基于病例的翻转课堂在诊断学见习教学中的应用及问题思考  

Application and problem thinking of case-based flipped classroom in the teaching of diagnostics probation

作　　者：单虎[1] 张蓉[2] 刘棣[3] 张秋红[1] 杨侠[1] 李雅莉[1] 王卫利[4] 张明[1] SHAN Hu;ZHANG Rong;LIU Di;ZHANG Qiuhong;YANG Xia;LI Yali;WANG Weili;ZHANG Ming(Respiratory and Critical Care Medicine Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;No.1 Gastroenterology Department,Shaanxi Provincial People's Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710068;Oncology Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Educational Affairs Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院呼吸与危重症医学科,陕西西安710004 [2]西安交通大学附属陕西省人民医院消化内一科,陕西西安710068 [3]西安交通大学第二附属医院肿瘤科,陕西西安710004 [4]西安交通大学第二附属医院教务部,陕西西安710004

出　　处：《临床医学研究与实践》2022年第21期184-187,共4页Clinical Research and Practice

基　　金：2020年西安交通大学医学部本科教育教学改革研究项目(西交医教〔2020〕12号)。

摘　　要：诊断学是连接基础医学与临床医学的重要桥梁,也是医学生掌握疾病诊断技巧和临床思维的重要课程,传统诊断学教学方式难以解决课时有限、理论知识枯燥乏味和调动学生积极性等难题。以病例为基础的教学方法(CBL)与翻转课堂结合起来在诊断学见习带教过程中取得了良好的教学效果,在诊断学见习课前,授课教师通过微信平台为医学生提供一个具体的临床病例和与该病例有关的微课视频和网络资料,学生利用课前碎片化时间积极主动地去复习理论课上学习到的相关知识,查阅相关资料,思考如何通过问诊、体格检查、辅助检查来确定患者的诊断。在课堂上,以学习小组为单位对相应患者进行问诊和体格检查,小组讨论后,向全体同学汇报讨论结果。在这一过程中,授课教师发挥类似于导师的作用,引导学生解决临床诊断问题,对学生诊断思维过程中存在的问题予以指出,引导学生再思考,得出正确的结论。基于病例的翻转课堂这一新型授课方式有助于激发学生自主学习的兴趣,提高学生的整体学习能力,有助于诊断学理论知识的灵活掌握和学生临床思维的锻炼,同时也促进了青年教师教学水平的提高,为培养卓越的临床医师提供了一条新的教学思路。Diagnostics is an important bridge connecting basic medicine and clinical medicine.It is also an important course for medical students to master disease diagnosis skills and clinical thinking.The traditional diagnostics teaching method is difficult to solve such problems as limited class hours,boring theoretical knowledge and mobilizing students'enthusiasm.The combination of case-based teaching(CBL)and flipped classroom has achieved good teaching results in the process of diagnostics internship.Before the diagnostics internship,the lecturer provides medical students with a specific clinical case and micro-lesson videos and network materials related to the case through the WeChat platform.The students use the fragmented time before class to actively review the relevant knowledge learned in the theoretical class and consult relevant materials,think about how to determine the patient's diagnosis through consultation,physical examination and auxiliary examination.In the class,the study group will be taken as the unit to conduct consultation and physical examination for the corresponding patients,after the group discussion,the discussion results will be reported to all the students.In this process,teachers play a role similar to tutors,guide students to solve clinical diagnostic problems,point out the problems existing in the process of students'diagnostic thinking,guide students to think again and draw correct conclusions.The case-based flipped classroom,a new teaching method,helps to stimulate students'interest in autonomous learning,improve students'overall learning ability,help to flexibly master diagnostic theoretical knowledge and exercise students'clinical thinking,at the same time,it also promotes the improvement of young teachers'teaching level,and provide a new teaching idea for training excellent clinicians.

关 键 词：诊断学 翻转课堂 体格检查 胸痛 

分 类 号：G462[文化科学—教育学]