建立丙型肝炎临床检验诊断路径的实验诊断学教学改革  

Establishment of a clinical laboratory diagnostic pathway for hepatitis C for the teaching of laboratory diagnostics

作　　者：吴泽刚 郑红云[2] 顾剑[2] 王京伟[1,2] 吴茜 包安裕[2] 童永清 Wu Zegang;Zheng Hongyun;Gu Jian;Wang Jingwei;Wu Qian;Bao Anyu;Tong Yongqing(Department of Clinical Laboratory Diagnostics,The First Clinical College of Wuhan University,Wuhan 430060,China;Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学第一临床学院实验诊断学教研室,武汉430060 [2]武汉大学人民医院检验医学中心,武汉430060

出　　处：《中华医学教育探索杂志》2024年第2期237-241,共5页Chinese Journal of Medical Education Research

基　　金：武汉大学医学部教学研究项目(2019013);武汉大学本科教育质量建设综合改革项目(2022ZG179);湖北高校省级教学研究项目(413200158)。

摘　　要：目的建立涵盖丙型肝炎诊断、鉴别诊断、药物毒副作用监测、治疗效果和预后评估的临床检验诊断路径,并探索以临床检验诊断路径为思路的实验诊断学教学。方法根据丙型肝炎的临床诊疗指南,制订与疾病不同阶段相关的实验室检测策略,建立丙型肝炎的临床检验诊断路径,以武汉大学第一临床学院2018级和2019级七年制本科生为研究对象,通过随堂问卷和小测试比较其课堂教学效果。应用SPSS 19.0软件对数据进行t检验。结果建立获得临床医生认可的丙型肝炎临床检验诊断路径,其涵盖丙型肝炎临床诊断、鉴别诊断、药物毒副作用监测、治疗效果和预后评估等全过程,该路径应用于2019级临床医学本科生课堂教学后,教学质量评估指标均有较大程度的提升(P<0.05),其中"已掌握本节课重难点"提升最明显,2018级为(60.90±2.15)分,2019级为(84.80±3.44)分。2019级对教学方法的评价总分(94.02±4.29)明显高于2018级(79.21±3.68)(P<0.05)。随堂测验2018级为(78.10±4.92)分,而2019级平均成绩为(94.60±5.63)分,得分也显著提高(P<0.001)。结论建立了丙型肝炎临床检验诊断路径并应用于实验诊断学教学,使实验诊断学与临床医学有机融合,同时显著提高了教学质量。Objective To establish a clinical laboratory diagnostic pathway for hepatitis C covering diagnosis,differential diagnosis,drug toxicity monitoring,and therapeutic and prognostic evaluation,and to explore a new teaching model for laboratory diagnostics based on the clinical laboratory diagnostic pathway.Methods According to the clinical diagnosis and treatment guidelines for hepatitis C,laboratory testing strategies for different stages of diagnosis and treatment of the disease were formulated to establish a clinical laboratory diagnostic pathway for hepatitis C.The pathway was applied in the teaching for undergraduate medical students of the seven-year program of grade 2019 of The First Clinical College of Wuhan University,with those of grade 2018 as the control to receive traditional teaching.The teaching effect was compared through questionnaires and quizzes in class.The data were analyzed through the t test with the use of SPSS 19.0.Results A clinical laboratory diagnostic pathway for hepatitis C recognized by clinicians was established,covering the entire process of clinical diagnosis,differential diagnosis,monitoring of drug side effects,and therapeutic and prognostic evaluation.The students of grade 2019 receiving the pathway-based teaching model had significant improvements in teaching quality evaluation indicators(P<0.05),with the most marked improvement in"having mastered the key and difficult points of this lesson",with a score of(60.90±2.15)points for grade 2018 and(84.80±3.44)points for grade 2019.The total score for teaching evaluation was significantly higher in students of grade 2019 than in those of grade 2018[(94.02±4.29)vs.(79.21±3.68)]points,(P<0.05).Grade 2019 also had a significantly higher classroom quiz score than grade 2018[(94.60±5.63)vs.(78.10±4.92),P<0.01].Conclusions We established and applied a clinical laboratory diagnostic pathway of hepatitis C in the teaching model of laboratory diagnostics,which organically integrates laboratory diagnostics and clinical medicine,and signifi

关 键 词：丙型肝炎 临床检验诊断路径 教学模式 

分 类 号：R-05[医药卫生]