【摘要】 目的 探索将案例学习（CBL）、患者学习（HBL）、思政学习（IBL）、循证学习（EBL）、反馈学习（FBL）、信息化学习（DBL）、团队学习（GBL）、思考学习（TBL）以及问题导向学习（PBL）进行整合（简称CHIEF DGTP），应用于疑难病例讨论。方法 对CHIEF DGTP疑难病例讨论教学的模式定位、具体内涵、实施方案、内容筛选等方面进行总结。以该院2024级、2023级和2022级住院医师为研究对象，采用匿名调查问卷的方式评价该模式教学效果。结果 CHIEF DGTP模式通过整合多种教学方法，为住院医师构建了全面、立体的教学框架。教学效果问卷显示，与传统的疑难病例讨论模式相比，90.0%以上的住院医师认为该模式可以提高疾病的诊断和治疗能力，95.0%以上的认为可以提高临床思维能力、学习积极性及兴趣、对知识的记忆能力，同时对该模式满意并推荐为固定教学模式可进行全院推广，仅0.6%住院医师认为该教学模式过于繁琐，在一定程度上增加了学习负担，劣于传统教学模式。结论 CHIEF DGTP疑难病例讨论模式为住院医师规范化培训提供了创新思路和方法。更多还原

【Abstract】 Objective To explore the integration of case-based learning(CBL), healthcare-based learning(HBL), ideology-based learning(IBL), evidence-based learning(EBL), feedback-based learning(FBL), digitalbased learning(DBL), group-based learning(GBL), thinking-based learning(TBL) and problem-based learning(PBL)(referred to as HIEF DGTP) and apply it in difficult case discussions. Methods We summarized the model orientation, specific connotation, implementation scheme and content screening of the CHIEF DGTP difficult case discussion teaching. The teaching effect of the model was evaluated by means of anonymous questionnaires with the residents of grades 2024, 2023 and 2022 of our hospital as the study subjects. Results The CHIEF DGTP model constructed a comprehensive and three-dimensional teaching framework for residents by integrating multiple teaching methods. The teaching effect questionnaire showed that, compared with the traditional difficult case discussion mode, more than 90.0% of the residents believed that this mode could improve the diagnosis and treatment of diseases, and more than 95.0 % believed that it could improve the ability of clinical thinking, the motivation and interest in learning, and the ability to memorize knowledge, and at the same time, were satisfied with this mode and recommended it as a fixed teaching mode that could be promoted throughout the hospital. Only 0.6%of the residents felt that the teaching model was too cumbersome, increased the learning burden to some extent, and was inferior to the traditional teaching model. Conclusion The CHIEF DGTP difficult case discussion model can provide innovative ideas and methods for residency training.更多还原