在肿瘤内科雪实习课中引入PBL教学法的实践

目的探讨PBL教学法在肿瘤内科学实习课中的应用效果。方法采用PBL教学法与传统教学法（LBL）在肿瘤内科临床实习课中进行实践,并比较其教学效果。结果PBL组教学效果显著优于LBL组。结论PBL教学法在肿瘤内科临床实习课教学中具有较明显优势,能提高实习教学质量。     

急诊医学教学中两种教学方法实施效果的比较研究

目的 比较以问题为基础学习(problem-based learning,PBL)结合智能化计算机模拟教学与传统的以授课为基础学习(lecture-based learning,LBL)两种教学方法在急诊医学教学中的应用效果.方法 以大连大学医学院2006级五年制临床医学专业1班和2班49名学生为研究对象,1班25名学生为对照组,2班24名学生为实验组.两组学生在年龄、性别、基础文化程度、专业知识掌握等方面差异无统计学意义.针对心肺脑复苏章节的急诊教学,对照组采用LBL教学方法;实验组采用PBL结合智能化计算机模拟教学方法.教学结束后,采用问卷调查、理论及操作技能考核等主客观评价方法共同评价教学效果.结果 与对照组学生比较,实验组学生在教学中能够主动提出问题,积极参与讨论,发言踊跃,课堂气氛活跃.调查结果显示,学生对PBL结合智能化计算机模拟教学方法满意度高于LBL教学方法.比较两组学生的考试成绩,无论是理论测试还是操作技能考核,实验组学生的成绩均明显优于对照组学生(P<0.05).结论 PBL结合智能化计算机模拟教学比LBL教学更能够增加学生学习的兴趣,加深学生对知识的理解和记忆,增进团体协作精神,并且能够更好地培养学生急诊医学思维和解决临床问题的能力,显著提高了急诊医学的教学效果.

Abstract：

Objective To evaluate the application effects of problem-based leaning (PBL) combined with intelligent simulation teaching and lecture-based learning (LBL) in course of cardio-pulmonary-cerebral resuscitation of emergency medicine. Methods Using 49 undergraduate students of grade 2006, five-year clinical medicine in Medical School of Dalian University as the object of research, and class 1 (n=25) for control group, class 2(n=24) for experimental group. The students of control group were taught by traditional LBL teaching method, and experimental group were taught by PBL combined with intelligent computer simulations teaching method. The teaching effect was evaluated by using the results of questionnaire survey and theory examination skills and operating skills together. Results Compared with controls group, the students of experimental group were able to question actively and participate in discussions, spoken enthusiastically, and active atmosphere. The results of students' questionnaires showed that satisfaction of students for PBL combined with intelligent simulation teaching method were better than LBL teaching method. Test scores, either in theory or skills assessment test experimental results are better than control group (P<0.05). Conclusions Compared with traditional LBL teaching method, PBL combined with intelligent simulation teaching method can increase students' interest in learning, deepen understanding and memory of the knowledge, enhance team spirit and bring up ability to emergency medicine clinical thinking and solving practical problems, and improve the teaching effect of emergency medicine greatly.     

临床教学中强化医学生医患交流能力培训的思考

医学生医患交流能力的培训是保证医学教育教学质量的重要环节,目前医学教育中对医学生医患交流能力的培训重视不够.本文探讨了临床教学中强化医学生医患交流能力培训的意义、医学生医患交流中存在的问题,并就如何做好医学生医患交流能力培训提出了建议,以期能够促进医学生医患交流能力的提高.

Abstract：

The education of physician-patient communication for the medical students is an important part, which can guarantee the quality of medical education in the work of clinical teaching. But in the present, medical colleges don't pay much attention to the training of physician-patient communication in the clinical practice for the medical students. This study discusses the importance to cultivate the ability of physician-patient communication for the medical students, the medical students' problems in the study of physician-patient communication in the clinical practice, and the learning suggestions of physician-patient communication for the medical students in the clinical practice, in order to provide reference for clinical teaching work.     

以问题为基础学习结合病案讨论教学法在普通外科学见习教学中的应用

Objective To investigate the application effect of 4 teaching methods, traditional teaching method, problem-based learning (PBL), case-based discussion and PBL combined with casebased discussion in clerkship teaching of general surgery. Methods One hundred and thirty-two clinical probationers of grade 2003 and 2004 were divided into 4 groups (33 in each group). Four teaching methods were applied respectively. Performance records of theoretical test, clinical skill assessments and questionnaires were analyzed statistically at the end of clerkship. Results The results of PBL and case-based discussion teaching were superior to traditional teaching ( P ＜ 0.05 ). And the result of PBL combined with case-based discussion teaching was superior to the others (P ＜0.05). Conclusions PBL combined with case-based discussion teaching method can stimulate clinical probationers' learning interests, promote the training of clinical thinking and elevate their learning efficiency.     

