逆向临床思维在内科住院医师规范化培训中的作用  

The Role of Reverse Clinical Thinking in the Standardized Resident Training Program of Internal Medicine

作　　者：梁淑芹[1] 齐洁[2] 杨阳[2] 崔建国[2] 张清潭[2] LIANG Shuqin;QI Jie;YANG Yang;CUI Jianguo;ZHANG Qingtan(Department of Neurology,Binzhou Medical University Hospital,Binzhou Shandong 256600,China;Department of Geriatric,Binzhou Medical University Hospital,Binzhou Shandong 256600,China)

机构地区：[1]滨州医学院附属医院神经内科,山东滨州256600 [2]滨州医学院附属医院老年医学科,山东滨州256600

出　　处：《中国继续医学教育》2020年第1期44-46,共3页China Continuing Medical Education

摘　　要：目的探讨逆向临床思维培养在内科住院医师规范化培训中的作用。方法选择2018年1月—2018年12月在滨州医学院附属医院老年内科(普通内科)参加住院医师规培的学员共30名,随机分成两组。两组规培学员均采用传统及PBL教学法。实验组重点培养学员的逆向临床思维,而对照组则主要培养学员的顺向临床思维。轮转完成后比较两组学员在内科疾病诊治理论方面的差异及对教学方法的评价。结果实验组学员在出科时的理论成绩高于对照组[(90.19±6.50)vs.(82.20±5.00),P=0.001];出科三个月时实验组的成绩高于对照组,差异有统计学意义[(85.63±5.57)vs.(78.40±4.15),P<0.001]。总体硕士学历的成绩提高幅度要高于本科学历学员[(15.57±6.30)vs.(10.76±4.56),P=0.020]。满意度调查结果显示实验组满意度评分高于对照组[(19.38±0.96)vs.(17.87±1.41),P=0.001]。结论逆行临床思维培养可以作为传统及PBL教学在住院医师规范化培训中的有效补充,可以加深学员对内科常见疾病的理解,但需要学员有一定的知识储备基础。Objective To explore the role of reverse clinical thinking in Resident Training Program of Internal medicine.Methods A total of 30 students from January 2018 to December 2018 in the Department of Geriatrics(General Internal Medicine)of Binzhou Medical College Hospital participated in resident training program.They were randomly divided into two groups.The traditional and PBL teaching methods were used in both groups.The experimental group focused on training students’reverse clinical thinking,while the control group mainly trained students'forward clinical thinking.After the rotation was completed,the differences of medical disease diagnosis and treatment theory between the two groups were compared and investigate the evaluation of teaching methods.Results The theoretical scores of the students in the experimental group were significantly higher than those in the control group[(90.19±6.50)vs.(82.20±5.00),P=0.001].Three months after discharge,the score of the experimental group were still higher than those of the control group[(85.63±5.57)vs.(78.40±4.15),P<0.001].The achievement of master degree is higher than that of undergraduate degree[(15.57±6.30)vs.(10.76±4.56),P=0.020].The satisfaction survey showed that the satisfaction score of the experimental group was higher than that of the control group[(19.38±0.96)vs.(17.87±1.41),P=0.001].Conclusion Reverse clinical thinking training can be an effective supplement to the traditional and PBL teaching in the standardized resident training program,which requires that the trainees have a certain knowledge reserve.

关 键 词：逆向临床思维 顺向临床思维 住院医师规范化培训 内科 PBL教学 毕业后教育 

分 类 号：G642[文化科学—高等教育学]