多元化教学模式在全科未分化疾病门诊教学中的构建与实践  

Construction and Practice of Multiple Teaching Mode in Outpatient Clinic Teaching of Medically Unexplained Physical Symptoms in General Practice

作　　者：马军庄[1] 邵双阳 任菁菁[2] 任文[2] 刘颖 MA Junzhuang;SHAO Shuangyang;REN Jingjing;REN Wen;LIU Ying(Department of General Practice,the First Division Hospital,Xinjiang Production and Construction Corps,Aksu Xinjiang 843000,China;Department of General Practice,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou Zhejiang 310003,China;Department of General Practice,Shepan Branch,Medical Service Community of Sanmen People’s Hospital,Taizhou Zhejiang 317111,China)

机构地区：[1]新疆生产建设兵团第一师医院全科医学科,新疆阿克苏843000 [2]浙江大学医学院附属第一医院全科医学科,浙江杭州310003 [3]三门县人民医院医共体蛇蟠分院全科医学科,浙江台州317111

出　　处：《中国继续医学教育》2023年第4期65-69,共5页China Continuing Medical Education

基　　金：全国全科医学教育教学研究课题(A-YXGP 20210201-08);浙江省医药卫生科技计划项目(2020KY135);浙江大学研究生教育研究立项课题(20210309)。

摘　　要：早期未分化疾病(medically unexplained physical symptoms,MUPS)是全科医生需掌握的必备技能之一,其诊治和处理不仅需要全科医师具备扎实的临床知识,还需要拥有清晰的临床思维和诊疗策略。传统的课堂教学和门诊带教均无法有效地培养和提升全科医生对该类问题的处理能力,多元教学模式是近年来提的越来越多的一种新的教学模式,其能弥补传统教学中的不足。全科多元教学模式将以案例为导向的教学模式(cased-based learning,CBL)、以问题为导向的教学模式(problem-based learning,PBL)、以资源为导向的教学模式(resource-based learning,RBL)有机结合,有助于提升全科住培医师临床诊疗能力,基于此,浙大一院全科住培基地构建了以“PBL+CBL”为基础、RBL为补充的多元化教学模式并应用于全科未分化疾病门诊教学。该教学模式依托全科教学门诊,以患者的相关症状问题为导向进行临床推理,以推理后总结的病例进行临床分析,且在门诊结束后以网络资源为支撑进行知识再提升。Medically unexplained physical symptoms(MUPS)are one of the essential skills that general practitioners need to master,and their diagnosis and treatment not only require solid clinical knowledge,but also clear clinical thinking and diagnosis strategies.Traditional classroom teaching and outpatient clinic teaching can not effectively cultivate and improve the ability of general practitioners to deal with these conditions.The multiple teaching mode is a new teaching model,which can make up for the shortcomings of traditional teaching.The diversified teaching mode of general practice organically combines problem-based learning(PBL),case-based learning(CBL)and resource-based learning(RBL),which is conducive to improving the clinical diagnosis and treatment ability of general practitioners.Based on this,the General Practice residential training base of the First Hospital of Zhejiang University has constructed a diversified teaching mode based on"PBL+CBL"and supplemented by RBL,which has been applied to the outpatient teaching of MUPS in general practice.This teaching mode relies on the general practice teaching clinic,conducts clinical reasoning guided by the patient’s related symptoms and problems,conducts clinical analysis based on the cases concluded after reasoning,and promotes knowledge with the support of network resources after the clinic.

关 键 词：全科医师 多元化教学方法 住院医师规范化培训 门诊教学 教学方法 未分化疾病 

分 类 号：G642[文化科学—高等教育学]