切换至 "中华医学电子期刊资源库"
高级检索
中华肾病研究电子杂志

中华肾病研究电子杂志 ›› 2026, Vol. 15 ›› Issue (05) : 280 -285. doi: 10.3877/cma.j.issn.2095-3216.2026.05.006

教学园地

生成式人工智能支持的纠错式案例教学在肾内科实习中的应用
林静1, 侯世会1, 王佳丽1, 甘宏博1, 封蕾2, 李民2, 陈客宏1,†()   
  1. 1400042　重庆，陆军军医大学大坪医院肾内科
    2400042　重庆，陆军军医大学大坪医院教学办
  • 收稿日期:2026-01-16 出版日期:2026-10-28
  • 通信作者: 陈客宏
  • 基金资助:
    陆军军医大学教学项目(Y2024B14，ZXAIYB011)

Application of generative artificial intelligence-assisted error-correction case-based teaching in nephrology clerkship

Jing Lin1, Shihui Hou1, Jiali Wang1, Hongbo Gan1, Lei Feng2, Min Li2, Kehong Chen1,†()   

  1. 1Department of Nephrology; Daping Hospital, Army Medical University, Chongqing 400042, China
    2Teaching Office; Daping Hospital, Army Medical University, Chongqing 400042, China
  • Received:2026-01-16 Published:2026-10-28
  • Corresponding author: Kehong Chen
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

林静, 侯世会, 王佳丽, 甘宏博, 封蕾, 李民, 陈客宏. 生成式人工智能支持的纠错式案例教学在肾内科实习中的应用[J/OL]. 中华肾病研究电子杂志, 2026, 15(05): 280-285.

Jing Lin, Shihui Hou, Jiali Wang, Hongbo Gan, Lei Feng, Min Li, Kehong Chen. Application of generative artificial intelligence-assisted error-correction case-based teaching in nephrology clerkship[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2026, 15(05): 280-285.

目的

探讨生成式人工智能支持的纠错式案例教学在肾内科临床实习中的应用效果。

方法

选取2024年6月至2025年9月在陆军特色医学中心肾脏病科轮转实习的医学生，采用随机数字表法分为试验组和对照组。对照组采用传统案例教学，试验组在实施生成式人工智能支持的纠错式案例教学。均接受为期2周的教学训练，比较两组教学前后的考核成绩、学习投入及批判性思维水平，并于教学结束后评价两组的综合学习效果与教学满意度。

结果

共纳入医学生64例，试验组、对照组各32例。教学结束后考核结果显示，试验组案例分析成绩[(42.50±4.56)分比(38.47±4.75)分]及总分[(82.06±8.09)分比(75.97±7.37)分]均高于对照组(P均<0.05)；试验组在奉献维度[(30.34±5.95)分比(27.63±4.84)分]、专注维度[(34.53±7.31)分比(25.38±5.66)分]及学习投入总分[(92.19±9.09)分比(79.19±8.10)分]高于对照组(P均<0.05)；试验组学习效果[(67.41±4.31)分比(60.25±6.61)分]、学习体验[(38.09±3.21)分比(34.19±5.37)分]、课堂互动[(18.41±1.88)分比(16.50±2.11)分]、学业负荷[(10.91±1.82)分比(9.56±2.69)分]得分均高于对照组(P均<0.05)；试验组批判性思维总分[(266.72±16.57)分比(252.06±13.86)分]较高，且寻找真相、开放思想、系统化能力、批判性思维自信心、求知欲各维度得分亦高于对照组(P均<0.05)。试验组总体教学满意度总分[(83.38±3.08)分比(79.16±4.15)分]高于对照组(P<0.05)。

结论

生成式人工智能支持的纠错式案例教学可提升医学生的案例分析能力、学习投入、学习效果及批判性思维，并提高教学满意度。

关键词: 生成式人工智能, 纠错式案例教学, 肾脏病学, 临床实习, 评价
Objective

To investigate the effectiveness of generative AI-supported error-corrective case-based teaching in clinical nephrology clerkship.

Methods

Medical students rotating through the Department of Nephrology at the Army Specialized Medical Center from June 2024 to September 2025 were selected and randomly assigned to an experimental group and a control group using a random number table. The control group received traditional case-based teaching, while the experimental group underwent generative AI-supported error-corrective case-based teaching. Both groups received a 2-week clinical training period. The pre- and post-teaching examination scores, learning engagement and critical thinking level were compared between the two groups, and their comprehensive learning effect and teaching satisfaction were evaluated after teaching.

