方法：从2010级临床医学专业本科生中随机选择5个班，共147人作为试验组，采用“以问题为基础的教学(problem-based learning，PBL)”模式，另外随机选择5个班，共149人采用“以授课为基础的教学(lecture-based learning，LBL)”模式作为对照。对两组学生的期末考试成绩进行比较，同时采用调查表对学生进行问卷调查，获得他们对PBL的评价信息。采用SPSS 13.0软件对所有数据进行统计学处理。

结果：基线调查的均衡性检验的结果显示，两组学生间的基本特征无显著性差异，具有可比性(P >0.05)。期末考试的结果显示，两组学生除了对EBM的基础知识考核的结果无显著性差异外(P >0.05)，对EBM的过程的5个步骤，即提出问题、寻找最佳证据、评价证据、应用和实践证据、并对证据进行再评估，以及总成绩的评价显示，两组间均存在显著性差异，并具有统计学意义(P<0.05)。学生对学习效果评价的结果显示，两组学生对采用PBL方式在更好消化课堂所学内容、提高语言表达能力，以及在锻炼写作能力的应答无显著性差异(P>0.05)，而其他各项均具有显著性差异(P<0.05)。尤其在调动学习积极性、提高自学能力、提高学习效率、提高信息分析与利用能力、加强团队协作意识，以及加强师生交流沟通方面，两组间的应答具有极其显著性差异(P<0.001)。

结论：PBL教学模式能有效提高EBM的教学效果，改善EBM的教学质量，值得进一步推广应用。

METHODS: Five classes(total 147 students)were randomly selected as experimental(PBL)group, at the same time, another 5 classes(total 149 students)were also randomly selected as control group, using traditional teaching method(lecture-based learning, LBL)in 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self-administered questionnaire to obtain their evaluation for PBL practice. SPSS13.0 software was used for statistical analysis.

RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable(P>0.05). Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students(P>0.05), for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re-evaluating the evidence, and the total scores between the two groups, there were significant statistically differences(P<0.05). The results to student learning evaluation showed that there was no significant difference between the two groups(P>0.05)in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference(P<0.05), especially in aspects of improving enthusiasm for learning, self-study ability, improving learning efficiency, information analysis and utilization ability, team collaboration, and communication between teachers and students, however, there was a very significant difference(P<0.001)between the two groups.

CONCLUSION:PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.