| 引用本文：倪芳英,管学妹,沈根海,李根华,宁志强,万良海,顾永春.医学生内科临床思维能力培养教学改革实践与思考[J].中华医学教育探索杂志,2020,19(4): |
| 医学生内科临床思维能力培养教学改革实践与思考 |
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| DOI： |
| 中文关键词: 实习医师 临床思维 导师制 基于团队的学习 形成性评价 |
| 英文关键词:houseman, clinical thinking, undergraduate tutorial system, Team-based Learning mode, formative assessment |
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| 基金项目:南通大学高等教育研究课题(2016GJ040) |
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| 中文摘要: |
| 【摘要】目的 了解临床教学综合改革对医学生内科临床思维能力培养的成效。方法 对内科轮转实习的44名临床医学专业实习医师实施本科生导师制和基于团队的学习（TBL）模式，并通过强化电子病历与手写病历相结合，引入形成性评价工具等一系列配套改革措施，全方位多维度培养医学生内科临床思维能力。采用SPSS 17.0 统计软件对实验组和对照组出科理论考试、病历书写竞赛成绩进行统计评价，并通过自行设计的本科生导师和实习医师调查问卷，综合评价改革成效。 结果 对实验组和对照组实习医师内科理论考试成绩和病历书写评阅成绩分别作独立样本t检验显示，2组成绩差异有统计学意义（P < 0.0001），实验组成绩好于对照组。问卷调查显示实验组师生充分肯定了临床教学综合改革对实习医师内科临床思维能力培训的积极成效。结论 在内科系统实施的本科生导师制与TBL教学模式相结合的临床教学综合改革对提高实习医师临床思维能力培养质量有积极成效。 |
| 英文摘要: |
| 【Abstract】 Objective To evaluate the effects of comprehensive reform of clinical education on cultivating the clinical thinking ability of medical students in internal medicine. Methods A total of 44 clinical interns on medicine rotation were included in this study, and a series of co-ordinate measures in reform of clinical teaching, which included the undergraduate tutorial system, team-based learning (TBL) mode, combination of electronic medical record and handwritten medical record, as well as formative assessment, were applied to fully promote the clinical thinking ability of medical students.SPSS 17.0 software was used to compare the scores of the final academic subjects examination of rotation and competition of medical record writing between the control and the experiment groups.Self-designed questionnaires on undergraduate tutors and clinical interns were applied to comprehensively evaluate the effects of education reform. Results Independent-sample t tests showed there were statistically significant difference （P < 0.0001）in the scores of the final academic subjects examination of rotation and competition of medical record writing between the two groups, and the mean score of the experiment group was higher than that of the control group. Questionnaire survey showed that tutors and clinical interns fully affirmed the positive effects of the educational reform on cultivating the clinical thinking ability of medical students in internal medicine. Conclusion
Application of comprehensive educational reform in clinical teaching of internal medicine, which based on introduction of undergraduate tutorial system and TBL mode, could effectively promote the clinical thinking ability of medical students and the teaching quality. |
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