以问题为基础学习结合病案讨论教学法在普通外科学见习教学中的应用

Objective To investigate the application effect of 4 teaching methods, traditional teaching method, problem-based learning (PBL), case-based discussion and PBL combined with casebased discussion in clerkship teaching of general surgery. Methods One hundred and thirty-two clinical probationers of grade 2003 and 2004 were divided into 4 groups (33 in each group). Four teaching methods were applied respectively. Performance records of theoretical test, clinical skill assessments and questionnaires were analyzed statistically at the end of clerkship. Results The results of PBL and case-based discussion teaching were superior to traditional teaching ( P ＜ 0.05 ). And the result of PBL combined with case-based discussion teaching was superior to the others (P ＜0.05). Conclusions PBL combined with case-based discussion teaching method can stimulate clinical probationers' learning interests, promote the training of clinical thinking and elevate their learning efficiency.     

七年制医学生急诊医学临床实习教学实践与思考

本文回顾了七年制医学生急诊医学临床实习教学的实践,初步探讨了本门课程的临床实习教学规律.针对教学活动中存在的问题,结合当前医疗环境,实施了转变急诊医学临床实习教学理念,优化教学方法,注重培养急诊医学临床思维能力,加强急救技能培训,提高医患沟通能力与技巧,强化医疗、科研综合素质,建立和谐平等师生关系等举措,取得了良好的教学效果.

Abstract：

In this paper the writer reviewed the experience gained from the clinical teaching of emergence medicine of seven-year program students and primarily explored the teaching principles of this clinical course. Targeted at solving the problems found in teaching activities and taking the current medical environment into account, the writer proposed the following clinical teaching methods to achieve a better effect With the transformation of clinical emergence medicine teaching philosophy, the clinical teaching should lay its focuses on the cultivation of capability of scientific thinking and the practical skill training of clinical emergence medicine. Besides, the enhanced communication skills between doctor and patient, the strengthened comprehensive quality of medical practice and scientific research of teachers and the establishment of equal and harmonious teacher-student relationship would contribute greatly to the improvement of clinical teaching as well.     

From Chinese Version of Integrative Medicine to Globalized Integrative Medicine： Impression on the 3rd World Integrative Medicine Congress

In the 1950's,Chinese medical scientists were trying to take advantage of both Western medicine and traditional Chinese medicine in clinical practice.The integrated traditional Chinese medicine and Western medicine became an academic branch in medical sciences.As more and more medical doctors were     

夜大学医学微生物学理论课程教学改革探索

目的 研究夜大学医学微生物学教学中存在的问题,实施理论课程教学改革,提高医学微生物学教学质量.方法 对参加2008年度医学微生物学学习的北京大学医学部夜大学2007级学生进行问卷调查,评价医学微生物学教学效果,并对教改形式与常规形式进行比较.结果 教学改革后的医学微生物学教学效果得到了学生的认同,学生喜欢学习与临床实践结合紧密的内容,喜欢电子演示文档(PowerPoint,PPT)加网络视频的授课形式.结论 夜大学的医学微生物学理论授课内容,应当密切结合学生的临床工作实际需要,课堂上充分调动学生学习的主动性,采用PPT辅以网络视频授课等形式能够提高教学效果.

Abstract：

Objective To investigate the problems existing in medical microbiology teaching for the evening university students and innovate the teaching method. Methods A self-administered questionnaire survey were conducted among the evening university students of 2007 enrollments in Peking University Health Science Center. Then the teaching effects were evaluated . Results The teaching effects of innovation were considered to be helpful. The students preferred studying the knowledge closely related to clinical practice and enjoying the teaching styles using PowerPoint together with web video. Conclusions The course content of medical microbiology should focus more on knowledge closely related to clinical practice.Encouraging active student participation in the learning process and using the teaching styles with not only PowerPoint but also web video were effective to improve the teaching effects.     

自助式教学模式在生物化学教学中的应用

目的 探讨自助式教学模式在生物化学理论教学中的应用价值.方法 将长治医学院2008级五年制临床医学专业371名学生随机分为实验组和对照组,在生物化学理论教学中,实验组采用自助式教学模式教学,对照组采用传统教学模式教学.教学结束后,比较两组学生的理论考试结果和问卷调查结果.结果 实验组学生理论考试成绩显著高于对照组学生;实验组学生对自助式教学模式评价较高.结论 自助式教学模式优于传统教学模式,自助式教学模式有助于提高生物化学的教学质量.

Abstract：

Objective To discuss application value of the self-service teaching model in biochemistry theory teaching. Methods 371 students who were in five year medical education, major in clinical medicine in 2008 were divided into the experimental group and the control group at random. The experimental group was adopted self-service teaching model and the control group was used traditional teaching model in biochemistry teaching. The score of two group students was compared, and questionnaire survey was made. Results The experimental group exceeded the control group in evaluation to theory teaching and teachers in the questionnaire survey and examination results. Conclusions The self-service teaching model was superior to the traditional teaching model. The self-service teaching model could improve the teaching quality of biochemistry.     

