Abstract: Objective To explore the application value of problem-based learning (PBL) in clinical teaching of intracranial aneurysms management. Methods The standardized training students in Department of Neurosurgery of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from August 2018 to August 2019 were randomly assigned to the observation group and control group, and the PBL teaching method was used in observation group and lecture-based learning (LBL) teaching method in control group. A one-month teaching course included basic theoretical knowledge, clinical practice and surgical strategy. After completing all the teaching courses, the two groups were tested by examination, and the scores of the two groups were compared. Results A total of 32 students were included, with 16 ones in each group. The test results showed that there was no statistical difference in score of basic theoretical knowledge between the two groups (77.3±1.20 vs. 76.9±0.98, P =0.310), the scores of clinical practice (84.7±3.11 vs. 81.8±2.93, P =0.011) and surgical strategy (73.0±2.58 vs. 70.5±2.88, P =0.015) in PBL group were higher than that in LBL group. Conclusions For the clinical teaching of surgical treatment of intracranial aneurysms, the PBL teaching method is more conducive to improving the clinical practice ability and cultivating dialectical thinking ability of surgical strategy for standardized training students.

Key words: Problem-based learning; Intracranial aneurysm; Standardized training students; Clinical teaching

摘要： 目的 探究以问题为基础教学法（probl em-based learning，PBL）在颅内动脉瘤外科治疗中的应用价值。 方法 将2018年8月-2019年8月在南京大学医学院附属鼓楼医院神经外科进行住院医师规范化培 训的医师随机分为两组，分别采用PBL教学法和以授课为基础教学法（lecture-based learning，LBL）进 行1个月的基础知识、临床实践和手术策略教学。教学完成后统一组织考核，比较两组学员以上3门 课程的平均成绩。 结果 共纳入32名规培生，PBL组和LBL组各16人。PBL组与LBL组的基础知识考核成绩无显著差异 （77.3±1.2分 vs. 76.9±1.0分，P =0.310）；PBL组临床实践（84.7±3.1分 vs. 81.8±2.9分，P =0.011）和 手术策略（73.0±2.6分 vs. 70.5±2.9分，P =0.015）的考核成绩较LBL组增高。 结论 对于颅内动脉瘤外科治疗的临床教学，PBL教学法更有利于提高规培生的临床实践能力和培 养手术策略选择的辩证思维能力。

关键词: 以问题为基础教学法; 颅内动脉瘤; 规培生; 临床教学