临床基本技能结合微课在见习课中的应用探索  

Application Exploration of Clinical Basic Skills Combined With Micro Course in Practice Class

作　　者：褚睿 王艳 陈娜 李艳梅 徐佳 王梦婷 田娜 CHU Rui;WANG Yan;CHEN Na;LI Yanmei;XU Jia;WANG Mengting;TIAN Na(Department of Nephrology,General Hospital of Ningxia Medical University/Department of Internal Medicine,School of Clinical Medicine,Ningxia Medical University,Yinchuan Ningxia 750004,China)

机构地区：[1]宁夏医科大学总医院肾脏内科/宁夏医科大学临床医学院内科学系,宁夏银川750004

出　　处：《中国继续医学教育》2022年第23期69-73,共5页China Continuing Medical Education

基　　金：2018年宁夏回族自治区高等教育教学改革研究与实践项目(NXBJG2018059);2020年宁夏医科大学线上教育教学改革研究项目(NYJY2028)。

摘　　要：目的通过将临床基本技能结合微课的新型教学模式引入医学生临床见习课中,加深学生对见习疾病临床诊断思路的训练,提高临床基本技能。方法纳入2020年9—12月期间在宁夏医科大学临床医学院肾脏内科进行见习课学习的宁夏医科大学2017级10个专业共410名学生为研究对象,借助标准化病人(standardized patients,SP)通过微课的形式为学生演示见习病种的病史采集及体格检查。通过问卷调查的方式和自身实践前后对照的方法对新见习模式进行评价。结果(1)总体情况:共纳入410名学生,新模式培训前后考核学生40名,发放满意度调查问卷410份,回收373份,回收率为90.98%。(2)问卷调查表总体平均分之和:85.3分。绝大部分学生认同临床见习中应用临床基本技能结合微课的教学改革能够激发学习的主动性和积极性(97.59%)、学到更多的医学知识(97.06%)、提高临床思维能力(96.78%)、提高问诊基本功(97.05%)、规范体格检查操作(97.32%)、提高口头表达能力(97.32%),并赞同在其他系统疾病的见习课中使用这样的模式(96.78%)。(3)新模式培训的学生培训后问诊成绩明显高于培训前,差异有统计学意义(P<0.001)。(4)新模式培训的学生体格检查成绩明显提高,差异有统计学意义(P<0.001)。结论临床基本技能与微课结合的创新见习模式,可以弥补传统教学模式的不足,强化了学生临床实践能力的培养和锻炼,提高了见习主要内容——问诊和查体的成绩,成为医学生向临床医生过渡的桥梁。Objective To introduce the novel teaching model combining basic clinical skills with micro lessons to the clinical practice classes of medicos,deepen the training of students in the diagnosis thoughts of clinical diseases and improve students’basic clinical skills.Methods A total of 410 students from 10 majors of Ningxia Medical University in 2017 who studied in the internship course in the Department of Nephrology,Clinical School of Medicine,Ningxia Medical University from September to December 2020 were included in the study.Standardized patients(SP)demonstrated the history collection and physical examination of trainee diseases for students in the form of micro-class.The new internship model was evaluated by means of questionnaire survey and self-practice before and after comparison.Results(1)General situation:410 students were included.40 students were assessed before and after the new training model,and 373 questionnaires are collected among 410 satisfaction questionnaires with the recovery rate of 90.98%.(2)Sum of the grand average of questionnaires:85.3 scores.The majority of students agreed that the teaching reform combining basic clinical skills with micro lessons applied in the clinical practice could simulate the initiative of learning(97.59%),acquired more medical knowledge(97.06%),improved the clinical thinking(96.78%)and basic inquiry skills(97.05%),standardized the operation of physical examination(97.32%),enhanced the oral expression ability(97.32%),and approved that this model could be used in practice classes of other systemic diseases(96.78%).(3)After the new-model training,students obviously improved their performance in inquiry,the difference was statistically significant(P<0.001).(4)After the new-model training,students obviously improve their performance in physical examination,the difference was statistically significant(P<0.001).Conclusion Innovative practice model combining basic clinical skills with micro lessons can make up for the defects of traditional teaching model,enhance the cu

关 键 词：临床基本技能 微课 标准化病人 问诊 体格检查 肾脏内科见习课 

分 类 号：G642[文化科学—高等教育学]