"基于器官系统学习"的临床实习教学模式改革探索  

Exploration on remodeling of clinical practice training based on organ system

作　　者：周庆[1] 唐东[1] 袁芳[1] 李丽[1] 施炜[2] 桑爱民[2] 史亚琴 高建林[2] Zhou Qing;Tang Dong;Yuan Fang;Li Li;Shi Wei;Sang Aimin;Shi Yaqin;Gao Jianlin(Education&Training Department,Affiliated Hospital of Nantong University,Nantong 226001,China;Affiliated Hospital of Nantong University,Nantong 226001,China;Medical School of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院教育培训处,226001 [2]南通大学附属医院,226001 [3]南通大学医学院,226001

出　　处：《中华医学教育杂志》2020年第8期623-627,共5页Chinese Journal of Medical Education

基　　金：江苏省高等教育教改课题重点项目(2017JSJG035);南通大学教学改革研究课题(2017B94)。

摘　　要：目的探索"基于器官系统学习"的临床实习教学模式改革实施的效果。方法本研究采用试验对照方法。2017年6月至2019年5月,选取南通大学和苏州大学2013级和2014级五年制临床医学专业147名实习生为研究对象,将2014级74名实习生设为试验组,采用"基于器官系统学习"的临床实习教学模式,除了床旁示教之外,引入基于团队学习的教学方法;将2013级73名实习生设为对照组,采用"以学科为中心"的临床实习教学模式,仅采用床旁示教的教学方式。通过两组实习生的考试成绩、Mini-CEX评分结果和对试验组实习生的问卷调查评价教学模式改革效果。结果试验组实习生和对照组实习生的理论知识考试成绩[(74.24±7.21)分比(68.23±7.86)分]、临床技能操作考核成绩[(89.68±5.36)分比(85.29±4.37)分]、病历书写成绩[(94.45±2.78)分比(87.29±4.05)分]和Mini-CEX总评分成绩[28(25,30)分比22(21,24)分]比较,其差异均具有统计学意义(均P<0.01)。81.1%(60/74)的实习生对"基于器官系统学习"的临床实习教学模式实施效果予以肯定和好评。结论"基于器官系统学习"的临床实习教学模式改革有助于提高实习生的学习成绩和实习质量,得到了实习生的认可。Objective To explore the outcomes of the remodeling clinical practice training based on organ system.Methods From June 2017 to May 2019, totally 147 interns of five-year curriculum of clinical medicine enrolled in 2013 and 2014 in Nantong University and Suzhou University were selected as the research objects. Totally 74 interns enrolled in 2014 grade were set as the experimental group, the organ-system based learning was adopted. In addition to bedside teaching, the team-based learning was also applied. The 73 interns enrolled in 2013 were set as the control group, with discipline-based training methodology and the bedside teaching model. Through examination scores Mini-CEX score of the two groups of interns and the questionnaire survey of the experimental group of interns, the effect of the reform of teaching mode was evaluated.Results The results of the experimental group and the control group in theoretical knowledge test were [(74.24 ± 7.21) vs (68.23 ± 7.86)], clinical skill operation test[ (89.68 ± 5.36) vs (85.29 ± 4.37)], medical record writing[ (94.45 ± 2.78) vs (87.29 ± 4.05)] and Mini-CEX total score [28 (25, 30) vs 22 (21, 24)], the differences were statistically significant (All P < 0.01). The questionnaire result showed that 81.1% (60 / 74) of the interns in the experimental group affirmed and praised the "organ-system based" clinical practice teaching mode and effect.Conclusions The remodeling of clinical practice training based on organ system is conducive to improving the learning outcomes and practice quality of interns, and has been recognized by interns.

关 键 词：基于器官系统学习 本科生导师制 基于团队学习 实习模式 教学改革 

分 类 号：G642.44[文化科学—高等教育学] R-4[文化科学—教育学]