救援医学专业急性中毒课程的优化教学研究

【目的】探讨提高我院救援医学专业学生急性中毒课程的教学效果。【方法】2013年3月-6月，我们在整合和优化三部教材中的急性中毒教学内容的基础上，将2010级30名救援医学专业的学生随机分为2组进入临床实习：一组基于案例实习（跟踪式实习组，15人），以实习科室遇到的中毒病例为起点，顺时或逆时追踪患者病情的发生发展，获取患者的完整病历资料。另一组采用传统转科实习（轮转式实习组，15人），以实习科室遇到的中毒病例为起点和终点，获取患者中毒的病历资料。期末通过理论与技能考核和问卷调查评估教学效果。【结果】（1）整合后的授课内容和课时分配得到优化，2013年学生的期未理论考核成绩（分）好于2012年学生（88．1±5．8）比（79．3±12．8），P〈0．01]。（2）2013年两种实习方式培养学生实践技能的效果显示，跟踪式实习组学生的实践技能成绩（分）高于轮转式实习组学生（79．1±6．9）比66．2±6．7）分，P〈0．01]。（3）对基于案例学习的跟踪式实习教学法的问卷调查，师生满意度分别为95．3％和93．3％。【结论】优化急性中毒教学内容有利于改良学生的知识结构和提高课堂授课的效果；基于中毒案例学习的跟踪式实习对于提高救援医学专业学生的实践技能有重要意义。

Research on the optimization of acute poisoning course teaching in rescue medical students

Objective] To explore the teaching effect of acute poisoning course in our rescue medical students. Methods] On the basis of integration and optimization of the content of three teaching materials for acute poisoning course, 30 rescue medical students （grade 2010） were randomly divided into two groups for the clinical practice. The first group was an case-based learning one （tracking gruop）, tracking cases from one department to another in chronological order or in reverse order, and exploring the cause of poisoning and the development of disease in order to obtain complete medical records of the patients. Another group was the traditional rotating internship one, starting and ending with the poisoning cases in the internship department in order to obtain the medical records of the patients. The clinical teaching effect was compared between the two groups through questionnaire survey and final examination. At the same time, theoretical scores were compared with those of the same professional students in the previous years. Results] The distribution of teaching content and class hours were more reasonable after Integration. Students＇ theoretical scores （points） 2013 （88.1± 5.8） vs. 2012 （79.3 ± 12.8）, P 〈 0.01] have increased significantly. Skill score （points） of tracking group was significantly higher than that of rotary type internship group （79.1 ± 6.9） vs. （66.2 ± 6.7）, P 〈 0.01]. According to questionnaire survey, as to the tracking group, satisfaction degrees of the teachers and the students were 95.3% and 93.3% respectively. Conclusion] The optimization of teaching content in acute poisoning course is helpful to improve the students＇ knowledge structure and the classroom teaching effect; Case--based learning of tracking is significant in improving the rescue practice skills of medical students.