基于案例的医学硕士研究生复杂临床情景决策研究  

Research on Case based Decision-making in Complex Clinical Scenarios for Master of Medicine

作　　者：薛仁杰 周小冬 唐维兵 洪琴[2] 张文馨[3] XUE Renjie;ZHOU Xiaodong;TANG Weibing;HONG Qin;ZHANG Wenxin(School of Pediatrics,Nanjing Medical University,Nanjing City,Jiangsu Province,China 210008;Women′s Hospital of Nanjing Medical University,Nanjing City,Jiangsu Province,China 210004;Children′s Hospital of Nanjing Medical University,Nanjing City,Jiangsu Province,China 210008)

机构地区：[1]南京医科大学儿科学院,江苏南京210008 [2]南京医科大学附属妇产医院,江苏南京210004 [3]南京医科大学附属儿童医院,江苏南京210008

出　　处：《卫生职业教育》2024年第19期16-19,共4页HEALTH VOCATIONAL EDUCATION

基　　金：2021年度南京市卫生科技发展专项资金项目“儿科专硕住院医师规范化培训期间‘科研能力培养’课程及服务体系构建”(GBX21308);2023年度南京医科大学教育研究课题重点项目“信息化赋能东西部高校课程共建共享—以《儿科疾病诊疗思维》课程为例”(2023ZD009)。

摘　　要：目的调查医学硕士研究生在面对复杂临床问题时的决策倾向。方法设计“继续母乳还是配方奶替代”的复杂临床情景,于2022年11月对南京医科大学选修儿科疾病诊疗思维课程的120名硕士研究生进行问卷调查,了解其决策倾向及原因。结果64.2%的学生首选建议家庭进行混合喂养,96.7%的学生认为混合喂养可以维持母亲上班和哺育婴儿的平衡。儿科方向、专业型硕士更倾向于让家属自己决定喂养方式,而非主动引导家属选择喂养方式。结论医学生临床决策与其专业素养、人文素养及医患关系等有关。医学院校要开展基于真实或模拟环境的整合式课程教学,培养学生应对实际问题的能力;学生在掌握基础医学、临床医学知识与技能的同时,也要重视医患沟通能力的提升;教师要帮助学生树立基于公众健康教育理念的学习思维,迎接医患共同决策时代的来临。Objective To investigate the decision-making tendencies of master of medicine when facing complex clinical problems.Methods A complex clinical scenario of "continuing breast milk or formula milk replacement" was designed,and a questionnaire survey was conducted in November 2022 on 120 masters who took the pediatric disease diagnosis and treatment thinking course at Nanjing Medical University to learn their decision-making tendencies and reasons.Results 64.2% of students preferred to recommend mixed feeding at home,and 96.7% of students believed that mixed feeding could maintain a balance between mother′s work and infant rearing.Pediatric and master of specialist tend to allow family members to decide their own feeding methods,rather than actively guiding them to choose feeding methods.Conclusion Medical students′ clinical decision-making is related to their professional competency,humanistic competency,and doctor-patient relationship.Medical colleges should carry out integrated course teaching based on real or simulated environments to cultivate students′ ability to deal with practical problems.Students should not only master basic and clinical medical knowledge and skills,but also attach importance to improving their doctor-patient communication skills.Teachers should help students establish a learning mindset based on the concept of public health education,and welcome the arrival of the era of shared decision-making between doctors and patients.

关 键 词：医学硕士研究生 复杂临床情景 临床决策 

分 类 号：G643.2[文化科学—高等教育学]