以培养临床思维能力为导向的实验诊断学见习实践  

An Exploration of Clinical Laboratory Medicine Practice Teaching Guided by Cultivating Clinical Thinking Ability

作　　者：梁玉芳[1] 周睿[1] 赵燕田[1] 吕娟[1] 苑惠敏[1] 霍虹[1] 徐静[1] 张顺利[1] 杨春霞[2] 王清涛[1] LIANG Yufang;ZHOU Rui;ZHAO Yantian;LYU Juan;YUAN Huimin;HUO Hong;XU Jing;ZHANG Shunli;YANG Chunxia;WANG Qingtao(Department of Clinical Laboratory,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Department of Infectious and Clinical Microbiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院,检验科,北京100020 [2]首都医科大学附属北京朝阳医院,感染和临床微生物科,北京100020

出　　处：《标记免疫分析与临床》2022年第9期1612-1616,1620,共6页Labeled Immunoassays and Clinical Medicine

基　　金：首都医科大学教学建设性课题(编号:2019JYJX111)。

摘　　要：目的以临床医学生实验诊断学见习课为依托,探寻在临床医学生实验诊断学见习过程中培养其临床思维能力的方式方法。方法2019年2月19日至2020年2月29日,为培养医学生临床思维能力,在2016级五年制及5+3长学制临床医学专业学生(共62人)第三学年实验诊断学临床免疫学检验见习课中,探索性实施依托检验报告进行综合分析及解读的见习方法,并收集医师和学生对此见习方式的反馈信息和建议共104份;以培养学生临床思维能力为目标,拟定见习方式及见习内容并为后续进一步实施提供依据。结果实施以培养医学生临床思维能力为目的的检验报告解读见习后,学生反馈61份问卷,最感兴趣的内容前两位分别为检验报告解读(90.16%)和检验项目的临床意义(83.60%);90.16%的学生认为在见习中采用基于患者检验报告的综合判读方式好。学生在临床科室见习中接触较多的检验项目前五位依次为血尿便常规、感染项目(乙肝、丙肝标志物;艾滋、梅毒检测)、肝功能、肾功能、电解质。医师反馈问卷43份,结果显示检验项目的临床意义(79.07%)和检验报告的判读(76.74%)对职业帮助最大;医师最关注的检验结果前五位依次为血尿便常规、肝功能、肾功能、电解质、感染项目(乙肝、丙肝标志物;艾滋、梅毒检测)。结论依托检验报告进行综合分析及解读的见习方式是临床医学生临床思维能力培养的有效途径,后续实施中应在此基础上,考虑增加更多教学评价方式和体系,进一步推广应用。Objective To explore the optimal approaches for clinical thinking ability of clinical medical students during clinical laboratory medicine practice teaching courses.Methods From February 19,2019 to February 29,2020,in order to cultivate the clinical thinking ability of medical students,in the clinical immunology course of the 2016 class,5-year and 5+3 long school system students(a total of 62 people)participated the study of implementation of the comprehensive analysis and interpretation based on the test report,and we collected a total of 104 pieces of feedback information and suggestions from the clinicians and students.The system and content of probation were proposed and the knowledge basis for further implementation was provided.Results After the practice of test report interpretation for the purpose of cultivating the clinical thinking ability of medical students,the enrolled students responded to 61 questionnaires,in the survey based on students were interested in:the top two were interpretation of test report(90.16%)and clinical significance of test items(83.60%).90.16%of students thought that the comprehensive interpretation based on patient test report was very good in the practice.The top five test items frequently contacted during clinical practice were routine test items for blood,urine and stool,infection items(hepatitis B,hepatitis C markers;HIV,syphilis test),liver function,kidney function,and electrolytes.61 questionnaires from clinical departments showed that the clinical significance of test items(79.07%)and the interpretation of test reports(76.74%)were most helpful to the profession.The top five test results that physicians care about most were routine test items for blood,urine and stool,liver function,kidney function,electrolytes,and infection items(hepatitis B,hepatitis C markers;HIV,syphilis test).Conclusion It is effective to cultivate clinical thinking ability of clinical medical students by carrying out comprehensive analysis and interpretation based on test reports.On this basis,more

关 键 词：实验诊断学 临床思维能力 检验报告判读 PBL教学 CBL教学 

分 类 号：R-331[医药卫生] G426[文化科学—课程与教学论]