调查临床医学生对见习中诊断学应用新型教学模式的认识，探讨适合现阶段临床医学生并能激发学生学习兴趣、提高实际能力的诊断学见习课的新型教学模式。

以2012级临床医学五年制本科生69人为研究对象，均在2015年2—6月参加了诊断学大课及临床见习课的学习，2015年6月26—30日通过问卷调查的方式；研究临床医学生对诊断学见习课中应用以问题为导向的教学方法(PBL)、以团队为基础的教学方法(TBL)、案例为基础的教学模式(CBL)三种新型教学模式的认识，并对诊断学见习课教学中使用传统讲授式教学法(LBL)与新型教学模式的有效性进行评价。

①86.96%(60/69)的学生对新型教学模式感兴趣；②TBL教学模式，学生对提高团队合作能力、分析问题能力、师生互动能力认可程度最高，分别占调查总人数的95.00%(57/60)，85.00%(51/60)和81.67%(49/60)；PBL教学模式，学生对提高分析问题能力、处理临床实践工作的能力、学习兴趣培养的帮助认可程度最高，分别占调查总人数的93.33%(56/60)，88.33%(53/60)和88.33%(53/60)；CBL教学模式，学生对提高处理临床实践工作能力、分析问题能力、学习兴趣培养的帮助认可程度最高，分别占调查总人数的100.00%(60/60)，93.33%(56/60)和91.67%(55/60)；③学生认为问诊及病历书写部分，LBL＋TBL教学模式优于LBL＋PBL及LBL＋CBL，组间比较差异有统计学意义(χ²＝18.94，5.82，5.57；P<0.05)；体格检查部分，LBL＋TBL教学模式优于LBL＋PBL及LBL＋CBL，组间比较差异有统计学意义(χ²＝23.80，18.19；P<0.05)；心电图检查部分，LBL＋PBL及LBL＋CBL教学模式优于LBL＋TBL，组间比较差异有统计学意义(χ²＝7.38，6.13；P<0.05)，但在该部分教学中，LBL＋PBL和LBL＋CBL教学模式组间比较差异无统计学意义(χ²＝20.08，1.02，0.55；P>0.05)；实验室检查部分LBL＋TBL、LBL＋PBL及LBL＋CBL三种教学模式比较差异无统计学意义(χ²＝22.00，12.91；P>0.05)；超声检查部分LBL＋CBL教学模式优于LBL＋TBL及LBL＋PBL，组间比较差异有统计学意义，P<0.05。

新型教学模式在提高团队合作能力、分析问题能力、师生互动能力、临床实践工作能力及帮助培养学习兴趣方面具有优越性；结合学生对见习课堂各种教学模式有效性的认识，不同的教学内容应采取不同的教学模式，相同的教学内容应采取多种教学模式的结合。

To investigate the understanding of the application of new teaching models on the diagnostics practice class in the medical students and explore a medical teaching model on the diagnostics practice class, and to stimulate students′ interest in learning and improve diagnostics capabilities.

Sixty-nine five-year undergraduate students of clinical medicine, who participated in the study of diagnostics in February 2015 to June were retrospectively analysed through the way of questionnaire survey.The understanding of problem-based learning(PBL), team-based learning(TBL), case-based learning(CBL) were studied and the effectiveness of the lecture-based learning(LBL) and the new teaching models was evaluated.

①Sixty (86.96%) students were interested in new teaching models, and 9(13.04%) students were not interested in.②There were 10 issues which connected with improving students′ comprehensions.For the team-based learning mode, the students thought that it could improve the capability of teamwork(57/60), the capability of analytical problem(51/60), and the ability of teacher-student interaction(49/60). For the problem-based learning mode, the students thought that it could improve the capability of analytical problem(56/60), the capability in clinical practice(53/60), and could help them to set up learning interests(53/60). For the case based learning mode, the students thought that it could improve the capability in clinical practice(60/60), the capability of analytical problem(56/60), and could help them to set up learning interests(55/60). ③In the inquiry, medical records and physical examination class, LBL+ TBL teaching mode was more effective.In the ECG, LBL+ PBL and LBL+ CBL teaching modes were more effective.In the laboratory examination, there was no difference among the three different teaching models.In the UCG, LBL+ CBL teaching mode was more effective.

The new teaching models have superioritious in improving teamwork skills, ability to analyze problems, teacher-student interaction capability, the ability to work in clinical practice and helping develop interest in learning aspects.Combined with the effectiveness of the various teaching models, different teaching content should adopt different teaching model, the same teaching content should adopt a variety of teaching models.