Results

A total of 64 medical students were enrolled, with 32 in each group. Post-teaching assessment results showed that the case-analysis score [(42.50±4.56) vs (38.47±4.75)] and total examination score [(82.06±8.09) vs (75.97±7.37)] in the experimental group were higher than those in the control group (all P<0.05). The scores of dedication dimension [(30.34±5.95) vs (27.63±4.84)], absorption dimension [(34.53±7.31) vs (25.38±5.66)] and total learning-engagement score [(92.19±9.09) vs (79.19±8.10)] were higher in the experimental group (all P<0.05). The experimental group also obtained higher scores in learning effect [(67.41±4.31) vs (60.25±6.61)], learning experience [(38.09±3.21) vs (34.19±5.37)], classroom interaction [(18.41±1.88) vs (16.50±2.11)], and academic load [(10.91±1.82) vs (9.56±2.69)] (all P<0.05). The total critical-thinking score was higher in the experimental group [(266.72±16.57) vs (252.06±13.86)], together with higher scores in the sub-dimensions of truth-seeking, open-mindedness, systematicity, critical-thinking self-confidence, and inquisitiveness (all P<0.05). The total teaching-satisfaction score of the experimental group was higher than that of the control group [(83.38±3.08) vs (79.16±4.15), P<0.05].

Conclusion

Generative AI-supported error-corrective case-based teaching can improve medical students′ case-analysis ability, learning engagement, learning effect, and critical thinking, and enhance teaching satisfaction.

