医学统计学实验教学课程的调查分析

目的 了解医学生对医学统计学实验课教学的需求及满意度.方法 选取某医科大学325名学生为调查对象,通过一个学期的医学统计学实验课程的学习,调查医学生对医学统计学实验教学的需求及满意度.结果 对于带教老师,68.3%的学生希望学历在硕士及以上,80.0%的学生希望职称在副教授及以上,75.4%的学生希望年龄在30～50岁之间;对于教学方法,86.5%的学生要求采用多媒体与传统教学结合的方式,86.8%的学生希望多开展相互讨论,96.9%的学生希望采用案例教学;对于时间和内容,70.7%的学生认为每次安排三节课最合适,72.4%的学生对30～40 min的理论讲解时间最认可,89.8%的学生要求增加先进统计技术和知识,72.9%的学生希望增加软件操作;96.9%的学生认识到实验课的重要性,94.4%的学生认为实验课需要老师的指导;56.3%的学生对目前带教老师感到满意.结论 医学统计学实验课教学水平有待进一步提高,需要不断提高带教老师的执教水平,完善实验课程设置,改革实验教学方法.     

SPSS软件在医学统计学教学中应用的探讨

目的 探讨SPSS软件对医学统计学教学的怍用。方法 教研室自1999年起在研究生、本科生的医学统计学教学中结合SPSS软件进行计算机辅助教学实践。结果 使用SPSS软件辅助医学统计学教学，激发了学生的学习积极性，提高了学生对实际资料的统计分析能力，明显地提高了教学效果。结论 使用SPSS软件来辅助医学统计学教学的方法对提高医学统计学的教学效果有重要的意义，值得推广。     

Integration of evidence based medicine into the clinical years of a medical curriculum

Teaching Evidence Based Medicine (EBM) helps medical students to develop their decision making skills based on current best evidence, especially when it is taught in a clinical context. Few medical schools integrate Evidence Based Medicine into undergraduate curriculum, and those who do so, do it at the academic years only as a standalone (classroom) teaching but not at the clinical years. The College of Medicine at King Saud bin Abdulaziz University for Health Sciences was established in January 2004. The college adopted a four-year Problem Based Learning web-based curriculum. The objective of this paper is to present our experience in the integration of the EBM in the clinical phase of the medical curriculum. We teach EBM in 3 steps: first step is teaching EBM concepts and principles, second is teaching the appraisal and search skills, and the last step is teaching it in clinical rotations. Teaching EBM at clinical years consists of 4 student-centered tutorials. In conclusion, EBM may be taught in a systematic, patient centered approach at clinical rounds. This paper could serve as a model of Evidence Based Medicine integration into the clinical phase of a medical curriculum.     

医学统计学多元化教学方法探讨

统计学的概念和原理抽象，分析方法丰富且实践性强。传统教学法在当前教学中日现其弊端，多媒体技术的应用以及统计软件的快速发展与普及，为统计学的教学提出了新要求。本文在分析医学统计学特点及当前统计学教学现状的基础上，提出集传统与现代教学手段之优点于一身的多元化教学方法，最大程度地激发学生学习统计学的兴趣与积极性，改善教学效果。     

Medical students' perspective on the teaching of medical statistics in the undergraduate medical curriculum

Two undergraduate medical students at the University of Bristol commented on their experiences of learning medical statistics. In general, medical students' focus is on acquiring skills needed to practice clinical medicine, and great care must be taken to explain why disciplines such as statistics and epidemiology are relevant to this. Use of real examples and an emphasis on the need for evidence has meant that medical students are increasingly aware of the pressure on clinicians to justify their treatment decisions, and the associated need to be able to understand and critically appraise medical research. It was felt that medical statistics courses should focus on critical appraisal skills rather than on the ability to analyse data, which can be acquired by particular students when they need to do this. Medical statistics should be taught early in the curriculum, but there is a need to reinforce such skills throughout the course. Teaching and assessment methods should recognize that what is being taught is a practical skill of clinical relevance. This means that problem based small groups, data interpretation exercises and objective structured clinical examinations will be more productive than traditional teaching and examination methods.     

