Effect observation of problem-based learning in obstetric and gynecological clinical nursing teaching

Effect observation of problem-based learning in obstetric and gynecological clinical nursing teaching | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect observation of problem-based learning in obstetric and gynecological clinical nursing teaching Yanyan Li, Ruixue Zhu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3736601/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Problem-based learning (PBL) is a "problem" centered teaching method, and it is also a critical new way needed in the nursing teaching of obstetrics and gynecology. Therefore, it is necessary to explore the effect of problem-based learning (PBL) in clinical nursing teaching of obstetrics and gynecology. Methods : 90 trainee nursing students of obstetrics and gynecology were randomly divided into control group (n=45, using traditional teaching mode) and PBL group (n=45, using PBL), and the teaching quality and other indicators were compared. Results : The teaching quality, assessment scores, graduation scores and satisfaction of nursing interns in the PBL group were all higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion : The application of PBL in obstetrics and gynecology nursing teaching is of great significance. PBL obstetric and gynecological satisfaction Introduction Obstetrics and Gynecology is a clinical science that requires high practical skills[ 1 ]. It requires nurses in the department to have abundant theoretical knowledge and proficient operational skills. Therefore, in the clinical nursing supervision of Obstetrics and Gynecology, higher requirements are proposed for clinical supervisors and nursing interns[ 2 ]. The aim is to consolidate the theoretical knowledge of nursing students and improve their practical operational abilities[ 3 ]. However, currently, the main body of Obstetrics and Gynecology clinical nursing education still follows the traditional lecture-based learning (LBL) [ 4 ], which emphasizes teaching as the foundation. In other words, clinical supervisors teach professional knowledge and nursing interns only need to listen, watch, and imitate. Clinical supervisors are active while nursing interns are passive, lacking the capability to stimulate clinical thinking and cultivate their ability to ask questions [ 5 ]. The development of nursing students' inherent potential is not given enough attention, which is not conducive to cultivating their comprehensive abilities [ 6 ]. Problem-based learning (PBL) is a teaching method that revolves around 'problems' and aims to stimulate students' enthusiasm and motivation for learning[ 7 ]. It deepens students' understanding and mastery of theoretical knowledge and practical skills, while cultivating their clinical thinking to better adapt to clinical demands[ 8 ]. This innovative teaching method differs fundamentally from the traditional teaching model, known as 'lecture-based teaching,' in terms of design concept, implementation approach, evaluation system, and actual outcomes[ 9 ]. PBL has demonstrated outstanding performance in improving students' learning interest and overall nursing competence, as well as nurturing their abilities to identify, analyze, and solve clinical problems[ 10 ]. Since its implementation, PBL has been increasingly accepted by various disciplines and fields, and has gained recognition from numerous educators [ 11 ]. Currently, it has become a popular teaching method internationally [ 12 ]. During the nursing teaching of obstetrics and gynecology, PBL teaching is mainly carried out to stimulate the learning interest of nursing interns, develop self-learning ability, cultivate the ability to discover clinical problems, analyze and solve clinical problems, and improve the overall nursing comprehensive ability of interns. Based on this, this study aims to explore the application effect of PBL teaching model in clinical nursing teaching practice of obstetrics and gynecology. Materials and Methods General information A total of 90 nursing interns who will undergo obstetric and gynecological internships in our hospital from January 2023 to August 2023 were selected and divided into control group and observation group, with 45 cases in each group, using random number table method. The clinical nursing teaching in the control group was conducted according to conventional teaching methods, while the clinical nursing teaching in the observation group was conducted using PBL teaching model. The baseline data of the two groups are shown in Table 1 . Inclusion Criteria Inclusion criteria: (1) Strictly adhering to internship requirements in the hospital; (2) Able to complete teaching hours on time; (3) Being informed and voluntarily participating in this study. Exclusion criteria: (1) Engaging in major disciplinary misconduct during the internship; (2) Withdrawing from the internship midway. Ethics approval and consent to participate This study was approved by the Research Ethics Committee, all patients are informed and voluntarily participating in this study. Methods The control group of clinical nursing teaching methods adopts traditional teaching methods, with the following specific content: according to the teaching outline and theoretical learning requirements, the preceptor teacher gives detailed explanations to the nursing students and answers the questions raised by the students seriously. Then, they guide the students to practice operations and finally summarize and analyze to understand the problems encountered in the students' work and provide corresponding explanations, allowing the students to take good notes. The PBL group adopts PBL teaching method, with the following specific content: (1) presenting problems: based on routine nursing operations, common difficult and complicated diseases, teaching plans, etc., clarify relevant knowledge points, such as methods for handling ectopic pregnancy, hormonal regulation methods, key points for eclampsia care, clinical nursing key points, and other problems. At the same time, the preceptor teacher can provide some typical cases for the students to propose nursing key points and develop nursing plans based on their own knowledge[13]. (2) Analyzing and discussing: In the teaching process, the preceptor teacher first explains the predetermined problems to the students and provides them with ways to