中文摘要：

摘要目的：探讨CBL结合PBL及LBL的教学方法在胸外科临床实习中的应用效果。方法：选取我院胸外科临床实习学生共60人为研究对象，随机将其分为实验组及对照组，每组各30人。实验组采用CBL＋PBL-4-LBL教学方法；对照组采用LBL教学方法。在学习结束时，采用闭卷考试的形式进行成绩考核；同时采用不记名问卷调查，进行两种教学效果和教学模式的评价。结果：两组学生在理论知识考试部分成绩水平持平，无统计学差异。但是实验组学生在病例分析、基本技能及总成绩等部分成绩明显高于对照组。PBL＋CBL＋LBL教学方法在激发学习兴趣、提高学习积极性、自学能力、建立独立思维模式等方面显著高于LBL组。结论：CBL＋PBL＋LBL教学方法优于传统教学，可以提高学习的积极性，有助于医学生临床思维和实践能力的培养。

英文摘要：

Objective： The study was designed to evaluate the effects of the CBL combined with PBL and LBL teaching method in thoracic surgery clinical teaching. Methods： Medical practicing students were divided into experimental and control groups （CBL ＋PBL＋ LBL group and LBL group）, respectively. Each group was 30 students. In experimental group, PBL combined with PBL and LBL was used while LBL was used in control group. At the end of the study, the assessment of teaching effects was conducted by the final exami- nation and questionnaires. Results： There was no significant difference in the theoretical test scores between the two groups （P〉0.05） but the satisfaction degree, case analysis skills and overall test scores in the final examination in the experimental group were higher than those of control group （P〈0.01）. Conclusions： CBL combined with PBL and LBL teaching method can stimulate the students＇ interests in thoracic surgery practice, strengthen the independent thinking ability and problem resolving ability. It is a better clinical thoracic practice teaching method.