【摘要】 目的 探讨分层递进式问题导向教学（PBL）在放射科住院医师教学阅片中的应用效果，旨在进一步完善分层教学策略。方法 选取2023年9月1日—2023年11月30日在中南大学湘雅二医院放射科住培基地轮转的63名放射专业住院医师，随机分为观察组（n=32）和对照组（n=31）。观察组采用PBL分层递进模式进行教学阅片，并以8人组成的阅片小组为单位，进行案例模拟情景练习。对照组采用传统教学方式进行教学阅片。通过理论考核、阅片考核及问卷调查评价教学效果，采用独立样本t检验和Mann-Whitney U检验进行统计比较。结果 观察组学员的理论考核成绩、阅片考核成绩（85.31±4.69,82.63±5.05）分均高于对照组（80.48±3.76,77.87±3.91）分，差异有统计学意义。问卷调查结果显示观察组在贴近临床日常工作、提高学习主动性、锻炼独立思考和解决问题的能力、有助于掌握影像理论知识、有助于提升影像诊断能力5个方面满意度评分均高于对照组，差异有统计学意义。结论 PBL联合分层递进的教学模式能够激发住院医师的学习积极性，提升放射住院医师的影像诊断思维能力、沟通交流等核心岗位胜任力，进一步提高放射科教学阅片的教学质量和效果。更多还原

【Abstract】 Objectives This study aims to explore the application effect of tiered, progressive problem-based learning(PBL) in radiology resident teaching of image interpretation. Methods A total of 63 radiology residents rotating at the radiology department of Xiangya Second Hospital of Central South University from September 1 to November 30, 2023 were selected and randomly divided into an experimental group(n=32) and a control group(n=31). The observation group used a PBL tiered and progressive model for teaching video review and conducted case simulation exercises in groups of eight. The control group used traditional teaching methods for film review. The teaching effectiveness was evaluated through theoretical assessments, film review assessments, and questionnaires. Statistical comparisons were performed using independent samples t-tests and Mann-Whitney U tests. Results The scores of theoretical and film-reading assessments in experimental group(85.31±4.69, 82.63± 5.05) were higher than those in the control group(80.48±3.76, 77.87±3.91), with statistically significant differences. The questionnaire results showed that the experimental group had higher satisfaction scores than the control group in terms of closeness to clinical daily work, improvement of learning initiative, enhancement of independent thinking and problem-solving abilities, mastery of imaging theoretical knowledge, and improvement of imaging diagnostic abilities, with statistically significant differences. Conclusions The combination of PBL and hierarchical-progressive teaching mode can stimulate the learning enthusiasm of residents, enhance their core competencies such as imaging diagnostic ability and communication skills, and further improve the teaching quality and effectiveness of radiology teaching film-reading.更多还原