南京医科大学PBL教学本土化适配与体系化建构的实践探索

The practical exploration of localized adaptation and systematic construction of PBL teaching at Nanjing Medical University

摘要

为探索问题导向学习(PBL)在医学教育中的本土化适配路径,南京医科大学以建构主义学习理论、情境学习理论和社会学习理论为基础,结合HOPE理念与I-CARE模式,构建了包含课程设计、导师发展、案例编写、教学组织、多元评价5个维度的PBL教学体系。课程采用“双向整合”设计,将基础与临床知识贯穿于渐进式案例中;导师发展实施“准入-培训-认证-动态评估”机制;案例开发坚持学科交叉与人文融合原则;教学组织采取矩阵式管理;评价机制引入“四个一”差异化考核,强化形成性评价。通过问卷调查和学生反馈分析,学生在自主学习、批判性思维、沟通协作等方面的能力提升获得较高认可。研究同时发现,规模化实施中面临教学质量均质化、教师角色转型困难、过程性评价与外部终结性考试之间存在制度性张力等问题。在此基础上提出了引入AI助教、融合多元教学方法、深化价值引领等优化方向,为PBL在中国医学教育环境中的体系化构建提供了可参考的框架与经验。

Abstract

To explore the localized adaptation pathway of Problem-Based Learning (PBL) in medical education,Nanjing Medical University,grounded in constructivist learning theory,situated learning theory,and social learning theory,and integrated with its HOPE philosophy and I-CARE model,has constructed a PBL teaching system encompassing five dimensions:curriculum design,tutor development,case writing,teaching organization,and multiple evaluation methods.The curriculum adopts a "bidirectional integration" design,threading foundational and clinical knowledge through progressive cases.Tutor development implements a mechanism of "access-training-certification-dynamic evaluation."Case development adheres to principles of interdisciplinary integration and humanistic infiltration.Teaching organization adopts a matrix management structure.The evaluation mechanism introduces a "four ones" differentiated assessment to strengthen formative evaluation.Analysis of questionnaire surveys and student feedback indicates high recognition of students′ improved abilities in self-directed learning,critical thinking,and communication and collaboration.The study also identifies challenges in large-scale implementation,including homogenization of teaching quality,difficulties in teachers′ role transformation,and institutional tensions between process-oriented evaluation and external summative examinations.Based on these findings,optimization directions such as introducing AI teaching assistants,integrating diverse teaching methods,and deepening value guidance are proposed,providing a reference framework and experience for the systematic construction of PBL within the Chinese medical education context.

关键词

PBL / 医学教育 / 本土化实践 / 双向整合课程 / 核心胜任力 / 形成性评价

Key words

PBL / Medical education / Localized practice / Bidirectional integration curriculum / Core competency / Formative assessment

[1]张小辉,张志伟,李咏梅,等.案例式PBL教学在医学影像技术教学意义的探索与思考[J].教育教学论坛,2021(2):153-156.
[2]杜翔云,Anette Kolmos,Jette Egelund Holgaard.PBL:大学课程的改革与创新[J].高等工程教育研究,2009(3):29-35.
[3]陈琦,刘儒德.教育心理学[M].3版.北京:高等教育出版社,2020:380-480.
[4]高文.情境学习与情境认知[J].教育发展研究,2001(8):30-35.
[5]阿尔伯特·班杜拉.社会学习理论[M].陈欣银,李伯黍,译.北京:中国人民大学出版社,2015:19.
[6]喻荣彬,李茜,高兴亚,等.南京医科大学基于HOPE理念和I-CARE模式的医学人才培养体系构建[J].医学教育管理,2018,4(1):1-5,10.DOI:10.3969/j.issn.2096-045x.2018.01.001.
[7]Li A,Bilgic E,Keuhl A,et al.Does your group matter? How group function impacts educational outcomes in problem-based learning:a scoping review[J].BMC Med Educ,2022,22(1):1-10.DOI:10.1186/s12909-022-03966-8.
[8]Sunarno I,Mannyu B,As′ad SA,et al.Faculty′s perception of their role as a tutor during Problem-Based Learning activity in undergraduate medical education[J].Asia Pacific Scholar,2024,9(2):87-91.DOI:1029060/TAPS.2024-9-2/SC3114.
[9]高欢玲,张红,李红梅,等.基于PBL教学的形成性评价方案的制订及初步应用[J].中华护理教育,2022,19(12):1096-1100.DO:10.3761/j.ssn.1672-9234.2022.12.008.
[10]Chao CT,Tsai CL,Lin MW,et al.Fully digital problem-based learning for undergraduate medical students during the COVID-19 period:Practical considerations[J].J Formos Med Assoc,2022,121(10):2130-2134.DOI:10.1016/j.jfma.2021.11.011.

基金资助

江苏省高等教育教改研究立项课题(2025JGYB502)