Four years' experience of an undergraduate medical nutrition course.

In 1992 the medical colleges of The Royal London and St Bartholomew's hospitals launched a new curriculum in which basic medical sciences were to be integrated with early exposure to clinical medicine in the first phase. The curriculum was to be modular and integrative, combining clinical and medical-science-based teaching of body systems, rather than the traditional teaching by departmental discipline. We describe the inception, content and evaluation of a 7-day course on nutrition which was developed as part of this curriculum. It was rated highly by the students, whose feedback led to important modifications. The programme works well in practice, and could provide a useful guide for other schools about to set up nutrition courses for medical students.     

Community-oriented medical education in Glasgow: developing a community diagnosis exercise

OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.     

医学留学生对医学中文课程评价的调查与分析

[目的]对留学生医学中文课程进行评价。[方法]对完成医学中文课程的75名医学留学生进行问卷调查。[结果]医学留学生认为医学中文课程设置合理、教学效果好、实现了教学目标、课程具有实用性;对教材和教师的授课过程的评价较高。[结论]医学中文课程设置在留学生进入临床前能促进留学生掌握医学知识并实现教学的目标,抓好教学过程能提高课程的教学效果。     

Comunicación médico-paciente: una de las competencias básicas pero diferente

Effective communication skills form part of being a good doctor. Today there is solid evidence to support the teaching of effective communication skills in all medical schools.This article describes how communication is different from the other skills that medical students and residents need to learn, how this affects teaching and learning, and the application of these ideas in a Chilean medical school.We describe the premises that need to be taken into consideration when planning teaching communication in medicine and illustrate how these affected the development of our teaching of communication in our undergraduate curriculum.All medical education programmes should include formal teaching on the doctor-patient relationship, but must take into consideration the aspects of communication teaching that make it different from teaching other aspects of medicine.     

多元化教学在医学统计学教学中的探索

目的 提升本校学生对医学统计学课程的重视度、兴趣和医学统计知识的专业应用能力,以全科医学专业为例,探讨多元化教学的应用效果。方法 整群抽取2017级临床医学（全科医学方向）2个班共253人作为研究对象,其中,1班125人为教改组,采用多元化教学模式;2班128人为对照组,采用传统教学模式。课程结束后通过统一命题试卷的考试成绩和教学效果问卷调查进行评价。结果 教改组的应用能力考试成绩高于对照组（t = 6.65,P＜0.05）,多元化教学能提高理论课课堂教学满意度（Z = - 2.448,P＜0.05）,实践课实用性满意度（Z = - 2.479,P＜0.05）,课程专业地位认识（Z = - 2.553,P＜0.05）,学习积极性(χ2 = 4.555,P＜0.05)和团队交流能力（χ2 = 7.823,P＜0.05）。结论 相比传统教学模式,该教学模式在全科医学专业医学统计学教学中体现出较好的教学效果,具有一定的推广应用价值,可尝试应用于其他专业并通过更大的样本、更细化的评价来证明。     

医学留学生诊断学中文教学效果调查及分析

目的 评估四川大学华西临床医学院针对医学留学生开展的医学中文课程（以诊断学为例）的教学效果,为课程改进奠定基础。方法 利用中、英文2种版本的临床诊断学试卷检测全体四川大学华西临床医学院2015级留学生（95人）诊断学中文课程前、后相关能力水平,同时用相同的试卷检测全体2014级留学生（90人）在完成该课程一年后的知识掌握情况,分析比较课程的教学效果。其中,2015级课前与课后中文答卷情况、2015级课前与课后英文答卷情况采用配对样本t检验分析,2015级课前不同语言的答卷情况、2015级课后不同语言的答卷情况、2014级与2015级中文答卷情况、2014级与2015级英文答卷情况采用独立样本t检验分析。结果 2015级留学生通过中文课程的学习,诊断学中文平均成绩与课前有统计学差异（P<0.001）,诊断学英文平均成绩无统计学差异（P=0.893）;课前中英文测试成绩有统计学差异（P<0.001）,而课后两者间没有统计学差异（P=0.223）。2014级留学生的中、英文诊断学知识的掌握情况和2015级留学生相比均没有统计学差异（中文:P=0.265,英文:P=0.696） 。结论 四川大学开展的医学中文课程（以诊断学为例）教学取得一定效果,对留学生掌握医学中文知识和今后的学习有一定意义,但需对教学方法不断创新以进一步提高教学效果。     

