加强医学生临床思维能力培养和考核的实践

目的提高医学生临床思维能力和解决临床实际问题的能力。方法针对2005—2010年在同济大学附属医院进行临床阶段学习的临床医学专业本科生，通过以问题为基础的学习、案例教学、临床实践环节中突出实习生角色作用、出科及毕业技能考核中强化临床思维考核等手段，将临床思维培养和考核贯穿本科生临床教学各阶段；同时完善教学管理，加强督导，并通过师资培训提高临床教师教学过程中强化学生临床思维培养的意识和能力，确保各阶段教学中将临床思维培养纳入教学和考核内容。结果经过5年实践，医学生自主学习、科学思维、表达能力、临床技能等得到较大提高；2006—2008年该校毕业生参加国家执业医师资格考试通过率逐年增高。结论在临床教学过程中强化临床思维能力培养对提高医学生临床实践能力有积极作用。

Practice of enhancing clinical thinking training and assessment in medical students

Objective To strengthen the ability of clinical thinking and the ability to solve practical clinical problems for medical students. Methods Medical undergraduates studying in affiliated hospitals of Tongji university from 2005 to 2010 were enrolled. The clinical thinking training and assessment in clinical teaching were enhanced by introducing problem-based learning, case-based learning and by strengthening the role of interns in clinical work and emphasizing clinical thinking ability assessment during various kinds of ehnieal skills examinations. Meanwhile, the teaching management and supervision were improved. The awareness and ability of clinical teachers to train students＇ clinical thinking were aroused and cultivated through teaching staff training so as to ensure that clinical thinking training and assessment were involved in the whole process of clinical teaching. Results The students＇ abilities of self-study, scientific thinking and oral expression were improved. The passing rates of our graduates in national general medical practitioner test were increasing yearly from 2006 to 2008. Conclusion Strengthening clinical thinking ability training during clinical teaching plays an active role in improving clinical skills in medical students.