多层次学员“一体化”临床思维培训与评价

随着“5+3”医学人才培养模式的推行,临床教学中更需注重对医学生临床思维的培养,然而现有的培训模式存在不足;如教学模式不完善,教师带教意识不够,学生难以适应角色转变,形成固有思维定势,依赖辅助检查等。通过梳理临床思维的内涵,并根据多层次学员不同的培训目标,从专业整体思维框架的建立、专题讲座、启发式查房、多点思路扩展实操训练、“传-帮-带”小组的自主互动学习、病例讨论等方面,探索并构建了多层次学员“一体化”临床思维培训及评价模式;且经过小范围应用后,得到了师生的广泛认可。

Investigation of "multi-level integrated training mode" of clinical thinking and its evaluation system

With the reform of medical education ("5+3"), the clinical mentors usually need to guide three kinds of students who are at different stages of medical education at the same time. And we summed up the core concept of clinical thinking and problems in its training, such as the imperfect teaching mode, insufficient teacher teaching awareness, students'' difficulties in adapting to role changes, thinking patterns, and relying on auxiliary examinations, etc. For the training targets of three kinds of students are different, we explored and constructed a "multi-level integrated" training mode and the evaluation system of clinical thinking from the building of professional thinking, lectures, heuristic rounds, multi-aspect thinking mode extension, group learning and case discussions. So far, they have made effective achievements among a small part of students, which are hopefully useful for clinical training.