Objective　To investigate practical effects of task based learning (TBL)

case based learning (CBL) and problem based learning (PBL) integrated teaching method in clinical novitiate of hepatobiliary disease and pancreatopathy. Methods　Total of 64 students majored in seven-year clinical practice were divided into TBL+CBL

TBL+PBL

PBL+CBL and TBL+CBL+PBL groups

using a cluster stratified random sampling method

with 16 students in each group. The students were taught with the same basic theoretical knowledge

followed by different course of the combination of TBL

CBL and PBL. In the TBL + CBL + PBL group

the typical patient data were sent to the students before the class

and at the same time

the catalogues of the reference materials and the preview questions were also provided for them. In the course of teaching

the results of the students' information and the answers to the preview questions were first carried out

and then the task test was carried out in the form of collective consultation

and then the students focused on the answers and tests. The theoretical difficulties and blind spots of the theory and the correction of mistakes

deficiency

the breakdown of the case after the end of the expla-nation

and the mistakes and shortcomings of the students' knowledge were discussed in class. The practical effects were evaluated by theory test

teaching and self-acceptance assessment. The data were analyzed by variance analysis

t test and Chi square test. Results　Average scores of students in the TBL+PBL

TBL+PBL

PBL+CBL and TBL+PBL+CBL group were (75.313±8.260)

(74.875±9.818)

(77.125±9.667) and (82.000±6.491)

respectively. Average scores of students in the TBL+PBL+CBL group are signifi-cantly higher than the TBL+PBL (t=0.217

P=0.016) and TBL+PBL (t=0.059

P=0.022) groups

while there was no difference with those of PBL+CBL groups (t=0.049

P=0.106). However

Tests grades of 4 students which were poor performance in TBL+CBL+PBL group were significantly higher than those of 4 students with poor performance in PBL+CBL groups (t=0.356

P=0.000). In addition

students in TBL+CBL+PBL group more greatly enhanced learning interest and initiative

and improved their comprehensive analysis ability than students in TBL+CBL ( χ2 and P value: 5.565

0.018; 5.109

0.024; 4.167

0.041)

TBL+PBL ( χ2 and P value: 7.127

0.008; 5.367

0.021; 5.565

0.018) and PBL+CBL ( χ2 and p value: 4.167

0.041; 5.000

0.025; 8.866

0.003). Conclusion　TBL

CBL and PBL integrated teaching method can improve students' mastery of theoretical knowledge

and especially can help poor students to improve their academic perfor-mance and interest.