基于医学生认知的分散实习模式教学质量同质化实证研究  

An empirical study on the homogenization of teaching quality under the dispersed clinical internship model based on cognition of medical students

作　　者：范冠华 杨棉华 林常敏[2] 黄展勤 陈海滨[4] Fan Guanhua;Yang Mianhua;Lin Changmin;Huang Zhanqin;Chen Haibin(Higher Medical Education Research Center,Shantou University Medical College,Shantou 515041,China;Medical Education Evaluation and Research Center,Shantou University Medical College,Shantou 515041,China;Department of Pharmacology,Shantou University Medical College,Shantou 515041,China;Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院高等医学教育研究室,515041 [2]汕头大学医学院医学教育评价与研究,中心515041 [3]汕头大学医学院药理学教研室,515041 [4]汕头大学医学院,515041

出　　处：《中华医学教育杂志》2020年第4期288-292,共5页Chinese Journal of Medical Education

基　　金：广东省科技计划项目软科学研究项目(2016A070706007);全国教育科学"十二五"规划教育部重点课题(DIA150305);教育部高等医学教育临床教学研究课题(Edu-CR-2016-8-3);汕头市科技计划医疗卫生类别项目(190716185262435);汕头大学医学院2019年研究立项(NU201903)。

摘　　要：目的以认知学徒制理论为基础,探讨不同类型医院实习医学生分散实习模式下对所在医院实习教学质量的认知状况,为保证和提高教学质量同质化提供参考。方法选取某医学院校在14家医院进行临床实习的2012级临床医学专业251名学生为研究对象,采用自编问卷对其就所在实习医院的教学质量进行调查。结果医学生就临床实习与其临床思维和能力、人文素质、沟通能力、团队精神、对患者责任感等5个变量的自我认知的结果显示,两两变量之间均具有显著相关关系。在执行实习大纲和带教方面,直属附属医院实习医学生的评价优于非直属附属医院实习医学生的评价。大部分二级学科对实习大纲的执行情况较好,但不同学科之间存在一定差异且具有统计学意义(t=-2.083,P=0.040),直属附属医院二级学科执行情况优于非直属附属医院。带教教师有效反馈对提高实习医学生的工作能力具有较为明显的正向线性关系。结论不同类型医院分散实习模式下医学生的临床能力可以得到连带性提升。不同类型医院在实习大纲执行的周密性和细致度上存在差异,带教教师的深度有效反馈和对学生的关怀有助于医学生适应临床实习与提高临床能力,医学院校需要更多地关注和加强对非直属附属医院的实习指导,促进分散实习模式下教学质量的同质化。Objective Based on the theory of cognitive apprenticeship,to explore the cognitive status of medical students in different types of hospitals in order to provide reference for ensuring and improving the quality of teaching.Methods A total of 251 medical students from grade 2012 who experienced clinical intern practice in 14 hospitals were selected as the research objects,and their training outcomes in teaching hospital was investigated by self-designed questionnaire.Results There was a significant correlation between the internship activities of medical students and their clinical capacity,humanistic quality,communication skill,team spirit and sense of responsibility for patients.Most of the disciplines have run a good implementation of the internship program,but there are significant differences between disciplines(t=-2.083,P=0.040).The implementation of affiliated hospital is better than that of the non-affiliated hospital.There is a positive linear relationship between the effective feedback from teachers and the improvement of students'capacity.Conclusions Under the dispersed pattern clinical internship model,the clinical ability of medical students can also be improved.For different kinds of teaching hospitals,there are homogeneity differences in the clinical intern implementation.The detailed feedbacks and concerns of teachers help medical students to adapt to clinical internship.Medical colleges need to strengthen the practice guidance of non-affiliated hospitals to promote the homogeneity of teaching quality.

关 键 词：分散临床实习 认知学徒制 医学生 同质化 实证研究 

分 类 号：R-05[医药卫生]