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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2026, Vol. 15 ›› Issue (3): 275-279.doi: 10.3969/j.issn.2095-378X.2026.03.017

• 卫生教育与管理 • 上一篇    下一篇

基于病例分析法的外科手术学清创术教学实践

张传昕1,2, 沈宏亮2, 王志农2, 李振杰3   

  1. 1.海军军医大学第二附属医院骨科,上海 200003;
    2.海军军医大学第二附属医院外科学与野战外科学教研室,上海 200003;
    3.海军军医大学第二附属医院麻醉科,上海 200003
  • 收稿日期:2026-04-06 出版日期:2026-09-28 发布日期:2026-09-30
  • 通讯作者: 李振杰,zhenjie007@outlook.com
  • 作者简介:张传昕（1992—）,男,硕士,主治医师,从事临床骨科工作
  • 基金资助:
    中文作者简介:超强激光科学与技术全国重点实验室开放基金（20260126）

Teaching practice of surgical debridement through case-based learning

ZHANG Chuanxin1,2, SHEN Hongliang2, WANG Zhinong2, LI Zhenjie3   

  1. 1. Department of Orthopedics, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China;
    2. Department of Surgery and Field Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China;
    3. Department of Anesthesiology, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
  • Received:2026-04-06 Online:2026-09-28 Published:2026-09-30

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摘要： 目的 探讨病例分析法在外科手术学清创术教学中的应用效果,为外科基础技能教学改革提供实践依据。方法 选取学校2023级五年制临床医学专业本科327名学生为研究对象,随机分为观察组（163人）与对照组（164人）。对照组采用传统大班理论授课联合手术录像观摩教学,观察组采用病例分析法开展教学。教学结束后采用改良操作技能直接观察评估表（DOPS）评价操作技能,采用视觉模拟量表（VAS）收集学生主观学习体验,计量资料行独立样本t检验,计数资料行χ²检验。结果 观察组在术前准备、清创术操作掌握程度、无菌操作规范、术后处理、整体操作表现等DOPS评分均显著高于对照组,直接操作耗时与教学反馈耗时显著短于对照组,差异有统计学意义（P<0.05）。VAS评价显示,观察组在临床学习兴趣、自学能力提升、知识点掌握程度、学习主动性与问题解决能力方面的正向评价占比显著高于对照组（P<0.05）。结论 病例分析法能够改善传统清创术教学理论与临床脱节、重操作轻思维、学生学习被动等问题,有效提升医学生清创术操作技能与临床思维能力,教学效果优于传统教学模式,可在外科手术学基础课程中推广应用。

关键词: 病例分析法, 外科手术学, 清创术, 教学改革, 临床思维

Abstract: Objective To explore the application effect of case-based learning in surgical debridement teaching, and to provide a practical basis for the teaching reform of basic surgical skills. Methods A total of 327 five-year undergraduate students majoring in clinical medicine from Grade 2023 of our university were selected and randomly divided into an observation group （163 cases） and a control group （164 cases）. The control group received traditional large-class theoretical lectures combined with surgical video observation, while the observation group was taught with case-based learning. After teaching. the modified Direct Observation of Procedural Skills （DOPS） scale was used to evaluate operational skills, and the Visual Analogue Scale （VAS） was used to collect students’ subjective learning experience. Independent sample t-test was used for measurement data, and χ² test was used for enumeration data. Results The DOPS scores of preoperative preparation, mastery of debridement operation, aseptic operation specification, postoperative treatment, and overall operation performance in the observation group were significantly higher than those in the control group, and the direct operation time and teaching feedback time were significantly shorter （P<0.05）. VAS evaluation showed that the proportions of positive evaluations in clinical learning interest, self-study ability improvement, knowledge mastery, learning initiative, and problem-solving ability in the observation group were significantly higher than those in the control group （P<0.05）. Conclusion Case-based learning can address problems of gap between theory and clinical practice, overemphasis on operation over thinking, and passive learning in traditional debridement teaching. It can effectively improve the debridement skills and clinical thinking of medical students, works better than the traditional teaching mode, and can be applied in basic surgical courses.

Key words: Case-based learning, Surgical skills, Debridement, Teaching reform, Clinical thinking

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