Cost-effectiveness of diagnostic approaches to vasovagal syncope

Background Syncope is a common clinical problem with multiple causes. Vasovagal syncope （VVS） is by far the most frequent cause of syncope in children and adolescents. The traditional diagnostic approach to VVS of children and adolescents is based on a series of tests to exclude all other causes, which is complex and time and medical resource consuming. Attempts have been made to develop a new cost-effective diagnostic approach to avoid these problems. This study aimed to compare the economic effectiveness and diagnostic value of the traditional diagnostic approach to VVS of children with a new diagnostic approach. Methods One hundred and eighteen children diagnosed as VVS were divided into two groups according to the different diagnostic approaches. The diagnostic value of the two diagnostic approaches was then analyzed. Meanwhile, the costs of hospitalization, diagnostic testing and hospital stay were determined. Data were evaluated by the cost-minimization analysis. Results The diagnostic value of the new diagnostic approach was similar to that of the traditional diagnostic approach （56.57% vs. 53.91%, P=0.697）. However, the cost of hospitalization per patient by the new diagnostic approach was （1507.08±144.63） Yuan （RMB） which was less than that of the traditional diagnostic approach （2603.64±2.08.19） Yuan. The costs of diagnostic tests per patient by the new diagnostic approach was （1256.04±109.14） Yuan and by the traditional approach （2175.22±153.32） Yuan. Conclusion Compared to the traditional diagnostic approach to diagnose VVS in children and adolescents, the new diagnostic approach is of a good economic value, and it should be popularized in clinical practice.     

PBL教学法在肿瘤内科临床实习教学中的应用

为评价以问题为基础的教学法（PBL）在肿瘤内科临床实习教学中的应用效果，80名实习生随机分为A，B两组，A组（40名）采用PBL教学法，B组（40名）采用传统教学法。A组的出科考核成绩和多数项目教学效果评价好于B组（P〈0．05），PBL教学法应该在肿瘤内科临床实习教学中推广应用。     

以案例为基础的PBL教学法在临床肿瘤学教学中的应用探讨

近年来,随着基础学科的快速发展,以教师和教材为中心,以讲授法为主导的临床肿瘤学的传统教学方法已不能适应新的发展形势。为了适应新形势发展和医学模式的转变、提高教学质量,需要在临床肿瘤学教学过程中采用新的教学方法。PBL(problem-based learning)教学法是以案例为基础,以问题为引导的,先提出问题后讲授内容的全新教学方法。通过学生的自主探究和分工协作来解决问题,更好地调动学生的主观能动性和培养了学生解决问题的能力,有利于加强对学生综合素质的培养。同时,PBL教学法对教师也提出了更高的要求,促进教师加强业务水平的学习,拓展相关知识领域,使教师的知识结构更加完善,知识更新更加快速,从而使教学水平得到进一步的提升。但PBL教学法在我国施行的时间不长,且受我国教育体系的限制,目前仍然是一种新的教学法,尚处于探索阶段,还未形成比较成熟的系统模式,很多教师对PBL教学模式认识不足。本文从PBL教学法在医学教育中的应用、较传统教学法的优势、在临床肿瘤学教学实施的具体方案和存在的问题及解决办法等方面阐述PBL教学法在临床肿瘤学教学中的应用。通过PBL教学法在临床肿瘤学教学过程中的实施,以素质教育模式逐步取代传统教学模式,培养出能够更好适应临床需求的肿瘤科医生。      

普外科实习带教中PBL教学法的应用体会

目的：探索普外科临床实习教学中PBL（problem-based learning）教学法的应用价值和教学效果。方法随机选择2013年1月~2013年10月皖南医学院在本科实习的40名五年制临床实习生,分为实验组和对照组两大组,每组20人,实验组实施PBL教学方法,对照组实施传统教学方法,通过问卷调查和理论考试评价教学效果。结果实验组同学在自主学习能力、分析解决问题能力和教学满意度等方面优于对照组,实验组同学理论考试成绩及病历书写成绩高于对照组,两组比较差异有统计学意义。结论普外科实习教学中采用PBL教学法,能够提高学生分析问题及解决问题的能力,有效提升专业技能和素质,使得学生能够较快地将理论知识运用到临床实践中,值得在普外科实习教学中推广应用。     

