病历书写对培养医学生临床综合能力的作用研究

目的：研究病历书写对培养医学生临床综合能力的作用。方法：对比传统的大病例书写和实时全病程病历书写对实习生出科考核成绩的影响。结果：在实时全病程病历书写组学生的出科考核成绩中，采集病史、临床操作、实验室检查分析、诊断与鉴别诊断、药物治疗、病情分析的得分明显高于对照组（P〈0．05或P〈0．01）。结论：加强实习生实时全病程病历书写训练，有利于提高医学生的临床综合能力。

Hospitalized records writing on training clinic comprehensive ability of medical college students

Objective： To investigate the effect on training the comprehensive ability of medical college students by writing hospitalized records. Methods： Exam achievement of the students in the group of traditional method was compared with that of the group of real-time case file writing while they finished the practice of the part. Results： The exam scores of traditional method group in collecting the history, clinical operation, laboratory analysis, diagnosis and differential diagnosis, drug therapy, the analysis of the illness, were less than those of the control group. Conclusion： Through strengthening medical college students training of hospitalized records, the ability of clinic comprehensive would be im- proved.