Objective:To investigate the application effect of the thinking pattern of "Six Thinking Hats" combined with case-based learning-reference induced self-education (CBL-RISE) teaching in clinical practice teaching of thoracic surgery.Methods:A total of 122 interns who received clinical practice teaching in Department of Thoracic Surgery in the Second Xiangya Hospital of Central South University were selected as subjects, and according to the admission order, they were divided into control group (61 interns receiving routine teaching) and observation group (61 interns receiving the thinking pattern of "Six Thinking Hats" combined with CBL-RISE teaching). After teaching, the two groups were compared in terms of assessment scores, self-learning ability, clinical thinking ability, self-expression ability, and recognition of teaching. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:The observation group had significantly higher theoretical and skill assessment scores than the control group [mastery of basic knowledge: (55.42±3.65) vs. (49.57±3.23), P<0.05; case analysis: (20.13±2.19) vs. (16.42±2.74), P<0.05; medical record writing: (18.29±2.17) vs. (15.12±2.05), P<0.05; operational ability: (20.32±2.04) vs. (17.51±1.89), P<0.05; performance score: (30.34±3.24) vs. (27.19±3.07), P<0.05]. After practice teaching, both groups had increases in the scores of self-learning ability and clinical thinking ability, and the observation group had significantly higher scores than the control group [self-learning ability: (90.73±6.88) vs. (85.54±6.53), P<0.05; clinical thinking ability: (105.62±10.19) vs. (100.47±10.45), P<0.05]. Compared with the control group, the observation group had a significantly better self-expression ability ( P<0.05) and a significantly higher degree of recognition of teaching ( P<0.05). Conclusions:The thinking pattern of "Six Thinking Hats" combined with CBL-RISE teaching can improve the assessment scores of interns in thoracic surgery and stimulate their learning ability, thinking ability, and self-expression ability.

Lobectomy and systematic nodules resection has been the standard surgical procedure for non-small cell lung cancer (NSCLC). However, increased small-size lung cancer has been identified with the widespread implementation of low-dose computed tomography (LDCT) screening, and it is controversial whether it is proper to choose lobar resection for the pulmonary nodules. Numerous retrospective researches and randomized clinical trials, such as JCOG0201, JCOG0804/WJOG4507L, JCOG0802 and CALGB/Alliance 140503, revealed that the sublobar resection was safe and effective for NSCLC with maximum tumor diameter≤2 cm and with consolidation tumor ratio (CTR)≤0.25, and that segmentectomy was superior to lobectomy with significant differences in 5-year overall survival rate and respiratory function for patients with small-size (≤2 cm, CTR>0.5) NSCLC and should be the standard surgical procedure. It is the principle for multiple primary lung cancer that priority should be given to primary lesions with secondary lesions considered, and it is feasible to handle the multiple lung nodules based on the patients' individual characteristics.