探讨BOPPPS联合情境模拟教学方法在心脏体格检查中的应用效果。

选取2025年9月至12月湖南中医药大学90名2022年级临床医学专业本科三年级学生，采用随机数字表法分为试验组与对照组，每组45人。对试验组采用BOPPPS结构化设计理念，融合情境模拟教学法进行心脏体格检查授课；对照组沿用传统教学模式。采用独立样本t检验和Mann-Whitney U检验比较两组临床技能考核成绩与知识测验成绩分布；采用配对t检验比较组内教学干预前后学习投入度变化，采用独立样本t检验比较组间学习投入度和课程学习满意度评分；并对两组学生的反思日志与访谈进行质性分析。

课程结束1周后，试验组技能考核成绩[(86.47±2.15)分]高于对照组为[(71.82±3.06)分]，差异有统计学意义(t＝26.26，P< 0.01)。试验组学生知识测验优秀比例[84.4%(38/45)]，优于对照组[42.2%(19/45)]，两组等级分布差异有统计学意义(Z＝4.19，P< 0.01)。教学干预前，两组活力、奉献、专注、行为自评4个维度和总分比较，均差异无统计学意义(均P > 0.05)；教学干预后，试验组均高于对照组，均差异有统计学意义(t＝7.332，7.947，6.881，6.434，24.928；均P< 0.01)。试验组学习满意度中教学目标明确性、教学结构逻辑性、情境模拟真实性、课堂参与深度、反思与反馈质量、知识整合与应用、团队协作体验、学习负担适宜性8个维度得分，均显著高于对照组，均差异有统计学意义(t＝5.010，5.087，5.657，6.774，7.011，5.380，2.300，2.263；均P< 0.05)。进一步结合学生反思日志与访谈质性数据分析发现，试验组学生的学习模式发生根本性转变，从传统被动的"程序性练习"转变为主动的"意义性探究"，能够在结构化教学情境中完成早期临床思维训练，同时逐步萌发、建立专业职业认同。

BOPPPS联合情境模拟教学可显著提升心脏体格检查的技能成绩和理论知识优秀率，并有效促进学生从程序性操作向意义性探究的学习模式转变。

To investigate the effects of BOPPPS combined with scenario-based simulation teaching method in cardiac physical examination.

A total of 90 third-year undergraduate students majoring in clinical medicine (class of 2022) from Hunan University of Chinese Medicine from September to December 2025 were selected and randomly divided into an experimental group and a control group by the random number table method, with 45 students in each group. The experimental group adopted the BOPPPS structured design concept, incorporating scenario-based simulation teaching method for instruction in cardiac physical examination, while the control group followed the traditional teaching model. Independent samples t-test and Mann-Whitney U test were used to compare the distributions of clinical skill examination scores and knowledge test scores between the 2 groups. Paired-samples t-tests were used to compare intragroup changes in learning engagement before and after the teaching intervention, while independent samples t-tests were performed for intergroup comparisons of learning engagement and course satisfaction scores. Qualitative analysis was performed on the reflective journals and interviews of students in 2 groups.

One week after course completion, the skills assessment score of the experimental group (86.47±2.15)was significantly higher than that of the control group (71.82±3.06), and the difference was statistically significant (t=26.26, P< 0.01). The excellent rate on the knowledge test among students in the experimental group (84.4%, 38/45) was higher than that in the control group (42.2%, 19/45), and the difference in grade distribution between the two groups was statistically significant (Z=4.19, P< 0.01). Before the teaching intervention, no significant differences were found between the 2 groups in the 4 dimensions of vigor, dedication, absorption, and behavioral self-assessment, or in the total score (all P> 0.05). After the teaching intervention, the experimental group scored significantly higher than the control group on all dimensions and the total score (t=7.332, 7.947, 6.881, 6.434, 24.928, all P<0.01). Regarding learning satisfaction, the experimental group scored significantly higher than the control group on all 8 dimensions: clarity of teaching objectives, logical coherence of teaching structure, authenticity of simulation scenarios, depth of classroom engagement, quality of reflection and feedback, knowledge integration and application, team collaboration experience, and appropriateness of learning workload (t=5.010, 5.087, 5.657, 6.774, 7.011, 5.380, 2.300, 2.263, all P< 0.05). Further qualitative analysis combining students′ reflective journals and interview data revealed a fundamental shift in the learning mode of students in the experimental group: they transitioned from conventional passive " procedural practice" to active " meaningful inquiry". Within structured teaching scenarios, students completed early clinical thinking training and gradually cultivated and established professional identity.

The combination of the BOPPPS model and scenario-based simulation teaching can significantly improve both skill performance and knowledge excellence rates in cardiac physical examination. Furthermore, it effectively facilitates students′ transition from procedural operations to meaningful inquiry-based learning.