探讨线上线下联合教学模式在物理诊断学教学中的教学效果。

选择2020年春季学期于空军军医大学第二附属医院学习物理诊断学的2017级临床医学本科三年级学生97人，采用线上线下联合教学模式，为线上线下联合组；同时选择2019年春季学期学习物理诊断学的2016级临床医学本科三年级学生116人，采用传统教学模式，为传统教学组。两组学生由同医院同教师授课，比较两组学生的理论和实践技能考核成绩及学生和教师对教学的反馈评价情况。

线上线下联合组学生的基础理论成绩、实践技能成绩以及总成绩分别为(34.05±4.29)分、(45.96±2.08)分和(80.02±5.03)分，传统教学组成绩分别为(34.86±4.70)分、(44.60±1.25)分和(79.40±5.34)分，两组基础理论成绩和总成绩比较，均差异无统计学意义(t＝1.30，0.77；均P>0.05)，线上线下联合组实践技能成绩高于传统教学组，差异有统计学意义(t＝5.89，P<0.05)。线上线下联合组在提高实践操作能力(97.94%，95/97)、激发学习兴趣(98.97%，96/97)、提高自主学习能力(96.91%，94/97)、对教学模式满意度(95.88%，93/97)的反馈评价均明显高于传统教学组[87.07%(101/116)，83.62%(97/116)，81.90%(95/116)，82.76%(96/116)]，均差异有统计学意义(χ²＝8.49，14.63，11.91，9.09；均P<0.05)。线上线下联合教学组教师对学生表现满意度91.75%(89/97)高于传统教学组81.89%(95/116)，差异有统计学意义(χ²＝4.36，P<0. 05)。

线上线下联合教学模式可显著提高学生的物理诊断学实践技能成绩，激发学生学习兴趣，提高自主学习能力，提高教师和学生的教学满意度，具有良好的教学效果，值得推广。

To explore the teaching effect of online combined with offline teaching mode in physical diagnostics teaching.

A total of 97 third-year clinical medicine undergraduates in 2017 grade who studied physical diagnostics in the Second Affiliated Hospital of Air Force Medical University in the spring semester of 2020 were selected. They were adopted the online and offline combined teaching mode as the online and offline combined group. At the same time, 116 third-year clinical medicine undergraduates in 2016 grade who also studied physical diagnostics in the spring semester of 2019 were selected to adopt the traditional teaching mode as the traditional teaching group. The two groups were taught by the same teachers in the same hospital. The results of the theoretical and practical skills assessment of the two groups, and the feedback and evaluation of the students and teachers on the teaching were compared.

The basic theoretical score, practical skill score and total score of students in the online and offline combined group were (34.05±4.29)points, (45.96±2.08)points and (80.02±5.03)points, respectively. The results of the traditional teaching group were (34.86±4.70)points, (44.60±1.25)points and (79.40±5.34)points, respectively. There were no statistical differences between the theoretical basic scores and total scores in the two groups (t=1.30, 0.77, all P>0.05), while the practical skill score of the online and offline combined group was significantly higher than that of the traditional teaching group (t=5.89, P<0.05). Based on the feedback evaluation, the online and offline combined mode improved students′ practical ability (97.94%, 95/97), stimulated learning interest (98.97%, 96/97), improved autonomous learning ability (96.91%, 94/97) and teaching satisfaction (95.88%, 93/97), which were significantly higher than those of traditional teaching group [87.07%(101/116), 83.62%(97/116), 81.90%(95/116) and 82.76%(96/116)] (χ²=8.49, 14.63, 11.91, 9.09, all P<0.05). Teachers′ satisfaction with students performance of the online and offline combined group was higher than that of the traditional teaching group [91.75% (89/97), 81.89% (95/116)], the difference was statistically significant (χ²=4.36, P<0.05).

Online and offline combined teaching mode can significantly improve students′ physical diagnostics practical skills, stimulate students′ interest in learning, improve autonomous learning ability and teaching satisfaction of teachers and students. It has a good teaching effect and is worthy of promotion.