案例教学法在临床医学硕士研究生培养中的应用

医学统计学是现代临床医学教育课程体系中的重要组成部分.教学实践中利用2009年全国博士生学术论坛<灾难医学的现状与未来>这一实验载体,作为教学案例进行教学.经过此课程,临床型硕士研究生对基本统计学方法的掌握程度有明显提高.案例教学法是临床型医学研究生统计思维培养的有效途径.     

Changing the attitudes of `tomorrow's doctors' towards mental illness and psychiatry: a comparison of two teaching methods

The General Medical Council's document ` Tomorrow ' s Doctors ' (1993, GMC, London) recommended major changes in the undergraduate curricula of UK medical schools. In Nottingham, the fourth-year psychiatric attachment became shorter in duration, and interactive, problem-oriented, workshop-based learning replaced lectures. We compared the efficacy of this new teaching style in changing medical students' attitudes towards psychiatry and mental illness with that of old-style, didactic, lecture-based teaching. On the first and last days of their psychiatric attachment, 110 fourth-year medical students (45 old curriculum; 65 new curriculum) completed two self-administered attitudinal measures: the Attitude to Psychiatry Questionnaire (ATP-30) and the Attitude to Mental Illness Questionnaire (AMI). We found that students had favourable attitudes towards psychiatry and mental illness before the attachment. These attitudes became more positive after the attachment in students from both curricula, with no significant difference between the groups and no gender difference. Students found patient contact rewarding, become more accepting of community care, and had greater appreciation of the therapeutic potential of psychiatric interventions. The interactive, student-centred, problem-oriented teaching of the shortened new curriculum appeared as effective in changing medical students' attitudes as a longer attachment with traditional teaching.     

The cost of problem-based vs traditional medical education

It is generally accepted that teachers' salaries are a major factor in the cost of medical education. Little is known about the effects of curriculum on teaching time. A comparison of teaching time devoted to each of two different medical education curricula is presented. In a traditional teacher-centered, subject-oriented curriculum, 61% of the total teaching effort expended by twenty-two teachers took place in the absence of students, i.e. in preparation for student contact. Only 39% of the effort devoted by these teachers to medical education took place in the presence of students. In a problem-based, student-centered curriculum which focuses upon small-group tutorial learning and early extended primary care experience in a rural community setting, 72% of the total teaching effort devoted to medical education was spent with students and only 28% was spent in preparation for student contact. Overall, there were no differences in the total amount of teaching time required by each of the two curricular approaches to medical education. There were, however, major differences in how teachers spent their teaching time.     

Extending community involvement in the medical curriculum: lessons from a case study

OBJECTIVES: Recent reports have stressed the importance of developing medical students' understanding of primary and community care and their ability to work in health-care teams. DESIGN: An innovative 3-year project aimed to achieve this understanding by broadening the range of health-care professionals and community organizations contributing to the medical curriculum. SETTING: King's College School of Medicine, London. SUBJECTS: Undergraduate medical students. RESULTS: Through partnerships with three local community health care trusts, non-medical health care disciplines in the teaching hospital and a range of voluntary and statutory services, students have been introduced to a broader spectrum of care. This has taken place both within the core curriculum and through the development of special study modules. CONCLUSIONS: Involving teachers and organizations which have not traditionally contributed to medical education raises philosophical issues around the aims and rationale of their involvement and practical issues such as gaining curriculum time, recruiting suitable teachers and gaining credibility for the courses. We analyse the benefits and difficulties inherent in broadening the curriculum in this way and assess the lessons our experience provides for the future expansion of such learning, both locally and nationally.     