collect information, allowing the students to search for relevant materials on their own after the teaching session. Group cooperation is used in the process of collecting information, and analysis and discussion are carried out. This not only enriches the students' theoretical knowledge but also mobilizes their practical abilities and cultivates their comprehensive abilities. (3) Summarizing and concluding: After completing the information collection task, the preceptor teacher lets the students explain the relevant information, present their own viewpoints, draw conclusions, and then summarize and conclude[14]. The correctness of the viewpoints is evaluated and appropriate guidance and timely corrections are provided. Finally, the preceptor teacher gives detailed comments on the students' information collection, corrects any incorrect viewpoints, clarifies the difficulties and key points of knowledge mastery, thereby promoting the students' subsequent learning and cultivating their comprehensive abilities. Observation indicators (1) Evaluate the assessment results from theoretical knowledge, case analysis, practical operation, and achieved results, with a score of 100 for each item. The closer the score is to 100, the better the assessment result. (2) Refer to the 'Teaching Quality Survey Form' to evaluate the teaching effectiveness in terms of teaching ability, nursing ability, coordination ability, cooperation ability, learning enthusiasm, work responsibility, analytical ability, and thinking ability, with a score of 10 for each item. The closer the score is to 10, the higher the effectiveness of teaching. (3) Evaluate comprehensive abilities in terms of self-learning ability, teamwork ability, expression and communication ability, problem analysis and clinical reasoning ability, knowledge acquisition and utilization ability, with a score of 20 for each item. The closer the score is to 20, the stronger the comprehensive ability. (4) Satisfaction with teaching: Assess the satisfaction of nursing students with teaching through a questionnaire survey. The maximum score is 100. The score range for very satisfied is 90-100, the score range for generally satisfied is 60-89, and the score range for dissatisfied is 0-59. Satisfaction rate = (number of very satisfied + number of generally satisfied) / total number of people × 100%. Statistical Methods The data obtained in this study were entered into the statistical software SPSS 24.0 for testing and comparison. Count data were represented by n (%), and the chi-square test was used. Measurement data were represented by (x̅±s), and the t-test was used. If P < 0.05, the difference was considered statistically significant. Results Comparison of general data between the two groups In the PBL group of 45 patients, there were 8 males and 37 females, with an average age of 22.8±3.5 years, BMI of 23.50±3.12, and graduation score of 89.31±5.62. In the control group of 45 patients, there were 6 males and 39 females, with an average age of 22.5±3.8 years, BMI of 24.01±2.85, and graduation score of 88.92±5.58. There was no statistically significant difference in general data such as gender, age, BMI, and graduation score between the two groups (P>0.05), indicating comparability, as shown in Table 1 . Comparison of teaching quality between two groups The PBL group showed significant improvement in teaching quality compared to the control group in terms of teaching ability, nursing ability, coordination ability, cooperation ability, learning enthusiasm, work responsibility, analytical ability, thinking ability, etc. The differences were statistically significant (P < 0.05), as shown in Table 2 . Comparison of assessment scores between two groups The PBL group had significantly higher scores in theoretical knowledge, case analysis, practical operations, and final exam results compared to the control group. The differences were statistically significant (P 0.05) in teamwork ability, self-learning ability, expression and communication ability, knowledge information acquisition and utilization ability, problem analysis and clinical reasoning ability between the two groups. However, after the teaching, the observation group had higher scores in teamwork ability, self-learning ability, expression and communication ability, knowledge information acquisition and utilization ability, and problem analysis and clinical reasoning ability compared to the control group. The differences were statistically significant (P < 0.05). Specific data can be found in Table 4 . Comparison of satisfaction between two groups The difference was statistically significant (P < 0.05), as shown in Table 5 . Discussion For nursing students, internships are the first step in completing their role transformation[13]. At this stage, students need to combine the theoretical knowledge they have learned with practical operations to form a deeper and more systematic understanding [14]. At the same time, they also need to develop various abilities such as communication, problem-solving, and clinical thinking in order to smoothly enter challenging obstetrics and gynecology work in the future[15,16]. Therefore, they have high expectations for clinical teaching. In recent years, PBL teaching has become a popular teaching method [17]. This teaching model emphasizes the teaching approach of asking questions, searching for information, and solving problems[18]. It encourages students to solve theoretical problems by consulting information and conducting group analysis and discussion, while also better understanding and solving problems in practice [19]. This teaching method shifts the teaching pivot from "teaching" to "learning", allowing students to develop various abilities in the problem-solving process, while also promoting the combination of theoretical knowledge and specialized skills, thus achieving better teaching results [20,21]. Compared with traditional teaching methods, PBL teaching method places more emphasis on students' subjectivity. Guided by the questions raised by the teacher, students will be more actively involved in the teaching process [22]. In order to better solve problems, students also actively think and communicate, which allows them to break away from their dependence on teachers' thinking and achieve the development of clinical thinking, thus obtaining preliminary job adaptability. The results of this study show