目的 探讨以病例为基础的教学法(CBL)联合循证医学教学法在心脏外科教学中的效果.方法 将2010级至2013级首都医科大学临床医学专业的142名本科生采用随机区组设计方法分为观察组(76人)和对照组(66人).观察组采用CBL联合循证医学教学法,对照组采用传统的以授课为基础的教学法.教学活动前后进行中文版批判性思维能力测量问卷调查,教学结束时进行随堂测试考核理论知识.比较2组问卷调查和随堂测试结果.结果 问卷调查结果显示,教学结束时观察组具有正性批判性思维能力,总分和分析能力、系统化能力、批判性思维的自信心、求知欲得分均高于对照组[(312±30)分比(256 ±30)分、(48±6)分比(39±7)分、(48 ±7)分比(37±7)分、(52±6)分比(35±7)分、(47±5)分比(38±7)分],差异均有统计学意义(均P ＜0.05).随堂测试结果显示,观察组总成绩和病例分析题成绩均高于对照组[85.5(82.0,88.5)分比78.0(68.5,82.0)分、45.5(40.0,50.0)分比35.0(31.5,38.0)分],差异均有统计学意义(均P＜0.05).结论 CBL联合循证医学教学法能够提高学生的学习主动性,有利于知识的掌握和临床分析能力、批判性思维能力的培养,有利于提高心脏外科临床教学质量.%Objective To evaluate the application value of case-based learning (CBL) combined with evidence-based medicine (EBM) teaching method in cardiac surgery education.Methods A total of 142 undergraduates majoring in clinical medicine(grade 2010-2013) in Capital Medical University were randomly divided into observation group(76 cases) and control group(66 cases).The observation group participated in CBL + EBM cardiac surgery education;the control group received traditional teaching lessons.The Critical Thinking Disposition Inventory(CTDI-CV) questionnaire was conducted and a classroom test was performed in both groups after classes.Results The total score of CTDI-CV and scores of analyzing ability,systematic ability,self-confidence and thirst for knowledge in observation group were significantly higher than those in control group[(312 ±30)points vs (256 ± 30) points,(48 ± 6) points vs (39 ± 7) points,(48 ± 7) points vs (37 ± 7) points,(52 ± 6) points vs (35 ± 7)points,(47 ± 5)points vs (38 ± 7)points] (P ＜ 0.05).The total test score and case analysis score in observation group were significantly higher than those in control group[85.5 (82.0,88.5) points vs 78.0 (68.5,82.0)points,45.5(40.0,50.0)points vs 35.0(31.5,38.0)points] (P＜0.05).Conclusions Combined education based on CBL and EBM can improve learning initiative,mastery of knowledge,critical thinking and practical analyzing abilities in students,which may enhance the quality of cardiac surgery education.
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