【摘要】 目的 探讨以问题为导向的教学法（problem-based learning,PBL）结合“实景化”教学模式在名老中医药专家学术经验传承工作室背景下中医住院医师规范化培训中的应用对学生临床理论知识，实践技能操作、学习兴趣，分析问题、解决问题能力的影响效果。为名老中医药专家学术研究传承与发展提供可参考的新途径，提升中医住院医师规范化培训质量，为中医药人才的现代化培养提供可借鉴的新方法。方法 选取2018年9月—2022年4月于天水市中医医院进行住院医师规范化培训的学员60名随机分为两组，每组各30名，对照组应用传统教学模式，观察组应用PBL与“实景化”结合的师承教育教学模式。对两组学员入科期间进行迷你临床演练（mini-clinical evaluation exercise,Mini-CEX）、操作技能直接观察评量即时考核，即时反馈学习掌握情况，出科时进行理论和技能考核进行比较分析。对两组学生学习兴趣、学习自主性、沟通技能、团队协作能力调查评分进行比较。结果 观察组理论、实践技能考核分均显著高于对照组，差异有统计学意义（P <0.05）。观察组学习自主性、沟通技能、团队协作调查评分均显著高于对照组，差异有统计学意义（P <0.05）。结论 基于名中医药专家学术师承培养的PBL与“实景化”相结合的教学模式，将理论授课和名老中医实践经验相融合，提高住培学生的理论知识思维学习，锻炼其实践应用能力。有利于增强学习兴趣，提高学生自学能力，也推动了名中医药专家学术的研究、传承与发展，开辟出地方医学流派传承的新模式。更多还原

【Abstract】 Objective To explore the effects of PBL combined with "real scene" teaching mode in standardized training for resident doctors on students’ theoretical knowledge, practical skills and operation ability, learning interest, problem analysis and solving ability. Methods From September 2018 to April 2022, a total of 60 students who went to Tianshui Traditional Chinese Medicine Hospital for standardized resident training were randomly divided into two groups, 30 students in each group. The control group applied the traditional teaching mode, and the observation group applied the teaching mode of PBL combined with "reality". Mini-clinical evaluation exercise(Mini-CEX)was conducted for the two groups of students during their admission, and their operation skills were directly observed and evaluated for immediate assessment, and their learning mastery was immediately fed back. Theoretical and skill assessments were conducted for comparative analysis upon graduation. A comparison was made on the survey scores of learning interest, learning autonomy, communication skills, and teamwork ability between two groups of students.Results The theoretical and practical skill assessment scores of the observation group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05). The observation group showed significantly higher scores in terms of learning autonomy,communication skills, and team collaboration compared to the control group, with statistically significant differences(P<0.05). Conclusion In the standardized training of resident doctors, the combination of PBL and "real scene" teaching mode can systematically combine theory with practice,integrate theoretical teaching with the practical experience of renowned traditional Chinese medicine practitioners,improve the theoretical knowledge and thinking learning of resident training students, and exercise their practical application abilities. It is beneficial for enhancing students’ interest in learning, improving their self-learning ability, and also promoting the research, inheritance, and development of renowned traditional Chinese medicine experts, opening up a new model for the inheritance of local medical schools.更多还原