that the PBL group using the PBL teaching method had higher scores in theoretical knowledge, case analysis, practical operations, and clerkship results compared to the control group using traditional teaching methods, with statistically significant differences (P < 0.05). The PBL group had a higher level of satisfaction from the intern nurses towards the teaching mentors (97.78%) compared to the control group (77.78%), with statistically significant differences (P < 0.05)，this is basically consistent with the findings of Amir LR et al[23-26]. The results indicate that the PBL group had higher scores in practical skill assessment and theoretical knowledge evaluation compared to the control group, with statistically significant differences (P < 0.05), previous studies have shown similar results [27]. It can be seen that the application of the PBL teaching mode has better effects than the traditional teaching mode, with the following reasons: the PBL teaching mode compensates for the shortcomings of traditional teaching, changes the teaching mode centered around the teacher to focus more on the intern nurses, and positions the teacher as a guide and error corrector. Under this mode, the intern nurses can independently access information, think, and discuss relevant issues, thereby mastering and learning new knowledge, and improving their ability for independent learning and critical thinking [28]. At the same time, it helps to enhance the enthusiasm for learning in the internship nursing classroom, which can prepare for the learning of theoretical knowledge. By combining the application of case analysis, the internship nursing is divided into several groups to discuss relevant issues together and clarify the focus of the course, which has significant teaching effects. PBL teaching method focuses on problem-based learning, and internship nursing needs further exploration and problem-solving[29]. During this period, internship nursing students can fully experience their self-worth and are more willing to actively participate in teaching, while improving their logical thinking abilities and enthusiasm. Compared to conventional teaching methods, PBL teaching method has more obvious effects. During the implementation of nursing intern teaching activities, teachers should reasonably apply PBL teaching method to mobilize nursing interns 'learning initiative and enthusiasm, and give full play to their subjective initiative. For example, nursing interns can transition to independent learning after basic knowledge learning, and with the assistance of teachers, conduct unified discussion and track the whole process of patient disease development, so as to exercise their teamwork ability in all aspects and promote their problem-solving ability and comprehensive literacy improvement. Conclusion In summary, the application of PBL teaching method in nursing teaching of obstetrics and gynecology is effective, which can not only enrich the theoretical knowledge of nursing students, improve their practical operation ability, but also improve the relationship between nursing students and teachers, and improve the satisfaction of nursing students with teachers, which is worthy of further clinical research. Declarations Ethics approval This study was approved by the Research Ethics Committee, all patients are informed and voluntarily participating in this study. Consent to participate Written informed consent obtained from all the participants in the manuscript. Consent for publication The authors agree to publish the manuscript. Availability of Data and Materials All data included in this study are available upon request by contact with the corresponding author. Competing Interests The authors declare that there is no competing interest associated with the manuscript. Funding This work was supported by Zhejiang Province Association for Higher Education, Research and Practice of Ideological and Political Construction of Higher Vocational Nursing Professional Courses Based on the Knowledge, Belief and Action Model: Taking 《Basic Nursing》 as an Example [grant numbers KT2022047]; Zhejiang Province Education Science Planning Project, Exploration of Project-based Instructional Design under the Guidance of Cognitive Load Theory: A Case Study of《Comprehensive Nursing Skills》[grant numbers 2023SCG186]; Zhejiang Province Ideological and Political Demonstration Course, Basic Nursing [grant numbers SF202210]. Authors' contributions Yanyan Li and Ruixue Zhu designed and performed the experiments. Yanyan Li provided support for data analysis and writing the manuscript and Ruixue Zhu provided the supervision, resourses, discussion, design and review process. Both the authors have seen and approved the manuscript. Acknowledgment The authors declare that there is no competing interest associated with the manuscript. Authors' information Yanyan Li 1# , MM, Lecturer, Taizhou Vocational & Technical college, Taizhou, 318000, [email protected] Ruixue Zhu 2* , MM, Chief Nurse, Nursing Department, Shandong First Medical University Third Affiliated Hospital, 250031, [email protected] References Zia T, Sabeghi H, Mahmoudirad G. Problem-based learning versus reflective practice on nursing students' moral sensitivity. BMC Nurs. 2023;22(1):215. Published 2023 Jun 20. Bi S, Liu R, Li J, Gu J. The effectiveness of problem-based learning in gynecology and obstetrics education in China: A meta-analysis of randomized controlled trials. Med (Baltim). 2021;100(9):e24660. Winzer A, Jansky M. Digital lesson to convey the CanMEDS roles in general medicine using problem-based learning (PBL) and peer teaching. GMS J Med Educ. 2020;37(7):Doc64. Published 2020 Dec 3. Garcia I, James RW, Bischof P, Baroffio A. Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation. Teach Learn Med. 2017;29(3):313–25. Andreae C, Tingström P, Nilsson S, Jaarsma T, Karlsson N, Kärner Köhler A. Does problem-based learning improve patient empowerment and cardiac risk factors in patients with coronary heart disease in a Swedish primary care setting? A long-term prospective, randomised, parallel single randomised trial (COR-PRIM). BMJ Open. 2023;13(2):e065230. Published 2023 Feb 24. Vu C, Farez R, Simpson P, Kaljo K. Gendered Differences in Teaching Performance Evaluations of Obstetrics and Gynecology Residents. J Surg Educ. 2021;78(6):2038–45. Garcia I, James RW, Bischof P, Baroffio A. Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation. Teach Learn Med. 2017;29(3):313–25. Servos U, Reiß B, Stosch C, Karay Y, Matthes J. 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Tables Table 1 Comparison of clinical data of the two groups of patients Index PBL group (n = 45) Control group (n = 45) χ2/t P Age (year) 22.8 ± 3.5 22.5 ± 3.8 0.390 0.698 Gender (n) 0.044 0.832 Male 8 6 0.338 0.561 Female 37 39 BMI (kg/m2) 23.50 ± 3.12 24.01 ± 2.85 0.796 0.427 Completion grades 89.31 ± 5.62 88.92 ± 5.58 0.330 0.742 Table 2 Comparison of teaching quality scores between the two groups (points, x̅± s) Group PBL group (n = 45) Control group (n = 45) t P Teaching level 97.36 ± 3.68 89.89 ± 3.59 9.747 <0.001 Teaching methods 91.52 ± 3.72 82.78 ± 3.17 11.996 <0.001 Theoretical knowledge 96.36 ± 5.23 87.89 ± 5.15 7.741 <0.001 Operational capability 93.62 ± 4.19 81.78 ± 4.21 13.372 <0.001 Responsibility 95.63 ± 3.04 83.91 ± 3.85 16.027 <0.001 Table 3 Comparison of assessment results of the two groups (points, x ± s) Group PBL group (n = 45) Control group (n = 45) t P Theoretical knowledge 90.31 ± 2.23 82.35 ± 3.45 12.999 <0.001 Case analysis 91.15 ± 2.36 84.36 ± 3.36 11.093 <0.001 Hands-on operation 93.36 ± 2.45 85.35 ± 3.15 13.465 <0.001 Academic results 94.52 ± 2.52 86.41 ± 3.58 12.427 <0.001 P:compared with control group, P < 0.05. Table 4 Comparison of comprehensive quality of patients in the two groups (points, x ± s) Group PBL group (n = 45) Control group (n = 45) t P Self-directed learning Before teaching 11.35 ± 2.16 11.41 ± 2.03 0.136 0.892 After teaching 17.23 ± 2.06 14.04 ± 2.31 6.914 <0.001 Teamwork Before teaching 12.35 ± 2.45 12.63 ± 2.52 0.534 0.594 After teaching 16.16 ± 3.36 14.31 ± 3.08 2.723 0.008 Expression and communication Before teaching 12.31 ± 2.23 12.15 ± 2.06 0.354 0.725 After teaching 17.35 ± 3.45 14.36 ± 3.37 4.159 <0.001 Problem analysis and clinical reasoning Before teaching 11.36 ± 2.36 11.52 ± 2.57 0.308 0.759 After teaching 16.35 ± 3.15 14.41 ± 3.08 2.954 0.004 P:compared with control group, P < 0.05. Table 5 Comparison of satisfaction of nursing instructors in the two groups Group Satisfied Basically satisfied Not satisfied Satisfaction PBL group (n = 45) 21 (46.67) 23(51.11) 1 (2.22) 44(97.78) Control group (n = 45) 18 (40.00) 17(37.78) 10(22.22) 35 (77.78) χ2 8.389 P <0.05 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3736601","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":269662099,"identity":"8484c41c-10ef-4abe-8289-448ee8243843","order_by":0,"name":"Yanyan Li","email":"","orcid":"","institution":"Taizhou Vocational and Technical College","correspondingAuthor":false,"prefix":"","firstName":"Yanyan","middleName":"","lastName":"Li","suffix":""},{"id":269662100,"identity":"7320c8cd-45cd-4fbb-8aa1-98559558ead2","order_by":1,"name":"Ruixue Zhu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYDACCRBhAMTMzAcffKiQkJMnXgt7W7LhjDMWxoYNRGkBAZ4zZtK8bRWJDAcI6JCf3WP2mafgcGK/RFqC5Mx5EgmMDcwPH93Ao4Vxzhnj2TwGaYkzZyQfMPi4TSKPnYHN2DgHjxZmiRxjZh4Dm8QNN9ISEmdukyhmbOBhk8anhQ2iRSJx/40cg8O8cyQSGw4Q0MIDt4XnjGEzbwMRWiQk0ooZ5xikGc843pbMOOOYhLFhMwG/yM9I3szw5s9h2f5m5uM/PtTUycmzNz98jE8LFsBMmvJRMApGwSgYBVgAAKgOR8N+uzu0AAAAAElFTkSuQmCC","orcid":"","institution":"Shandong First Medical University Third Affiliated Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ruixue","middleName":"","lastName":"Zhu","suffix":""}],"badges":[],"createdAt":"2023-12-11 03:14:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3736601/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3736601/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":77847151,"identity":"cabf5e5b-1d68-4a85-9997-471f5923c708","added_by":"auto","created_at":"2025-03-06 06:03:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":769809,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3736601/v1/daea522a-6e9d-4733-a880-2545dc9b152a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect observation of problem-based learning in obstetric and gynecological clinical nursing teaching","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObstetrics and Gynecology is a clinical science that requires high practical skills[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It requires nurses in the department to have abundant theoretical knowledge and proficient operational skills. Therefore, in the clinical nursing supervision of Obstetrics and Gynecology, higher requirements are proposed for clinical supervisors and nursing interns[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The aim is to consolidate the theoretical knowledge of nursing students and improve their practical operational abilities[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, currently, the main body of Obstetrics and Gynecology clinical nursing education still follows the traditional lecture-based learning (LBL) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], which emphasizes teaching as the foundation. In other words, clinical supervisors teach professional knowledge and nursing interns only need to listen, watch, and imitate. Clinical supervisors are active while nursing interns are passive, lacking the capability to stimulate clinical thinking and cultivate their ability to ask questions [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The development of nursing students' inherent potential is not given enough attention, which is not conducive to cultivating their comprehensive abilities [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eProblem-based learning (PBL) is a teaching method that revolves around 'problems' and aims to stimulate students' enthusiasm and motivation for learning[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. It deepens students' understanding and mastery of theoretical knowledge and practical skills, while cultivating their clinical thinking to better adapt to clinical demands[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This innovative teaching method differs fundamentally from the traditional teaching model, known as 'lecture-based teaching,' in terms of design concept, implementation approach, evaluation system, and actual outcomes[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. PBL has demonstrated outstanding performance in improving students' learning interest and overall nursing competence, as well as nurturing their abilities to identify, analyze, and solve clinical problems[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Since its implementation, PBL has been increasingly accepted by various disciplines and fields, and has gained recognition from numerous educators [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Currently, it has become a popular teaching method internationally [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuring the nursing teaching of obstetrics and gynecology, PBL teaching is mainly carried out to stimulate the learning interest of nursing interns, develop self-learning ability, cultivate the ability to discover clinical problems, analyze and solve clinical problems, and improve the overall nursing comprehensive ability of interns. Based on this, this study aims to explore the application effect of PBL teaching model in clinical nursing teaching practice of obstetrics and gynecology.