【摘要】 目的 探讨SBAR(situation, background, assessment and recommendation)沟通联合案例情景模拟教学模式对妇产科见习的医学生的医际沟通和批判性思维的影响。方法 2022年11月—2023年5月参加妇产科临床见习培训的临床医学本科生共156人，随机分成观察组和对照组。对照组应用传统的见习教学模式，针对医际沟通的教学以授课和床旁观察形式进行。观察组医学生入科时进行SBAR沟通模式联合案例情景模拟教学，其余教学同对照组。比较两组见习生出科考核成绩(理论知识成绩和临床技能成绩)、批判性思维能力和对临床见习教学的满意度。结果 观察组病史采集和医际沟通成绩优于对照组，差异具有统计学意义(P<0.05),但两组理论知识成绩和临床技能操作成绩无统计学差异(P>0.05)。观察组的批判性思维总分显著高于对照组(P<0.05),其中分析能力、系统化能力、批判性思维自信心和认知成熟度四个维度的得分均高于对照组，差异具有统计学意义(P<0.05),但两组的寻找真相、开放思维和求知欲三个维度的得分差异无统计学意义(P>0.05)。观察组学生对教学满意度高于对照组，差异具有统计学意义(P<0.05)。结论 在临床医学本科生妇产科见习阶段引入SBAR沟通模式联合案例情景模拟教学，有利于本科生提高学习兴趣，增强批判性思维能力，提升医际沟通能力，可在各类学科的见习教学中推广。更多还原

【Abstract】 Objective To explore the effects of SBAR(Situation, Background, Assessment and Recommendation) communication combined with case-scenario simulation teaching model on intermedical communication and critical thinking of medical students in obstetrics and gynecology clerkship. Methods A total of 156 undergraduate clinical medical students who participated in clinical clerkship training in obstetrics and gynecology from November 2022 to May 2023 were randomly divided into the experimental and control groups. The medical students in the experimental group were trained with SBAR communication model combined with case scenario simulation model when they were admitted to the department, and the rest of the training was the same as that of the control group. In the control group, the traditional training mode was applied, and the teaching of intermedial communication was carried out in the form of lectures and bedside observation. We compared the discharge assessment scores(theoretical knowledge and clinical skills), critical thinking ability and satisfaction with the clinical training teaching of the two groups.Results The experimental group trainees’ grades in history taking and intermedial communication were better than those of the control group, with significant difference(P<0.05). However, there was no significant difference in the theoretical knowledge grades between the two groups(P>0.05). The score of critical thinking in the experimental control group was significantly higher than that in the control group(P<0.05). The scores of analytical ability, systematization ability, self-confidence in critical thinking and cognitive maturity were higher in experimental group(P<0.05), while the scores of truth-seeking, open-mindedness and curiosity were similar between the two groups(P>0.05). Students in the experimental group were more satisfied with training model than that in the control group(P<0.05). Conclusion The implementation of SBAR communication model combined with case scenario simulation teaching model in the trainee stage of obstetrics and gynecology for undergraduate students of clinical medicine is conducive to students’ interest in learning, enhancement of critical thinking ability, and improvement of inter-doctoral communication ability, respecting that it can be popularized in trainee teaching of all kinds of disciplines.更多还原