Inquiry”—was developed and integrated into medical functional laboratory teaching. This approach addresses the limitations of conventional PBL driven by a single, predefined problem by integrating clinical scenario simulation, critical deliberation on scientific controversies, and experimental validation using animal models. At the knowledge level, the model connects pharmacological mechanisms, pathophysiological changes, and clinical decision-making; at the competency level, it integrates differential diagnostic reasoning, evidence-based medicine literacy, and experimental design skills; and at the value level, it incorporates the cultivation of scientific thinking and humanistic values in medicine. Teaching practice indicated that the proposed model enhanced students’ autonomous learning, critical thinking, and clinical decision-making awareness, providing a potentially transferable framework for the pedagogical reform of medical functional experiment education.