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003eA total of 90 nursing interns who will undergo obstetric and gynecological internships in our hospital from January 2023 to August 2023 were selected and divided into control group and observation group, with 45 cases in each group, using random number table method. The clinical nursing teaching in the control group was conducted according to conventional teaching methods, while the clinical nursing teaching in the observation group was conducted using PBL teaching model. The baseline data of the two groups are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInclusion Criteria\u003c/h2\u003e \u003cp\u003eInclusion criteria:\u003c/p\u003e \u003cp\u003e(1) Strictly adhering to internship requirements in the hospital;\u003c/p\u003e \u003cp\u003e(2) Able to complete teaching hours on time;\u003c/p\u003e \u003cp\u003e(3) Being informed and voluntarily participating in this study.\u003c/p\u003e \u003cp\u003eExclusion criteria:\u003c/p\u003e \u003cp\u003e(1) Engaging in major disciplinary misconduct during the internship;\u003c/p\u003e \u003cp\u003e(2) Withdrawing from the internship midway.\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Research Ethics Committee, all patients are informed and voluntarily participating in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe control group of clinical nursing teaching methods adopts traditional teaching methods, with the following specific content: according to the teaching outline and theoretical learning requirements, the preceptor teacher gives detailed explanations to the nursing students and answers the questions raised by the students seriously. Then, they guide the students to practice operations and finally summarize and analyze to understand the problems encountered in the students' work and provide corresponding explanations, allowing the students to take good notes.\u003c/p\u003e\n\u003cp\u003eThe PBL group adopts PBL teaching method, with the following specific content: (1) presenting problems: based on routine nursing operations, common difficult and complicated diseases, teaching plans, etc., clarify relevant knowledge points, such as methods for handling ectopic pregnancy, hormonal regulation methods, key points for eclampsia care, clinical nursing key points, and other problems. At the same time, the preceptor teacher can provide some typical cases for the students to propose nursing key points and develop nursing plans based on their own knowledge[13]. (2) Analyzing and discussing: In the teaching process, the preceptor teacher first explains the predetermined problems to the students and provides them with ways to collect information, allowing the students to search for relevant materials on their own after the teaching session. Group cooperation is used in the process of collecting information, and analysis and discussion are carried out. This not only enriches the students' theoretical knowledge but also mobilizes their practical abilities and cultivates their comprehensive abilities. (3) Summarizing and concluding: After completing the information collection task, the preceptor teacher lets the students explain the relevant information, present their own viewpoints, draw conclusions, and then summarize and conclude[14]. The correctness of the viewpoints is evaluated and appropriate guidance and timely corrections are provided. Finally, the preceptor teacher gives detailed comments on the students' information collection, corrects any incorrect viewpoints, clarifies the difficulties and key points of knowledge mastery, thereby promoting the students' subsequent learning and cultivating their comprehensive abilities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObservation indicators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e(1) Evaluate the assessment results from theoretical knowledge, case analysis, practical operation, and achieved results, with a score of 100 for each item. The closer the score is to 100, the better the assessment result.\u003c/p\u003e\n\u003cp\u003e(2) Refer to the 'Teaching Quality Survey Form' to evaluate the teaching effectiveness in terms of teaching ability, nursing ability, coordination ability, cooperation ability, learning enthusiasm, work responsibility, analytical ability, and thinking ability, with a score of 10 for each item. The closer the score is to 10, the higher the effectiveness of teaching.\u003c/p\u003e\n\u003cp\u003e(3) Evaluate comprehensive abilities in terms of self-learning ability, teamwork ability, expression and communication ability, problem analysis and clinical reasoning ability, knowledge acquisition and utilization ability, with a score of 20 for each item. The closer the score is to 20, the stronger the comprehensive ability.