以多学科协作为导向的PBL、CBL教学方法在急诊教学中的应用

Application of PBL and CBL Teaching Methods Guided by Multi-Disciplinary Team in Emergency Teaching

摘要: 目的：探讨以多学科协作(multidisciplinary team, MDT)为指导，以问题为基础的学习教学方法(problem-based learning, PBL)，同时结合临床典型案例的教学方法(case-based learning, CBL)在急诊科实习带教中的应用效果。方法：将2022年6月~2023年6月在新疆医科大学第一附属医院急诊科和急救重症监护室(emergency intensive care unit, EICU)实习的新疆医科大学2018级~2020级五年制临床医学专业120名本科学生为研究对象，随机分为LBL组(40名)，PBL CBL组(40名)，MDT联合PBL CBL组(40名)，第一组采用传统的LBL教学方法，第二组采用PBL联合CBL的教学方法，第三组采用以MDT为引导的PB联合CBL的教学方法。比较三组学生的出科理论考试成绩，并对三组学生进行调查问卷。结果：MDT PBL CBL组的理论成绩和技能考核成绩分别为(93.8 ± 6.4)分和(89.6 ± 5.4)分，PBL CBL组的两项考核成绩分别为(87.6 ± 5.3)分和(84.1 ± 5.2)分，LBL组的两项成绩分别为(82.2 ± 4.5)分和(78.7 ± 5.5)分，三组进行比较差异具有统计学意义(P < 0.01)。以MDT为引导的PBL联合CBL教学方法的评价优于以PBL CBL联合教学的教学方法和以LBL教学方法的评价，比较差异有统计学意义(P < 0.01)。结论：以MDT为引导的PBL联合CBL的教学方法不但能提高急诊实习生的成绩，而且也有利于医学生的急诊临床思维的形成与能力的培养。

Abstract: Objective: To explore the application effect of problem-based learning (PBL) teaching method and case-based learning (CBL) teaching method guided by multi-disciplinary team (MDT) therapy in emergency medicine teaching. Methods: Experimental and control methods were used. From June 2022 to June 2023, in the Emergency Trauma Center of the First Affiliated Hospital of Xinjiang Medical University, including emergency intensive care unit (EICU), 120 undergraduate students majoring in clinical medicine from 2018 to 2020 in Xinjiang Medical University were randomly divided into LBL group (n = 40), PBL CBL group (n = 40) and MDT combined with PBL CBL group (n = 40), the first group adopted the traditional LBL teaching method, the second group adopted the PBL combined with CBL teaching method, and the third group adopted the MDT-oriented PBL and CBL teaching methods. Compare the examination results of the three groups of students, and conduct a questionnaire survey of the three groups of students. Results: The scores of theory and skill examination were (93.8 ± 6.4) and (89.6 ± 5.4) in MDT PBL CBL group, (87.6 ± 5.3) and (84.1 ± 5.2) in PBL CBL group, (82.2 ± 4.5) and (78.7 ± 5.5) in LBL group, and there was significant difference among the three groups (P < 0.01). Students’ evaluation of MDT-oriented PBL CBL teaching method was better than that of PBL CBL combined teaching method and traditional LBL teaching method, and the difference among the three groups was statistically significant (P < 0.01). Conclusion: The MDT-oriented PBL CBL teaching method can improve the academic performance of emergency interns and is beneficial to the cultivation of emergency clinical thinking ability and comprehensive quality of medical students.