探讨案例教学法在医学本科生心力衰竭诊治教学中的应用价值。

选择2020年7月至10月于济宁医学院附属医院心内科接受内科学课程学习的济宁医学院2017级五年制临床本科四年级见习医学生126人，按随机数字表法分为对照组(n＝63)和案例教学组(n＝63)。对照组采用传统讲授式教学法，案例教学组通过典型病例为学生讲授心力衰竭知识，病例选自济宁医学院附属医院心内二科心力衰竭病例库；比较两组学生的理论考核成绩和学生对教学满意度及对心力衰竭知识掌握程度的反馈情况。

案例教学组理论成绩、病例分析成绩和总成绩[(45.71±0.94)分，(41.40±2.01)分，(87.12±2.07)分]均高于对照组[(42.35±3.03)分，(38.37±3.28)分，(83.62±3.24)分]，均差异有统计学意义(t＝8.41，6.28，7.21；均P<0.01)。案例教学组对授课模式、学习兴趣提高、临床思维能力提升、团队沟通能力提升、自我学习能力提升和对疾病概念、病因、发病机制、诊断及治疗掌握程度的满意度分别为100.00%，100.00%，100.00%，100.00%，100.00%，98.41%，100.00%，96.83%，98.41%，96.83%，均高于对照组(满意度分别为93.65%，87.30%，92.06%，85.71%，95.24%，87.30%，84.13%，84.13%，84.13%，82.54%)，均差异有统计学意义(χ²＝6.19，13.90，8.33，15.05，5.13，8.72，17.39，9.83，11.97，10.89；均P<0.05)。

以心力衰竭病例库为基础的案例教学方法丰富了教学的形式，提高了心力衰竭知识的教学效果，值得进一步推广。

To explore the application value of case-based learning (CBL) method in the teaching of diagnosis and treatment of heart failure for medical undergraduates.

From July to October 2020, 126 fourth-year clinical students of five-year program in 2017 grade who studied internal medicine in Affiliated Hospital of Jining Medical University were selected and randomly divided into two groups (control group and CBL group) for teaching. The control group (n=63) received the lecture-based learning (LBL), while the CBL group (n=63) were taught heart failure knowledge through typical cases which were selected from the Second Department of Cardiology in Affiliated Hospital of Jining Medical University. The results of assessment and the feedback of students′ satisfaction with teaching methods and mastery of heart failure knowledge were compared between the two groups.

The theoretical score, case analysis score and total score [(45.71±0.94)points, (41.40±2.01)points, (87.12±2.07)points] of the CBL group were higher than those of the control group [(42.35±3.03)points, (38.37±3.28)points, (83.62±3.24)points] (t=8.41, 6.28, 7.21, all P<0.01). The CBL group′s satisfactions of teaching mode, learning interest increasing, clinical thinking ability, team communication ability, self-learning ability evaluation and mastery of disease concept, etiology, pathogenesis, diagnosis and treatment were 100.00%, 100.00%, 100.00%, 100.00%, 100.00%, 98.41%, 100.00%, 96.83%, 98.41%, 96.83%, respectively, and they were higher than those of control group (93.65%, 87.30%, 92.06%, 85.71%, 95.24%, 87.30%, 84.13%, 84.13%, 84.13%, 82.54%). The differences were statistically significant (χ²=6.19, 13.90, 8.33, 15.05, 5.13, 8.72, 17.39, 9.83, 11.97, 10.89, all P<0.05).

The CBL method which based on heart failure case library enriches the teaching forms, improves the teaching effect of heart failure knowledge, and is worthy of further promotion.