\u003c/p\u003e\n\u003cp\u003e(4) Satisfaction with teaching: Assess the satisfaction of nursing students with teaching through a questionnaire survey. The maximum score is 100. The score range for very satisfied is 90-100, the score range for generally satisfied is 60-89, and the score range for dissatisfied is 0-59. Satisfaction rate = (number of very satisfied + number of generally satisfied) / total number of people × 100%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data obtained in this study were entered into the statistical software SPSS 24.0 for testing and comparison. Count data were represented by n (%), and the chi-square test was used. Measurement data were represented by (x̅±s), and the t-test was used. If P \u0026lt; 0.05, the difference was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eComparison of general data between the two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the PBL group of 45 patients, there were 8 males and 37 females, with an average age of 22.8±3.5 years, BMI of 23.50±3.12, and graduation score of 89.31±5.62. In the control group of 45 patients, there were 6 males and 39 females, with an average age of 22.5±3.8 years, BMI of 24.01±2.85, and graduation score of 88.92±5.58. There was no statistically significant difference in general data such as gender, age, BMI, and graduation score between the two groups (P\u0026gt;0.05), indicating comparability, as shown in \u003cstrong\u003eTable 1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of teaching quality between two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PBL group showed significant improvement in teaching quality compared to the control group in terms of teaching ability, nursing ability, coordination ability, cooperation ability, learning enthusiasm, work responsibility, analytical ability, thinking ability, etc. The differences were statistically significant (P \u0026lt; 0.05), as shown in \u003cstrong\u003eTable 2\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of assessment scores between two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PBL group had significantly higher scores in theoretical knowledge, case analysis, practical operations, and final exam results compared to the control group. The differences were statistically significant (P \u0026lt; 0.05), as shown in \u003cstrong\u003eTable 3\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of comprehensive qualities between two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore the teaching, there was no statistically significant difference (P \u0026gt; 0.05) in teamwork ability, self-learning ability, expression and communication ability, knowledge information acquisition and utilization ability, problem analysis and clinical reasoning ability between the two groups. However, after the teaching, the observation group had higher scores in teamwork ability, self-learning ability, expression and communication ability, knowledge information acquisition and utilization ability, and problem analysis and clinical reasoning ability compared to the control group. The differences were statistically significant (P \u0026lt; 0.05). Specific data can be found in\u003cstrong\u003e\u0026nbsp;Table 4\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of satisfaction between two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe difference was statistically significant (P \u0026lt; 0.05), as shown in \u003cstrong\u003eTable 5\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eFor nursing students, internships are the first step in completing their role transformation[13]. At this stage, students need to combine the theoretical knowledge they have learned with practical operations to form a deeper and more systematic understanding [14]. At the same time, they also need to develop various abilities such as communication, problem-solving, and clinical thinking in order to smoothly enter challenging obstetrics and gynecology work in the future[15,16]. Therefore, they have high expectations for clinical teaching. In recent years, PBL teaching has become a popular teaching method [17]. This teaching model emphasizes the teaching approach of asking questions, searching for information, and solving problems[18]. It encourages students to solve theoretical problems by consulting information and conducting group analysis and discussion, while also better understanding and solving problems in practice [19]. This teaching method shifts the teaching pivot from \"teaching\" to \"learning\", allowing students to develop various abilities in the problem-solving process, while also promoting the combination of theoretical knowledge and specialized skills, thus achieving better teaching results [20,21]. Compared with traditional teaching methods, PBL teaching method places more emphasis on students' subjectivity. Guided by the questions raised by the teacher, students will be more actively involved in the teaching process [22]. In order to better solve problems, students also actively think and communicate, which allows them to break away from their dependence on teachers' thinking and achieve the development of clinical thinking, thus obtaining preliminary job adaptability.\u003c/p\u003e\n\u003cp\u003eThe results of this study show that the PBL group using the PBL teaching method had higher scores in theoretical knowledge, case analysis, practical operations, and clerkship results compared to the control group using traditional teaching methods, with statistically significant differences (P \u0026lt; 0.05). The PBL group had a higher level of satisfaction from the intern nurses towards the teaching mentors (97.78%) compared to the control group (77.78%), with statistically significant differences (P \u0026lt; 0.05)，this is basically consistent with the findings of\u0026nbsp;Amir LR\u0026nbsp;et al[23-26]. The results indicate that the PBL group had higher scores in practical skill assessment and theoretical knowledge evaluation compared to the control group, with statistically significant differences (P \u0026lt; 0.05),\u0026nbsp;previous studies have shown similar results [27]. It can be seen that the application of the PBL teaching mode has better effects than the traditional teaching mode, with the following reasons: the PBL teaching mode compensates for the shortcomings of traditional teaching, changes the teaching mode centered around the teacher to focus more on the intern nurses, and positions the teacher as a guide and error corrector. Under this mode, the intern nurses can independently access information, think, and discuss relevant issues, thereby mastering and learning new knowledge, and improving their ability for independent learning and critical thinking [28]. At the same time, it helps to enhance the enthusiasm for learning in the internship nursing classroom, which can prepare for the learning of theoretical knowledge. By combining the application of case analysis, the internship nursing is divided into several groups to discuss relevant issues together and clarify the focus of the course, which has significant teaching effects. PBL teaching method focuses on problem-based learning, and internship nursing needs further exploration and problem-solving[29]. During this period, internship nursing students can fully experience their self-worth and are more willing to actively participate in teaching, while improving their logical thinking abilities and enthusiasm. Compared to conventional teaching methods, PBL teaching method has more obvious effects.