探讨重症康复疑难病例讨论和基于问题的学习（PBL）法对于康复团队临床能力培养的效果评价。

选取2023—2024年在四川大学华西医院春季/秋季进修生共120名，随机分配到实验组和对照组，每组60人，其中进修医师和进修治疗师各30人。实验组实施重症康复疑难病例讨论+PBL法教学，对照组进修学员仅参与常规临床相关工作。2组学员在进修开始1周内和进修结束前1周进行理论考试。在培训结束后2组学员需要完成调查问卷，主要涉及教学内容、教学质量、教学新颖性、参与学习后对培养临床能力的效果和教学效果评价，该调查问卷采用Likert5级评分法评估。2组康复医师和治疗师在教学内容、教学质量、教学新颖性、参与学习后对培养临床能力的效果和教学效果5个方面进行亚组分析。

实验组学员在进修结束前1周的理论考核评分高于进修前，且实验组高于对照组，差异均有统计学意义（P<0.05）。2组学员完成的调查问卷在教学内容、教学质量、教学新颖性、参与学习后对培养临床能力的效果和教学效果等方面比较，差异均有统计学意义（P<0.05）。在亚组分析中，2组康复医师和治疗师分别在教学内容、教学质量、教学新颖性、参与学习后对培养临床能力的效果和教学效果等方面比较，差异均有统计学意义（P<0.05）。

重症康复疑难病例讨论+PBL法可增强康复团队临床技能，有效调动进修学员主观能动性，提高教学效果，加强团队间的合作。

To explore the effectiveness of severe case-based discussions and problem-based learning (PBL) methods in cultivating clinical abilities of medical treatment teams.

A total of 120 visiting trainees (including both physicians and therapists) from the spring and autumn intakes of 2023-2024 at West China Hospital of Sichuan University were enrolled and randomly assigned to either an experimental group or a control group, with 60 participants in each group. Each group consisted of 30 visiting physicians and 30 visiting therapists. The experimental group received a teaching intervention combining complex case discussions in critical care rehabilitation with PBL, while the control group participated only in routine clinical activities. Both groups underwent theoretical examinations before and after the training period. Following the training, all participants completed a survey questionnaire covering five domains: teaching content, teaching quality, instructional innovativeness, perceived effectiveness in developing clinical competencies, and overall teaching effectiveness. Responses were collected using a 5-point Likert scale. Subgroup analyses were performed separately for visiting physicians and therapists across these five dimensions.

The theoretical assessment scores of the trainees in the experimental group were higher one week before the end of the refresher course compared to before the course, and those in the experimental group were also higher than those in the control group, with statistically significant differences (P<0.05). There were statistically significant differences between the two groups in the survey evaluations across all measured domains: teaching content, teaching quality, instructional innovativeness, perceived enhancement of clinical competencies, and overall teaching effectiveness (P<0.05). In the subgroup analysis, there were statistically significant differences between the two groups of rehabilitation physicians and therapists in terms of teaching content, teaching quality, teaching novelty, and the effect on clinical ability development and teaching effectiveness after participation in the learning (P<0.05).

The integration of complex case discussions with PBL in critical care rehabilitation training enhances the clinical competencies of the rehabilitation team, effectively motivates the active engagement of trainees, improves instructional outcomes, and strengthens interprofessional collaboration.