多层次学员“一体化”临床思维培训与评价  

Investigation of "multi-level integrated training mode" of clinical thinking and its evaluation system

作　　者：杨慧 段志军[1] 常庆勇[2] 张维升[3] 王丽霞[1] 刘莉[4] Yang Hui;Duan Zhijun;Chang Qingyong;Zhang Weisheng;Wang Lixia;Liu Li(Department of Diagnositics and the Second Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China;Neurosurgery, the Affiliaied Zhongs han Hospital of Dalian University, Dalian 116001, China;3Minis try of Education, the First Affiliate d Hospital of Dalian Medical University, Dalian 116011, China;Minis try of Education, the Affiliated Zhongs h(ui Hospital of Dalian University, Dalian 116001, China)

机构地区：[1]大连医科大学附属第一医院诊断学教研室/消化二科,116011 [2]大连大学附属中山医院神经外科,116001 [3]大连医科大学附属第一医院教务部,116011 [4]大连大学附属中山医院教务部,116001

出　　处：《中华医学教育探索杂志》2019年第3期217-222,共6页Chinese Journal of Medical Education Research

基　　金：2017年辽宁省教育评价协会第二届教学改革与教育质量评价研究项目(PJHYYB17028);2016年中华医学会医学教育研究立项课题(2016A-YD001);2016年辽宁省教育科学“十三五”规划立项课题(JG16DB082);2015年辽宁省教育评价协会第一届教学改革与教育质量评价研究项目(PJHYYB15144).

摘　　要：随着"5+3"医学人才培养模式的推行,临床教学中更需注重对医学生临床思维的培养,然而现有的培训模式存在不足;如教学模式不完善,教师带教意识不够,学生难以适应角色转变,形成固有思维定势,依赖辅助检查等。通过梳理临床思维的内涵,并根据多层次学员不同的培训目标,从专业整体思维框架的建立、专题讲座、启发式查房、多点思路扩展实操训练、"传-帮-带"小组的自主互动学习、病例讨论等方面,探索并构建了多层次学员"一体化"临床思维培训及评价模式;且经过小范围应用后,得到了师生的广泛认可。With the reform of medical education ("5+3"), the clinical mentors usually need to guide three kinds of students who are at different stages of medical education at the same time. And we summed up the core concept of clinical thinking and problems in its training, such as the imperfect teaching mode, insufficient teacher teaching awareness, students' difficulties in adapting to role changes, thinking patterns, and relying on auxiliary examinations, etc. For the training targets of three kinds of students are different, we explored and constructed a "multi-level integrated" training mode and the evaluation system of clinical thinking from the building of professional thinking, lectures, heuristic rounds, multi-aspect thinking mode extension, group learning and case discussions. So far, they have made effective achievements among a small part of students, which are hopefully useful for clinical training.

关 键 词：临床思维 多层次“一体化” 培训模式 评价 

分 类 号：R-05[医药卫生]