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDuring the implementation of nursing intern teaching activities, teachers should reasonably apply PBL teaching method to mobilize nursing interns 'learning initiative and enthusiasm, and give full play to their subjective initiative. For example, nursing interns can transition to independent learning after basic knowledge learning, and with the assistance of teachers, conduct unified discussion and track the whole process of patient disease development, so as to exercise their teamwork ability in all aspects and promote their problem-solving ability and comprehensive literacy improvement.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, the application of PBL teaching method in nursing teaching of obstetrics and gynecology is effective, which can not only enrich the theoretical knowledge of nursing students, improve their practical operation ability, but also improve the relationship between nursing students and teachers, and improve the satisfaction of nursing students with teachers, which is worthy of further clinical research.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Research Ethics Committee, all patients are informed and voluntarily participating in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent obtained from all the participants in the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors agree to publish the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data included in this study are available upon request by contact with the corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no competing interest associated with the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by\u0026nbsp;Zhejiang Province Association for Higher Education, Research and Practice of Ideological and Political Construction of Higher Vocational Nursing Professional Courses Based on the Knowledge, Belief and Action Model: Taking\u0026nbsp;《Basic Nursing》\u0026nbsp;as an Example [grant numbers KT2022047]; Zhejiang Province Education Science Planning Project, Exploration of Project-based Instructional Design under the Guidance of Cognitive Load Theory: A Case Study of《Comprehensive Nursing Skills》[grant numbers 2023SCG186]; Zhejiang Province Ideological and Political Demonstration Course, Basic Nursing [grant numbers SF202210].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYanyan Li\u0026nbsp;and Ruixue Zhu\u0026nbsp;designed and performed the experiments.\u0026nbsp;Yanyan Li\u0026nbsp;provided support for data analysis and writing the manuscript and\u0026nbsp;Ruixue Zhu\u0026nbsp;provided the supervision, resourses, discussion, design and review process. Both the authors have seen and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no competing interest associated with the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYanyan Li \u003csup\u003e1#\u003c/sup\u003e, MM, Lecturer, Taizhou Vocational \u0026amp; Technical college, Taizhou, 318000, [email protected]\u003c/p\u003e\n\u003cp\u003eRuixue Zhu \u003csup\u003e2*\u003c/sup\u003e, MM, Chief Nurse, Nursing Department, Shandong First Medical University Third Affiliated Hospital, 250031, [email protected]\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eZia T, Sabeghi H, Mahmoudirad G. Problem-based learning versus reflective practice on nursing students' moral sensitivity. BMC Nurs. 2023;22(1):215. 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Nurse Educ Today. 2018;60:67\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFaisal R, Khalil-ur-Rehman, Bahadur S, Shinwari L. Problem-based learning in comparison with lecture-based learning among medical students. J Pak Med Assoc. 2016;66(6):650\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDong H, Guo C, Zhou L, et al. Effectiveness of case-based learning in Chinese dental education: a systematic review and meta-analysis. BMJ Open. 2022;12(2):e048497. Published 2022 Feb 21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim YJ. Observational Application Comparing Problem-Based Learning with the Conventional Teaching Method for Clinical Acupuncture Education. Evid Based Complement Alternat Med. 2019;2019:2102304. Published 2019 Mar 18.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of clinical data of the two groups of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePBL group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ2/t\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.698\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.832\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.01\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.796\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.427\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompletion grades\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.31\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.92\u0026thinsp;\u0026plusmn;\u0026thinsp;5.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.742\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of teaching quality scores between the two groups (points, x̅\u0026plusmn; s)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePBL group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeaching level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e97.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e89.89\u0026thinsp;\u0026plusmn;\u0026thinsp;3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeaching methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e91.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e82.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.996\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheoretical knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e96.36\u0026thinsp;\u0026plusmn;\u0026thinsp;5.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e87.89\u0026thinsp;\u0026plusmn;\u0026thinsp;5.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.741\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperational capability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e93.