CBL联合PBL模式在肿瘤内科临床实习教学中的应用

肿瘤内科学是医学生临床教学的重要内容,需要掌握的知识繁多、复杂,临床教学难度较大。传统的讲授教学法存在手段单一、过程枯燥、与临床脱节等不足,易造成学生自主学习意识差、综合利用知识能力不足等问题。为了克服传统教学的缺点,将案例教学法（CBL）联合以问题为基础的教学法（PBL）应用于肿瘤内科的临床实习带教教学中,培养学生的临床思维和临床实践能力,达到提高肿瘤内科学临床教学质量的目的。     

肿瘤科实施PBL教学培养学生循证医学思维模式的探索

目的建立适合肿瘤科教学特点的PBL教学体系,培养学生循证医学临床思维模式。方法在肿瘤科临床教学中,选取40名临床医学系七年制学生,进行"以问题为基础的学习(PBL)",与传统教学方法进行对比研究,探讨PBL启发式教学在培养学生循证医学临床思维模式方面的作用。结果 PBL教学组理论学习成绩中基础知识部分成绩与传统教学组无明显差异,但是临床问题分析及处理能力考核成绩显著优于传统教学组(P<0.001)。结论在肿瘤科临床教学中的运用和实施PBL教学法,能够使得学生的循证医学思维得到良好的建立,临床能力得到更好的提高,该方法值得进一步实践推广。     

加强医事法律教育，提高医学生依法执业的依从性

目的探索以问题为基础的学习（Problem-based learning,PBL）在临床教学中培养实习医师临床思维能力和解决问题能力方面的效果。方法编写PBL教学案例,以2010年度临床医学专业72名实习医师为实验组,开展PBL教学。以传统临床教学方式带教的2009年度临床医学专业55名实习医师作为对照组。对2组问临床思维型客观题理论考试成绩和病历书写质量评比成绩行t检验。同时,通过专家组对实验组点评与考核、对教师和学生行问卷调查,评价PBL教学效果。结果实验组和对照组理论考试成绩和病历书写成绩差异有统计学意义（P〈0．01）。问卷调查显示,师生均认为PBL在培养学生临床思维能力和解决问题能力等方面效果优于传统教学方式。结论临床实习阶段实施PBL的效果较好,PBL对提高临床实践教学质量和推动临床实践教学改革有着积极的意义。     

PBL教学结合标准化病人在肾内科临床教学中的应用

目的 评价以问题为导向的学习(PBL)结合标准化病人(SP)方法在肾内科临床教学中的应用效果。方法 选取某医学院校五年制临床医学专业在某医院临床见习的2013、2014级四年级医学生共270人作为研究对象,将学生分为三组:PBL教学组、PBL+SP教学组和传统教学组,课程结束后进行问卷调查及考核。结果 PBL+SP组100%的学生对课堂评价为满意或十分满意,PBL组98.51%的学生对课堂评价为满意或十分满意,而传统教学组仅有80.74%的学生对课堂评价为满意或十分满意。PBL+SP组和PBL组学生十分满意和满意总和率明显高于传统教学组(P＜0.05),PBL+SP组十分满意率明显高于PBL组(P＜0.05)。PBL+SP组学生均愿意再次在教学中应用SP。在提高上课学习兴趣、自主学习能力、医患沟通能力、临床思维能力、知识掌握能力、语言表达能力、团队协作能力、批判思维能力及临床实践能力方面,PBL+SP组和PBL组得分明显高于传统教学组(P＜0.05),在提高上课学习兴趣、医患沟通能力、临床思维能力、语言表达能力及临床实践能力方面,PBL+SP组得分明显高于PBL组(P＜0.05)。PBL+SP组和PBL组病史采集和理论知识成绩明显高于传统教学组(P＜0.05),PBL+SP组病史采集成绩明显高于PBL组(P＜0.05)。结论 在肾内科临床教学中运用PBL结合SP的教学模式,能够提高医学生的学习主动性、创造性,增加学习兴趣,提升医学生的医患沟通、团队协作、批判思维及临床实践等综合能力,值得推广。     

生物化学PBL教学法应用探析

目的探讨分析PBL教学法在各级临床医学生中的应用效果,为生物化学教学方法的进一步改进提供有效指导。方法用传统教学法与PBL教学法进行教学,比较分析不同级别学生对PBL教学法的适应性。结果与传统教学法相比,七年制本科生总评成绩显著升高（P〈0.05）;五年制本科与专升本学生分析项成绩显著升高（P〈0.05）;专科生总评成绩下降（P〈0.05）。结论生物化学PBL教学法在七年制本科班中应用效果最好,五年制本科与专升本学生也比较适应该教学法,专科生不太适应。     

医学统计学PBL教学改革初探

在八年制临床医学专业学生的医学统计学理论教学中选择4个内容实施PBL教学,并与实施传统教学相互比较。发现实施PBL教学的学生成绩与传统教学无显著性差异,但是PBL教学对提高学生学习能力、促进知识掌握、激发学习兴趣、提高协作表达有积极作用。PBL教学法值得在八年制医学生医学统计学理论教学中进一步推广。