目的：探讨以问题为导向的教学方法(problem-based learning，PBL)在眼科临床实习教学中培养学生临床思维的教学效果。

方法：选取2017/2018年上学期参加眼科学课程学习的临床本科学生141人，参加临床实习课时随机分为传统教学组(lecture based learning，LBL)69人及PBL模式教学组72人。两组学生前期所学课程相同，高考入学成绩、性别、年龄、眼科实习时间差异均无统计学意义(P>0.05)。实习结束通过学生课评问卷调查及临床考核成绩两种形式比较分析两种教学方式的教学效果。

结果：学生对课程各种能力的培养满意度评价显示：参与PBL教学组各能力满意度均高于LBL组。其中学习兴趣提升、知识拓展能力、解决问题能力及医患沟通能力差异具有统计学意义(P<0.05)。临床考核成绩中病例分析与技能操作两项PBL组高于LBL组，差异有统计学意义(P<0.05)。

结论：PBL教学法在眼科临床实习教学中的效果显著，有利于临床思维培养并提高教学质量。

METHODS: A total of 141 clinical undergraduate students were selected to attend the ophthalmology course in the first semester of the 2017-2018 academic year, students were randomly assigned to the traditional lecture based learning(LBL)teaching group of 69 and the PBL model teaching group of 72 in the clinical practice class. The two groups of students studied the same courses at the early stage, and there was no statistically significant difference in college entrance examination scores, gender, age, and practice time of ophthalmology(P>0.05). At the end of the internship, the teaching effects of the two teaching methods were compared and analyzed by means of students' curriculum assessment questionnaire survey and the clinical examination results.

RESULTS: The evaluation of students' satisfaction with the training of various abilities of the course showed that the satisfaction of each ability of the PBL teaching group was higher than that of the traditional teaching group(LBL). Among these abilities, there were statistically significant differences in learning interest improvement, knowledge expansion ability, problem-solving ability and doctor-patient communication ability(P<0.05). The PBL group was higher than LBL group in terms of case analysis and skill operation in clinical assessment, and the difference was statistically significant(P<0.05).

CONCLUSION: PBL teaching method is more effective in clinical practice teaching of ophthalmology, which is beneficial to train clinical thinking and improve teaching quality.