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e81.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResponsibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e95.63\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e83.91\u0026thinsp;\u0026plusmn;\u0026thinsp;3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of assessment results of the two groups (points, x\u0026thinsp;\u0026plusmn;\u0026thinsp;s)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePBL group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheoretical knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e90.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e82.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCase analysis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e91.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e84.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHands-on operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e93.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e85.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcademic results\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e94.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e86.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eP:compared with control group, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of comprehensive quality of patients in the two groups (points, x\u0026thinsp;\u0026plusmn;\u0026thinsp;s)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePBL group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSelf-directed learning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBefore teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e11.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.892\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfter teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e14.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.914\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTeamwork\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBefore teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e12.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e12.63\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.534\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfter teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e16.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e14.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.723\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eExpression and communication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBefore teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e12.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e12.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.725\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfter teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e14.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProblem analysis and clinical reasoning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBefore teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e11.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.759\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfter teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e16.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e14.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.954\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eP:compared with control group, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of satisfaction of nursing instructors in the two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBasically satisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot satisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePBL group (n\u0026thinsp;=\u0026thinsp;45)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (46.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23(51.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (2.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e44(97.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eControl group (n\u0026thinsp;=\u0026thinsp;45)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (40.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17(37.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10(22.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35 (77.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eχ2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.389\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"PBL, obstetric and gynecological, satisfaction","lastPublishedDoi":"10.21203/rs.3.rs-3736601/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3736601/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eProblem-based learning (PBL) is a \"problem\" centered teaching method, and it is also a critical new way needed in the nursing teaching of obstetrics and gynecology. Therefore, it is necessary to explore the effect of problem-based learning (PBL) in clinical nursing teaching of obstetrics and gynecology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: 90 trainee nursing students of obstetrics and gynecology were randomly divided into control group (n=45, using traditional teaching mode) and PBL group (n=45, using PBL), and the teaching quality and other indicators were compared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The teaching quality, assessment scores, graduation scores and satisfaction of nursing interns in the PBL group were all higher than those in the control group, and the differences were statistically significant (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The application of PBL in obstetrics and gynecology nursing teaching is of great significance.\u003c/p\u003e","manuscriptTitle":"Effect observation of problem-based learning in obstetric and gynecological clinical nursing teaching","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-29 12:38:48","doi":"10.21203/rs.3.rs-3736601/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e54ad226-0c4f-4841-9f46-ef465a3c78cf","owner":[],"postedDate":"January 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-06T05:39:05+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-29 12:38:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3736601","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3736601","identity":"rs-3736601","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}