Key words: Generative artificial intelligence, Error-corrective case-based teaching, Nephrology, Clinical clerkship, Evaluation
图1 生成式人工智能支持的纠错式案例教学实施流程注：GenAI，generative artificial intelligence，生成式人工智能
表1 两组医学生基线资料及考核成绩比较
组别 男性[例(%)] 年龄(岁) 基础知识(分) 案例分析(分) 总分(分)
对照组(32例) 14(43.8) 23.09±0.86 33.25±5.04 27.25±4.27 60.05±7.74
试验组(32例) 16(50.0) 23.06±0.80 32.19±5.78 28.88±5.12 61.06±9.14
统计量(χ2/t) χ2＝0.251 t＝0.151 t＝0.784 t＝－1.380 t＝－0.266
P值 0.616 0.881 0.436 0.173 0.791
表2 教学结束后两组医学生考核成绩比较(±s)
成绩(分) 对照组(32例) 试验组(32例) t值 P值
基础知识 37.50±4.45 39.56±5.23 －1.644 0.105
案例分析 38.47±4.75 42.50±4.56 －3.500 0.001
总分 75.97±7.37 82.06±8.09 －3.149 0.003
表3 两组医学生入组前后学习投入比较(±s)
时间 指标 对照组(32例) 试验组(32例) t值 P值
入组前 活力 24.34±4.37 25.44±4.16 －1.025 0.308
  奉献 25.78±4.61 24.00±4.42 1.577 0.120
  专注 23.41±5.71 24.84±6.63 －0.929 0.356
  合计 73.53±8.04 74.28±7.20 －0.393 0.696
入组后 活力 26.19±4.43 27.31±4.34 －1.026 0.309
  奉献 27.63±4.84 30.34±5.95 －2.006 0.049
  专注 25.38±5.66 34.53±7.31 －5.603 <0.001
  合计 79.19±8.10 92.19±9.09 －6.040 <0.001
表4 学习效果评价(±s)
指标 对照组(32例) 试验组(32例) t值 P值
学习体验 34.19±5.37 38.09±3.21 －3.532 0.001
课堂互动 16.50±2.11 18.41±1.88 －3.815 <0.001
学业负荷 9.56±2.69 10.91±1.82 －2.342 0.023
合计 60.25±6.61 67.41±4.31 －5.128 <0.001
表5 批判性思维得分比较(±s)
时间 指标 对照组(32例) 试验组(32例) t值 P值
入组前 寻找真相 30.88±3.54 30.22±3.42 0.754 0.454
  开放思想 28.78±4.40 29.59±4.88 －0.699 0.487
  分析能力 35.09±3.57 34.16±3.55 1.054 0.296
  系统化能力 31.84±3.03 33.09±3.39 －1.555 0.125
  批判思维的自信心 46.19±3.94 47.25±4.02 －1.067 0.290
  求知欲 38.97±3.49 39.72±3.21 －0.896 0.374
  认知成熟 30.91±4.31 31.69±3.85 －0.765 0.447
  合计 242.66±15.62 245.72±17.54 －0.738 0.464
入组后 寻找真相 33.22±3.32 35.53±3.57 －2.682 0.009
  开放思想 31.16±4.54 33.34±3.42 －2.175 0.033
  分析能力 36.22±3.70 38.25±4.61 －1.945 0.056
  系统化能力 31.69±3.23 33.72±3.49 －2.416 0.019
  批判思维的自信心 47.28±3.74 49.50±4.28 －2.209 0.031
  求知欲 40.59±3.03 42.78±3.20 －2.81 0.007
  认知成熟 31.91±4.24 33.59±4.13 －1.614 0.112
  合计 252.06±13.86 266.72±16.57 －3.839 <0.001
表6 教学满意度比较(±s)
指标 对照组(32例) 试验组(32例) t值 P值
总体授课效果 19.78±1.91 20.78±1.54 －2.304 0.025
教学方法 19.38±1.76 20.75±1.19 －3.667 0.001
教学内容 20.13±2.06 21.03±1.79 －1.880 0.065
教师表现 19.88±1.70 20.81±1.23 －2.528 0.014
总分 79.16±4.15 83.38±3.08 －4.618 <0.001
[1]
Bello AK, Okpechi IG, Levin A, et al. An update on the global disparities in kidney disease burden and care across world countries and regions [J]. Lancet Glob Health, 2024, 12(3): e382-e395.
[2]
Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus [J]. Nat Rev Nephrol, 2024, 20(7): 473-485.
[3]
Hu B, Wang L, Wu JX, et al. A combination of case-based learning with flipped classroom improved performance of medical students in nephrology bedside teaching [J]. BMC Med Educ, 2024, 24(1): 995.
[4]
李好，赵诺，阮冰玉，等. 以案例为基础的整合式教学模式在冠心病合并慢性肾脏病教学中的应用[J/OL]. 中华肾病研究电子杂志，2025, 14(2): 110-114.
[5]
Delavari S, Barzkar F, Rikers RMJP, et al. Teaching and learning clinical reasoning skill in undergraduate medical students: a scoping review [J]. PLoS One, 2024, 19(10): e0309606.
[6]
Klein M, Otto B, Fischer MR, et al. Fostering medical students′ clinical reasoning by learning from errors in clinical case vignettes: effects and conditions of additional prompting procedures to foster self-explanations [J]. Adv Health Sci Educ Theory Pract, 2019, 24(2): 331-351.
[7]
Boscardin CK, Gin B, Loeser H, et al. ChatGPT and generative artificial intelligence for medical education: potential impact and opportunity [J]. Acad Med, 2024, 99(1): 22-27.
[8]
