【摘要】 目的 探讨PBL联合临床路径教学法在肾内科住院医师规范化培训中的应用效果,以提高教学质量。方法 选取2021年1月1日-2022年12月31日在某院肾内科轮转的住院医师共90名作为研究对象。根据常用医学教学模式分组，分为PBL教学组、临床路径教学组及PBL联合临床路径教学组各30名，比较三组住院医师的理论考试成绩、迷你临床演练评估评分及教学满意度，以评价教学效果。结果 PBL联合临床路径组住院医师的理论考试成绩显著高于PBL组和临床路径组(90.23±1.94分与88.10±2.34分与88.83±2.25分)，差异有统计学意义(P<0.05)。PBL组在病史采集(6.83±1.12分)、体格检查(6.77±0.90分)、临床判断(7.00±0.95分)、沟通技能(6.47±0.97分)、人文关怀(6.67±0.99分)、组织效能(6.57±0.86分)、整体能力(6.97±0.81分)7个方面的迷你临床演练评估评分显著高于其他两组，差异有统计学意义(P<0.05)。包含临床实践能力提高、学习兴趣提高等4个方面的问卷调查显示PBL联合临床路径组住院医师对教学模式的整体满意度显著高于PBL组和临床路径组(100%与76.7%与86.7%)，差异有统计学意义(P<0.05)。结论 PBL联合临床路径教学模式有效提高了住院医师的理论知识水平和临床实践能力，显著提高肾内科住院医师规范化培训的教学质量，值得推广。更多还原

【Abstract】 Objectives This study aims to investigate the application effect of PBL combined with clinical pathway teaching method in standardized training of nephrology residents, so as to improve teaching quality.Methods A total of 90 residents who were trained in the nephrology department of a hospital from January 1, 2021 to December 31, 2022 were selected as the subjects of study. Based on the commonly used medical teaching models,they were divided into PBL teaching group, clinical pathway teaching group and PBL combined with clinical pathway teaching group with 30 students each. Theoretical examination results, Mini-CEX scores and resident satisfaction evaluation of the three groups were compared to evaluate the teaching effect. Results The results of theoretical examination of the PBL combined with clinical pathway group were significantly better than those of the other two groups [(90.23±1.94) vs.(88.10±2.34) vs.(88.83±2.25)]. The differences were statistically significant(P<0.05). The PBL combined with clinical pathway group scored higher than the other two groups in the seven aspects of Mini-CEX evaluation including medical interviewing skills(6.83±1.12), physical exam skills(6.77±0.90), clinical judgment(7.00±0.95), counseling skills(6.47±0.97), humanistic qualities/professionalism(6.67±0.99), organization and efficiency(6.57±0.86), and overall clinical competence(6.97±0.81). The differences were statistically significant(P<0.05). Resident satisfaction rates of the PBL combined with clinical pathway group were higher than those in the other two groups in the four aspects such as improving clinical practice ability and stimulating learning enthusiasm, and the satisfaction of the overall teaching mode(100.0% vs. 76.7%vs. 86.7%). The differences were statistically significant(P<0.05). Conclusions PBL combined with clinical pathway teaching method can effectively increase the theoretic knowledge level and clinical practice ability of residents. This teaching model obviously improved the quality of standardized residency training in department of nephrology and is worth popularizing.更多还原