CBL教学联合三维成像技术在胸外科见习教学中的应用

目的 探讨以案例为基础的学习（case-based learning，CBL）联合三维成像技术在胸外科见习教学中的应用效果。方法 选取2019年在扬州大学附属医院胸外科见习的90名学生，按照随机数字表法分为常规理论授课组（A组）、CBL教学组（B组）和CBL教学联合三维成像技术组（C组）。其中A组行常规理论授课；B组行CBL教学；C组在CBL的基础上，使用三维成像软件利用CT数据对患者的影像资料进行三维重建。分别评估两组的理论考试成绩，并对学生进行问卷调查（包括教学是否有利于激发学习兴趣和热情、是否有利于临床思维的建立、教学方法优劣的评价、是否有利于理论知识的掌握）。采用 SPSS 20.0 进行方差分析、t 检验和卡方检验。结果 理论成绩A组（85.83±4.62）为3组最低；B组理论成绩（89.71±5.84）低于C组（94.60±6.28）；答题时间C组（286.68±77.56） s为3组最低，B组（359.78±80.55） s低于A组（423.31±83.53） s，差异有统计学意义（P<0.001）。在教学是否有利于激发学习兴趣和热情、是否有利于临床思维的建立、教学方法优劣的评价、是否有利于理论知识的掌握等方面C组优于B组和A组，B组又优于A组，差异有统计学意义（P<0.001）。结论 CBL教学联合三维重建技术，提高了胸外科见习学生对教学方法的认可度，提升了学生的理论成绩，激发了学生的学习兴趣和热情、培养了其临床思维，增加了其对理论知识的掌握。

Application of CBL combined with 3D imaging technology in thoracic surgery probationary teaching

Objective To explore the application effect of case-based learning (CBL) combined with three-dimensional (3D) imaging technology in thoracic surgery probationary teaching.Methods Ninety thoracic surgery interns in the Affiliated Hospital of Yangzhou University, China in 2019 were selected and divided into the conventional theoretical teaching group (group A), CBL group (group B), and CBL combined with 3D imaging technology group (group C) according to the random number table method. Group A was taught with conventional theory; group B was taught by CBL; in group C, 3D imaging software was used to reconstruct computed tomography data based on CBL. The theoretical scores of the three groups were evaluated respectively, and a questionnaire survey was conducted on the students (including whether the teaching is conducive to stimulating the interest and enthusiasm of learning, whether it is conducive to the establishment of clinical thinking, evaluation of advantages and disadvantages of the teaching method, and whether the teaching method is conducive to the mastery of theoretical knowledge). SPSS 20.0 was used for analysis of variance, t test, and Chi-square test.Results The theoretical score of group A (85.83±4.62) was the lowest, and the theoretical score of group B was significantly lower than that of group C (89.71±5.84 vs. 94.60±6.28); the answer time of group C (286.68±77.56 seconds) was the shortest, and the answer time of group B was significantly shorter than that of group A (359.78±80.55 vs. 423.31±83.53 seconds, P<0.001). Group C was significantly better than group B and group A in the aspects of stimulating interest and enthusiasm in teaching, conducive to the establishment of clinical thinking, advantages of the teaching method, and conducive to the mastery of theoretical knowledge, and group B was significantly better than group A (P<0.001).Conclusion The combination of CBL and 3D reconstruction technology improves the recognition of thoracic surgery interns to the teaching method, increases their theoretical scores, stimulates their learning interest and enthusiasm, cultivates their clinical thinking, and enhances their mastery of theoretical knowledge.