基于多学科综合诊疗协作的淋巴瘤临床教学  

The clinical teaching model of lymphoma based on multiple disciplinary team

作　　者：董宝侠[1] 顾宏涛[1] 高广勋[1] 梁蓉[1] 白庆成[1] 张涛[1] 杨岚[1] 陈协群[1] 黄亚渝[2] 

机构地区：[1]第四军医大学西京医院血液内科,西安710032 [2]第四军医大学西京医院内科教研室,西安710032

出　　处：《中华医学教育探索杂志》2016年第7期745-749,共5页Chinese Journal of Medical Education Research

基　　金：国家自然科学基金（81370609）

摘　　要：目的：探讨基于多学科综合诊疗协作（multiple displinary team, MDT）平台的临床教学在淋巴瘤实习教学中的应用和效果。方法将2012级临床医学专业五年制实习学生随机分为实验组（30人）和对照组（30人）。实验组实施基于MDT平台的临床教学，在淋巴瘤临床教学中导入MDT会议、病例讨论等；对照组实施常规小讲课及教学查房为主的临床教学。教学结束后通过答题考核及问卷调查评价教学效果，采用SPSS 20.0进行数据处理，行t检验及卡方检验。结果两组学生淋巴瘤课程客观题考核成绩相近，但实验组学生主观论述性题目及病例分析得分较对照组高[（16.5±2.3）vs.（10.5±1.8）；（37.5±2.5）vs.（27.5±1.8）]，差异有统计学意义（P=0.000）。实验组考核总分也高于对照组[（93.5±5.2）vs.（76.0±6.2）]，差异有统计学意义（P=0.000）。课程满意度调查显示，实验组有27名（90.0%）学生对此教学方式具有浓厚兴趣；29名（96.7%）学生认为通过临床教学，能够熟练掌握并强化对淋巴瘤临床诊疗流程的理解及记忆；25名（83.3%）学生认为通过新的临床教学可加强对淋巴瘤的鉴别诊断能力并拓宽诊治思路；28名（93.3%）学生认为能增强临床思维能力；26名（86.7%）学生认为能增强医患沟通能力，相对对照组学生在各项目上的选择情况，差异有统计学意义（P〈0.05）。结论基于MDT平台临床教学的创新，有利于医学生依据多学科间交流及沟通，对淋巴瘤患者制定更为个体化的综合诊疗方案，有利于培养医学生诊断、鉴别诊断及临床思维能力，值得推广应用。Objective To explore the value of applying multiple disciplinary team （MDT） in the clinical practice teaching of lymphoma. Methods 5-year program clinical medicine undergraduate students of 2012 were divided into experimental and control group randomly, with 30 cases in each group. The ex-perimental group received MDT in clinical teaching through MDT conference and cases analysis. The control group received conventional teaching mainly by smal class presentation and ward round . The effect of teaching was evaluated by examination and questionnaire. The data were analyzed through t-test and chi-square test by SPSS 20.0 software. Results The results showed the students＇ scores of the theory knowledge test of two groups were similar to each other, but the scores of discussional topic and clinical cases analysis were higher in experimental group than control group and statistically difference [（16.5 ±2.3）vs. （10.5 ±1.8）;（37.5±2.5） vs.（27.5±1.8）], （P=0.000）, and the final score of two groups showed statistically difference （93.5± 5.2 vs. 76.0 ±6.2） （P=0.000）. Meanwhile, questionnaire survey of satisfaction showed that 27 students of experimental group （90.0%） were interested in this new teaching model, 29 students （96.7%） believed it im-proved understanding and memory to the process of lymphoma diagnosis and treatment, 25 students （83.3%） believed it could improved the ablility to diagnose and differential diagnose lymphoma and expanded their clinical view. 28 students （93.3%） had consolidated clinical thinking, and 26 students （86.7%） improved negotiation with patients. All issues were significantly better than control group （P〈0.05）. Conclusions The clinical teaching model innovation based on MDT could help medical students use the cross-discipinary interviewing and make optimal treatment plan for patients. It is conducive to the cultivation of their diagnosis, differential diagnosis and clinical thinking ability, which is worthy of promotion in hemat

关 键 词：淋巴瘤 多学科综合诊疗协作 临床教学 

分 类 号：R6[医药卫生—外科学]