“反刍”影像学教学的应用--一种改良的PBL教学方法

摘要

目的：评估改良后PBL用于影像学病例讨论和教学中的效果。材料和方法：基于PBL理念，以问题为导向，采用前期病例讨论，后期反馈教学方法，评估了387例影像病例讨论的过程和效果。评价参与者的参与性、交流能力、研讨精神等。结果：讨论前298例定位正确，275例定性正确，讨论后364例定位正确，347例定性正确。讨论前后有明显统计学差异（P<0.01）。讨论前后比较，通过讨论，征象的发现率提高了24.7%，纠正不正确的征象71个。整个讨论过程，参与性最强的是临床医师（平均18.5分）；影像专科医师有较强的研讨精神和交流能力（分别为17.8分和17.3分）；规培医师最欠缺的是研讨精神（11.2分）。通过学习，每个规培医师的参与性、研讨精神及交流能力均有较显著的提高，对三基的掌握成绩平均提高了17.8分（P<0.05）。结论：改良的PBL应用于影像学教学，兼顾了临床和教学，提高了教学效益，锻炼了规培医师和住院医师的临床技能。%Objective:To evaluate the effect of post- modified PBL (Problem based learning) in medical imaging case discussion and teaching. Methods:With the PBL idea and based problem the teaching method of pre- case discus-sion correlation with a later feedback teaching were administrated in 387 cases. The participants were evaluated in par-ticipation,ability of communication,discussion. Results:Correct location diagnosis in 298 cases and correct qualitative diagnosis in 275 pre- discussion.Correct location diagnosis in 364 cases and correct qualitative diagnosis in 347 after dis-cussion (P<0.01).The discovery rate of signs increased to the 24.7%and correcting 71 mistakes of signs.At the process of discussion,The clinical doctors have better ability in participation(average 18.5),the radiologists better in communication and discussion (average 17.8,17.3).The training doctors lack in ability of discussion (average 11.2).After learning the ability of training- doctor improved in participation,communication,discussion.The grade of basic theory and operation improved significantly (average 17.8,P<0.01).Conclusion:The medical imaging teaching method with post- modified PBL combined with clinical improved the effect and give the valuable clinical training.