Rodman A, Mark NM, Artino AR Jr, et al. Using generative artificial intelligence in medical education [J]. Acad Med, 2025, 100(2): 250.
[9]
Li J, Yin K, Wang Y, et al. Effectiveness of generative artificial intelligence-based teaching versus traditional teaching methods in medical education: a meta-analysis of randomized controlled trials [J]. BMC Med Educ, 2025, 25: 1175.
[10]
Li L, Zhang W, Zhang K, et al. The role of generative AI tools in case-based learning and teaching evaluation of medical biochemistry [J]. BMC Med Educ, 2025, 25: 1185.
[11]
Bentegeac R, Florens N, Maanaoui M, et al. ECOSBot: a multicenter validation pilot study of a generative AI tool for OSCE-based nephrology training [J]. Clin Kidney J, 2025, 18(10): sfaf308.
[12]
Sheikh MS, Thongprayoon C, Craici IM, et al. Artificial intelligence in nephrology education: a multicenter survey of fellowship trainees at Mayo Clinic [J]. Front Nephrol, 2025, 5: 1607017.
[13]
Astbury H, Fortune E, Dal Ponte C, et al. Generative artificial intelligence for teaching and assessment in health professions education: a scoping review [J]. Nurse Educ Pract, 2026, 91: 104697.
[14]
Basil M, Ahmed W, Hajeomar R, et al. A scoping review of the use of generative artificial intelligence tools in health profession education [J]. BMC Med Educ, 2026, 26: 291.
[15]
方来坛，时勘，张风华. 中文版学习投入量表的信效度研究[J]. 中国临床心理学杂志，2008, 16(6): 618-620.
[16]
吴凡，陈诗敏，赵泽宁. 大学生学习投入、学习时间及学习效果的比较研究——基于F省高校大学生线上线下学习经验调查[J]. 中国高教研究，2022(10): 22-27, 34.
[17]
彭美慈，汪国成，陈基乐，等. 批判性思维能力测量表的信效度测试研究[J]. 中华护理杂志，2004, 39(9): 644-647.
[18]
Xin Y, Yan D, Shuren L, et al. AI literacy mediates AI assisted diagnosis participation and critical thinking among medical students under supervision [J]. NPJ Digit Med, 2026, 9(1): 344.
[19]
孙李杰，罗从娟，骆锋，等. 基于游戏化理念的翻转课堂教学法在肾脏病学规范化培训中的应用效果[J/OL]. 中华肾病研究电子杂志，2025, 14(3): 171-174.
[1] 刘畅, 蒋洁, 胥雪冬, 崔立刚, 张睿超, 王淑敏, 陈文. 基于C-TIRADS词典的甲状腺结节超声结构化报告使用评价[J/OL]. 中华医学超声杂志（电子版）, 2025, 22(07): 620-627.
[2] 孙丽, 蔡媛, 米会敏, 张亚妮. 横滨报告系统在乳腺肿块空芯针穿刺组织印片快速现场评价中的应用[J/OL]. 中华乳腺病杂志(电子版), 2026, 20(05): 305-310.
[3] 张心, 杜勇, 王珍惜, 滕雪宝, 金宝. 血清25羟基维生素D3、膜联蛋白以及急性生理学和慢性健康状况评价Ⅱ与支气管肺炎患儿病情和预后的关系[J/OL]. 中华实验和临床感染病杂志(电子版), 2025, 19(04): 242-248.
[4] 杨静, 王华芬, 卢芳燕, 董丽, 蓝蕾. 术前营养状况对儿童肝移植术后早期临床结局的影响[J/OL]. 中华移植杂志(电子版), 2026, 20(03): 174-179.
[5] 白玲, 祝锦江, 张永鹏, 陈国振, 刘海平, 丁晨光, 王华. 器官获取手术专用剖腹单应用效果分析[J/OL]. 中华移植杂志(电子版), 2025, 19(06): 447-450.
[6] 王文娟, 傅博, 王旭, 沈婉君, 汪鹏, 洪权, 冯哲, 蔡广研, 陈香美. 新时代肾科学术型研究生初入实验室规范化培训模式的思考与实践[J/OL]. 中华肾病研究电子杂志, 2026, 15(03): 170-172.
[7] 张修潜, 王旭, 刘冉, 崔少远, 沈婉君, 朱晗玉, 傅博, 欧阳清. 项目驱动式学习在肾脏病学研究生科研能力培养中的应用及效果评价[J/OL]. 中华肾病研究电子杂志, 2026, 15(02): 108-111.
[8] 田明威, 陈曦曌, 章敏. 基于案例教学法的"学生主导式病例汇报"模式在肾脏内科规培生临床教学中的实践与思考[J/OL]. 中华肾病研究电子杂志, 2026, 15(02): 112-115.
[9] 李青峰, 王泽林, 聂小钧, 刘文科. 不同年龄的中重型创伤性颅脑损伤患者多维度康复功能评估及差异性分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2026, 16(01): 26-33.
[10] 张静, 王帅鹏, 何竟. 重症康复疑难病例讨论+PBL法对康复团队临床能力培养的效果评价及现状分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2026, 16(01): 46-51.
[11] 朱名超, 朱娅, 郭飞波, 王俊, 黄梦格. 自制稀释液在全自动粪便分析中的诊断效能验证与临床应用评价[J/OL]. 中华诊断学电子杂志, 2026, 14(03): 167-174.
[12] 胡立娟, 刘艳丽, 邹芳, 逯晶. BOPPPS联合情境模拟教学在心脏体格检查中的应用[J/OL]. 中华诊断学电子杂志, 2026, 14(03): 212-218.
[13] 张真真, 杨婷, 郝婧, 李冰, 李惠惠, 丁伟伟, 邓芬, 邱晓珏. 消化专科护理质量评价表的构建[J/OL]. 中华胃肠内镜电子杂志, 2026, 13(03): 201-204.
[14] 陈倩倩, 左歆烨, 王思竣, 唐平, 邵群, 晏阳, 袁新普, 张朝军, 令狐恩强. 局部进展期直肠癌经新辅助治疗后序贯阶梯式超级微创全层切除术的适应证与手术效果分析[J/OL]. 中华胃肠内镜电子杂志, 2025, 12(04): 259-266.
[15] 霍俊艳, 朱翠婷, 何明月, 胡秀朝, 王韵. 急性缺血性脑卒中患者入院时营养风险的影响因素[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(02): 170-177.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？