Medical students' attitudes towards and perception of the basic sciences: a comparison between students in the old and the new curriculum at the University Medical Center Utrecht,The Netherlands

OBJECTIVES: The attitudes towards the basic sciences of medical students enrolled in either of 2 different curricula at the University of Utrecht Medical School in The Netherlands were investigated. The purpose of this study was threefold: first, to compare students (beginning clerks) in a conventional and an innovative curriculum; second, to compare beginning clerks with advanced clerks; and third to compare the present results with those of 2 previous American and Canadian studies in which the same questionnaire was used. SETTING: Beginning clerks in the old and in the innovative curriculum, and advanced clerks in the old curriculum, rated 9 statements on a 5-point (disagree - agree) Likert scale. The statements assessed students' attitudes toward the basic sciences. RESULTS: The results showed that beginning clerks in our innovative curriculum, unlike those in a conventional curriculum, consider the basic sciences as somewhat less important for medical practice and do not think that as many biomedical facts as possible should be learned before entering clinical practice. On the other hand, students in the innovative curriculum are more excited by the faculty's teaching of the basic sciences. This latter result confirms the findings in a previous Canadian study. No significant differences were found between beginning and advanced clerks in the conventional curriculum. CONCLUSION: Students experience teaching of the basic sciences as more exciting when they are integrated in organ system blocks with clinical bearings, though they are somewhat less positive about the actual importance of these sciences.     

《生活技能教育与心理健康促进》课程教学模式研究与效果评估

目的 了解大学生对《生活技能教育与心理健康促进》课程的需求,以及该课程对大学生健康相关态度和行为的影响,为建立大学生生活技能教育教学模式提供依据.方法 在北京大学医学部开设《生活技能教育与心理健康促进》选修课,共9周18个学时.采用参与式教学方法,以培养医学生健康的生活方式为切入口,为学生提供生活技能的理论教学与实践培训.通过课程前后2次问卷调查,对课程教学内容、教学方式和教学效果和学生健康相关行为及态度进行评估.结果 教育后,学生健康相关行为和态度有了明显转变,接受教育后学生上网查阅学习资料的比例较教育前显著增加(P＜0.01),而聊天的比例显著下降(P＜0.05).健康相关态度也有了明显的正向改变,6个问题中有5个差异有统计学意义.教育后学生心理社会能力 "总分"、 "好"、 "有能力"、"快乐"4个方面评分均高于教育前(P＜0.05).教学内容和互动式教学模式深受学生欢迎.学生对学习该课程的必要性、有效性及课程对促进大学生心理健康,减少不健康生活方式的作用评价很高.结论 加强医学院校学生的生活技能教育,是促进医学生心理健康的关键.开设相关生活技能教育课程是必要、有效且可行的,可以在高校推广应用.     

Use of a journal club and letter-writing exercise to teach critical appraisal to medical undergraduates

INTRODUCTION: There is growing interest in methods of teaching critical appraisal skills at undergraduate and postgraduate levels. We describe an approach using a journal club and subsequent letter writing to teach critical appraisal and writing skills to medical undergraduates. METHODS: The exercise occurs during a 3-week public health medicine attachment in the third year of the undergraduate curriculum. Students work in small groups to appraise a recently published research paper, present their findings to their peers in a journal club, and draft a letter to the journal editor. Evaluation took place through: informal and formal feedback from students; number of letters written, submitted and published, and a comparison of marks obtained by students submitting a literature review assignment with and without critical appraisal teaching during the public health attachment. RESULTS: Feedback from students was overwhelmingly positive. In the first 3(1/2) years, 26 letters have been published or accepted for publication, and 58 letters published on the Internet. There were no significant differences in overall marks or marks for the critical appraisal component of the literature review assignments between the two student groups. DISCUSSION: We believe our approach is an innovative and enjoyable method for teaching critical appraisal and writing skills to medical students. Lack of difference in marks in the literature review between the student groups may reflect its insensitivity as an outcome measure, contamination by other critical appraisal teaching, or true ineffectiveness.