目的：应用临床操作技能直接观察评估(DOPS)探索翻转课堂结合小组合作学习(TBL)在眼科实习教学中的效果。

方法：自2021-06-15/11-14在眼科实习的临床医学“5+3”一体化和临床医学五年制学生54人，分为传统教学组(A组)和翻转课堂结合TBL组(B组)，通过DOPS评分比较A组、B组裂隙灯显微镜和直接眼底镜的教学效果，采用Mann-Whitney U检验进行统计分析。

结果：A组学生裂隙灯显微镜DOPS总评分为59(58.00，60.00)分，B组学生总评分为63(61.00，65.00)分，A组评分显著低于B组(P<0.001)。A组学生直接眼底镜DOPS评分为63(61.00，63.75)分，B组评分为66(63.75，66.25)分，A组评分显著低于B组(P<0.001)。在“适应证、相关解剖结构的了解及操作步骤的熟练程度”“执行操作前的准备工作”“操作的技术能力”等方面，两项操作B组学生单项评分均显著高于A组(P<0.05)。

结论：在眼科实习教学中采用翻转课堂结合TBL，较传统教学可以显著提升眼科实习生的临床操作技能水平。

METHODS: A total of 54 students of clinical medicine “5+3” integration and clinical medicine for five years, interned at the department of ophthalmology from June 15th to November 14th, 2021 were divided into traditional teaching group(group A)and flipped classroom combined with TBL group(group B). The teaching effects of slit lamp microscopy and direct ophthalmoscopy in group A and group B were compared by DOPS score, and Mann-Whitney U test was used for statistical analysis.

RESULTS: Total DOPS score for slit-lamp microscopy in group A was 59(58.00, 60.00)points,which was significantly lower than that of group B 63(61.00,65.00)points(P<0.001). The DOPS score for direct ophthalmoscopy in group A was 63(61.00, 63.75)points, which was significantly lower than that of group B, 66(63.75,66.25)points(P<0.001). In the two operations and especially in the aspects of “understanding of complications,relevant anatomical structure and proficiency in operation”“preparatory work” and “technical ability of operation”, the scores of group B was significantly higher than those of group A(P<0.05).

CONCLUSION: Flipped classroom combined with TBL has significant advantages in clinical practice teaching for interns in ophthalmology, which is worthy of promotion and application compared with traditional teaching.