关键词: 案例为基础的学习, 小组合作式学习, 眼科学教学

Abstract:  Objective  To explore the application value of case-based learning (CBL) combined with team-based learning (TBL) teaching model in ophthalmology teaching. Design  Teaching research. Participants Two classes of five-year program undergraduate students majoring in clinical medicine, with a total of 89 students, who participated in clinical probation at Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in 2023. Methods The control group (44 students) adopted TBL alone, while the experimental group (45 students) adopted the CBL-TBL integrated teaching model. Teaching effectiveness was comprehensively evaluated through multi-dimensional indicators, with specific assessment methods detailed as follows: Phased tests (100-point scale): conducted monthly for 3 consecutive times (Phased test Ⅰ, Ⅱ, Ⅲ), with the score calculated as the average of the three tests. Each test included two components: a closed-book basic theory test (individual assessment), covering question types such as term explanation and multiple-choice questions; and a practical application ability test (group assessment), focusing on teamwork performance and knowledge application capacity. Questionnaire survey: scoring was carried out from three dimensions, namely students' satisfaction with teaching, self-evaluation of learning outcomes, and teachers' satisfaction with teaching. Final overall score (100-point scale): calculated via a weighted conversion mechanism, where stage test scores accounted for 20%, final theory scores accounted for 60%, and questionnaire survey scores accounted for 20%. Main Outcome Measures  Scores of Phased test Ⅰ, Ⅱ, Ⅲ, final theory scores, score of the teaching effectiveness questionnaire, and final total score. Results No statistically significant difference was observed in the score of Phased test Ⅰ between the two groups (88.02±6.01 vs. 87.11±5.44, t=0.746，P=0.457). The scores of Phased test Ⅱ (91.24±4.58 vs. 87.91±6.10), Phased test Ⅲ (92.02±4.14 vs. 88.09±6.36) and final theory score (92.66±3.89 vs. 88.34±5.55) of the experimental group were significantly higher than those of the control group (t=2.920, 3.460, 4.218; all P<0.05). At the end of the semester, there were no statistically significant differences between the two groups in terms of students' satisfaction with teaching methods, learning interest, learning efficiency, self-learning ability, team cooperation ability, language communication ability, literature reading ability, PPT-making ability, and the degree of emotional improvement among students (all P>0.05). Nevertheless, the experimental group outperformed the control group in clinical thinking ability, ability to integrate theory with practice, and the possibility of choosing ophthalmology as a specialty after graduation (all P<0.05). No statistically significant differences were found between the two groups in teachers' satisfaction with teaching methods, satisfaction of other teachers with teaching methods, rationality of teaching design, and ideological and political education effectiveness. As for the evaluation of teaching effectiveness (final total score), the experimental group achieved a significantly higher score than the control group (91.91±4.30 vs. 87.82±6.31, t=3.578, P＜0.001). Conclusion The integration of CBL and TBL in undergraduate ophthalmology teaching enhances medical students' clinical reasoning and theoretical-practical application abilities, warranting wider implementation.

Key words: Case-based learing, Team-based learning, Ophthalmology teaching