Abstract:  Objective　To explore the application effect of case-based PBL (problem-based learning) combined with teachers and students' three-dimensional evaluation teaching method in the clinical teaching of general surgery. Methods　A total of 135 general surgery interns from Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University from January 2017 to September 2019 were randomly divided into a traditional group, a control group, and an observation group. There were 45 subjects in the traditional group, including 27 males and 18 females, aged (22.6±1.9) years; there were 45 subjects in the control group, including 29 males and 16 females, aged (22.3±1.8) years; there were 45 subjects in the observation group, including 25 males and 20 females, aged (23.1±1.7) years. The traditional group, the control group, and the observation group were taught by traditional teaching method, case-based PBL teaching method, and case-based PBL combined with teachers and students' three-dimensional evaluation teaching method respectively. After different teaching methods, the effect was evaluated in terms of teaching effect, satisfaction, and examination results. ANOVA was used for the measurement data and χ² test was used for the count data. Results　The case-based PBL combined with teachers and students' three-dimensional evaluation teaching method improved the interns' satisfaction on the teaching of general surgery, and improved their examination scores [(79.9±11.9) points in the traditional group vs. (82.4±12.5) points in the control group vs. (87.5±10.3) points in the observation group ], with statistically significant differences (all P<0.05). Conclusion　The case-based PBL combined with teachers and students' three-dimensional evaluation teaching method has a good effect in clinical teaching of general surgery, which is worthy of application and popularization in surgery teaching.

Key words: Problem-based learning, Case-based learning, Teachers and students' three-dimensional evaluation, Clinical teaching of general surgery, Medical education

摘要： 目的　探讨案例式PBL（以问题为基础的教学法）结合师生立体式评价教学法在普外科临床教学中的应用效果。方法　采用非同期对照，将2017年1月至2019年9月深圳沙井医院135名普外科实习生，随机分为传统组、对照组和观察组。传统组45人，其中男27人，女18人，年龄（22.6±1.9）岁；对照组45人，其中男29人，女16人，年龄（22.3±1.8）岁；观察组45人，其中男25人，女20人，年龄（23.1±1.7）岁。传统组、对照组和观察组分别采用传统教学方法、案例式PBL教学法、案例式PBL结合师生立体式评价进行教学，经过不同教学方法后，在教学效果、满意度、考试成绩方面进行效果评价。计量资料采用方差分析，计数资料采用χ²检验。结果　案例式PBL结合师生立体式评价教学法提高了实习生在普外科教学中的满意度，提升了考试成绩［传统组（79.9±11.9）分比对照组（82.4±12.5）分比观察组（87.5±10.3）分］，差异均有统计学意义（均P<0.05）。结论　案例式PBL结合师生立体式评价教学法在普外科临床教学效果良好，值得在外科教学中应用推广。

关键词: 以问题为基础的教学法, 以案例为基础的教学法, 师生立体式评价, 普外科临床教学, 医学教育