同步化沉浸式见习课程在八年制外科学教学实施与教学效果的队列研究  

A Cohort study of synchronized immersion course to improve teaching effectiveness of clinical practice of surgery for eight-year program students

作　　者：蔡正昊 郑民华[1,2] 顾倩[3] 何琳[1] 龚震晔[3] 胡伟国[1,2] 何永刚[1,2] 臧潞[1,2] CAI Zhenghao;ZHENG Minhua;GU Qian;HE Lin;GONG Zhenye;HU Weiguo;HE Yonggang;ZANG Lu(Department of Surgery Teaching,Ruijin Clinical School,Shanghai Jiao Tong University,Shanghai 200025,China;Department of General Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Medical Education Office,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学瑞金临床医学院外科学教研室,上海200025 [2]上海交通大学医学院附属瑞金医院普外科,上海200025 [3]上海交通大学医学院附属瑞金医院医学教育处,上海200025

出　　处：《外科理论与实践》2024年第3期254-259,共6页Journal of Surgery Concepts & Practice

基　　金：上海交通大学医学院附属瑞金医院教学激励计划(沪瑞院[2017]85号);上海交通大学医学院课程建设基金[沪交医教[2018]10号];上海市教育委员会上海高校市级重点课程(2020年);上海市教育委员会上海高校一流本科课程(2022年)。

摘　　要：目的:探究同步化沉浸式见习课程(SIC)对临床医学八年制外科学教学效果的作用。方法:选取2017年9月至2019年6月在上海交通大学瑞金临床医学院进行外科学各论学习的临床医学专业八年制法文班和“4+4”班学生共94人,作为教改试验组,接受SIC。选取同期按传统方式见习带教的八年制英文班学生共91人,作为横向对照组。选取教改前2015年9月至2017年6月进行学习的临床医学专业八年制法文班和“4+4”班学生共84人,作为纵向对照组。比较各组学生的教学满意度评价、考试成绩和专业方向选择情况以评估教学效果。结果:试验组满意度问卷实际得分(3.8±0.3分)及满意率(98.9%)均优于横向对照组(3.6±0.4分,90.1%),且差异有统计学意义(P=0.001,P=0.008)。客观结构化临床考试(OSCE)病例分析考站,试验组平均分(86.2±6.9分)和及格率(97.9%)优于横向对照组(79.7±11.4分,89.0%),且差异有统计学意义(P=0.001,P=0.014),也优于纵向对照组(79.5±13.5分,88.1%),且差异有统计学意义(P=0.001,P=0.009)。病史采集考站,试验组平均分(86.3±10.7分)和及格率(96.8%)优于横向对照组(81.4±11.6分,86.8%),且差异有统计学意义(P=0.003,P=0.013)。试验组学生选择外科专业方向的比例(55.3%)在数值上高于横向对照组(46.2%)和纵向对照组(44.0%),但差异无统计学意义。结论:SIC帮助八年制学生强化临床思维能力,拓展临床实践技能,提升教学满意度及对外科学的兴趣。Objective To investigate the application of synchronized immersion course(SIC) in teaching of clinical practice of surgery for eight-year program students.Methods A total of 94 eight-year program students in French class and 4+4 class who received SIC in the study of surgery in Ruijin Clinical School,Shanghai Jiao Tong University from September 2017 to June 2019 were selected as the pilot group.A total of 91 students in English class who were taught in the traditional way in the same period were selected as a horizontal control group.A total of 84 students in French class and 4+4 class who were studying from September 2015 to June 2017 were selected as the longitudinal control group.Teaching satisfaction evaluation,examination results and specialization choice were compared among students in each group to assess teaching effectiveness.Results The total score(3.8±0.3) and satisfaction rate(98.9%) of the questionnaire in the pilot group were better than those in the horizontal control group(3.6±0.4,90.1%)(P=0.001,P=0.008).For the case analysis station in objective structured clinical examination(OSCE),the mean score(86.2±6.9) and pass rate(97.9%) in the pilot group were better than those in the horizontal control group(79.7±11.4,89.0%)(P=0.001,P=0.014),as well as better than those in the longitudinal control group(79.5±13.5,88.1%)(P=0.001,P=0.009).For the history inquiry station,the mean score(86.3±10.7) and pass rate(96.8%) in the pilot group were better than those in the horizontal control group(81.4±11.6,86.8%)(P=0.003,P=0.013).The proportion of students choosing the surgical specialty was higher in the pilot group(55.3%) than in the horizontal control group(46.2%) and the longitudinal control group(44.0%) without statistically significant difference.Conclusions SIC can help eight-year program students strengthen their clinical thinking and practice skills.Meanwhile,SIC can increase students' satisfaction with teaching and their interest in surgery.

关 键 词：外科学各论 临床见习 课程改革 八年制学生 

分 类 号：R6[医药卫生—外科学]