摘要: 目的：探讨微信平台支持下PBL + CBL联合教学法在医学本科生急性冠脉综合征临床见习教学中的应用效果。方法：选取2020年10月到11月于济宁医学院附属医院心内科接受内科学见习课程的2017级临床医学本科五年制大四学生100名，采用随机抽样法将学生分成观察组(n = 50)和对照组(n = 50)。2组学生的教学内容均为急性冠脉综合征，观察组50名学生在教学中采用微信平台支持下PBL + CBL联合教学法进行教学；对照组50名学生在教学中采用传统的讲授式教学法进行教学。通过比较2组学生理论考试、技能考核成绩，以及调查学生对微信平台支持下PBL + CBL联合教学法的满意度，进而评估微信平台支持下PBL + CBL联合教学法的有效性。结果：观察组理论成绩、心电图成绩[(83.72 ± 7.0)分，(85.4 ± 10.7)分]明显高于对照组[(77.6 ± 7.6)分，(79.1 ± 11.9)分]，差异均有统计学意义(P = 0.000 < 0.01, P = 0.009 < 0.01)说明两样本整体理论成绩优于观察组；技能成绩中，观察组问诊成绩、体格检查成绩、病历书写成绩[(83.7 ± 8.7)分，(80 ± 11.2)分，(79.6 ± 11.1)分]均高于对照组[(75.7 ± 11.4)分，(74.8 ± 11.5)分，(74.4 ± 12.6)分]，差异均有统计学意义(P = 0.002 < 0.01, P = 0.024 < 0.05, P = 0.044 < 0.05)。观察组对急性冠脉综合征掌握程度、锻炼医患沟通能力、培养团队协作精神、激发学习积极性和能动性、提高语言表达和沟通能力、提高语言表达和沟通能力、调动学习兴趣、提高解决问题能力、锻炼临床思维能力、提高临床技能能力、对教学方法满意程度的满意度分别为92%，96%，88%，87%，94%，90%，90%，86%，98%，96%，均高于对照组(满意度分别为：92%，90%，76%，60%，60%，64%，76%，62%，56%，68%)，差异均有统计学意义(χ2 = 2.76，21.31，26.86，23.57，27.78，12.56，20.56，15.92，35.26，22.70；均P < 0.05)。结论：微信平台支持下PBL + CBL联合教学法在急性冠脉综合征临床见习教学中有较好成效，是心血管内科见习教学值得推广的教学方式。
Abstract:
Objective: to explore the effect of the teaching method with PBL + CBL supported by Wechat plat-form in clinical probation teaching of acute coronary syndrome (ACS) for medical undergraduates. Methods: 100 trainee five-year senior level 2017 clinical medical undergraduate students who were accepted internal medicine in Jining medical college affiliated hospital in Oct., 2020 and Nov., 2020 are divided students into observation group (n = 50) and the control group (n = 50) with random sampling method. The teaching contents of the two groups were all acute coronary syndrome. 50 students in the control group were taught with the traditional teaching method, and 50 students in the observation group were taught with the teaching method with PBL + CBL supported by Wechat platform. By comparing the scores of the two groups of students in the theory test and skill exami-nation, and investigating the students’ satisfaction with the PBL + CBL joint teaching method supported by Wechat platform, the effectiveness of PBL + CBL joint teaching method supported by Wechat platform was evaluated. Result: the theoretical scores and ECG scores [(83.72 ± 7.0), (85.4 ± 10.7) score] were significantly higher than in the control group [(77.6 ± 7.6) score, (79.1 ± 11.9) points]. The differences were all statistically significant (P = 0.000 < 0.01, P = 0.009 < 0.01). It shows that the two overall theoretical results are better than the observation group; Skills scores, consul-tation results of the observation group, physical examination results, and medical record writing results [(83.7 ± 8.7) points, (80 ± 11.2) points, (79.6 ± 11.1) score] were all higher than in the con-trol group [(75.7 ± 11.4) score, (74.8 ± 11.5) points, (74.4 ± 12.6) points]. The differences were all statistically significant (P = 0.002 < 0.01, P = 0.024 < 0.05, P = 0.044 < 0.05). The satisfaction of the observation group on the mastery of acute coronary syndrome, the training of doctor-patient communication ability, the training of teamwork spirit, the stimulation of learning enthusiasm and ini-tiative, the improvement of language expression and communication ability, the improvement of language expression and communication ability, the mobilization of learning interest, the improvement of problem solving ability, the exercise of clinical thinking ability, the improvement of clinical skills and the satisfaction of teaching methods were respectively 92%, 96%, 88%, 87%, 94%, 90%, 90%, 86%, 98%, 96%, all higher than the control group (satisfaction: 92%, 90%, 76%, 60%, 60%, 64%, 76%, 62%, 56%, 68%); the difference was statistically significant (χ2 = 2.76, 21.31, 26.86, 23.57, 27.78, 12.56, 20.56, 15.92, 35.26, 22.70; All P < 0.05). Conclusion: the combination of PBL + CBL teaching method with the support of Wechat platform can improve the teaching effect, enrich the teaching form, keep up with the trend of the times. It improves students’ interest in learning and teaching satisfaction. Its application in cardiology teaching has certain clinical value and is worth further popularizing.