内科学本科教学课程改革和考评体系建设初探

随着社会的发展、科技的进步，全球化交流逐渐增多，为了培养具有岗位胜任力的医学人才，实现“卓越医师计划”的培养目标，实现健康中国的伟大战略，迫切需要进行医学教育改革。内科学是对医学科学发展有重要影响的临床医学学科, 是一门涉及面广和整体性强的学科，是各临床医学学科的基础学科，内科学的内容在临床医学的理论和实践中具有重要意义，是学习和掌握其他临床学科的重要基础，因此内科学教学改革至关重要。蚌埠医学院内科学教研室根据国内外医学教育改革的先进经验，结合自身实际情况，完成了内科学分阶段课程体系和考评体系的教学改革，将内科学教学分为理论教学和实践教学2个阶段，根据不同阶段的教学目的制定了系统的、科学的课程规划和考评方案。在课程建设方面，制定各阶段的教学目标，优化课堂教学，推广线上教学，开展以问题为基础及以案例为基础的学习，医学模拟教学、标准化病人教学、思维导图等多元化的教学方法。完善教师考评和学生考评的方案，教师考核实现了教研室考核、系部考核、学院考核、学生评价4个方面的综合评价体系。学生评价实现了理论考核、过程性评价和客观结构化临床考试等多种形式的考核方法，全面考察学生的学习过程和学习效果。通过教学改革，提高了教师的职业素养和教学水平，提高了学生的学习兴趣，培养了学生临床思维能力和医学人文素质。 

Observation on the effect of pressing needle embedding acupuncture point combined with swallowing rehabilitation training on dysphagia after stroke

Objective To explore the intervention effect of pressing needle embedding needle therapy combined with rehabilitation training on stroke patients with dysphagia.Methods Total 120 patients with dysphagia after stroke were enrolled in our hospital from January to December 2019 for clinical observation.They were randomly divided into observation group and control group.Both groups were given basic treatment,the control group received conventional rehabilitation training for dysphagia,and the treatment group received conventional rehabilitation training for dysphagia combined with pressing needle embedding needle for acupoint.The clinical therapeutic effect,dysphagia symptom score and adverse events were compared between the two groups.Results After treatment,the clinical symptoms of dysphagia in the two groups were improved to varying degrees,in the observation group:19 cases were cured,32 cases were improved and 9 cases were ineffective.While in the control group:11 cases were cured,24 cases were improved and 25 cases were ineffective,the difference between the two groups was statistically significant(U=9.070,P<0.05).The effective rate was 85.0%in the observation group and 58.33%in the control group,there was no significant difference in the effective rate between the two groups(χ²=10.510,P<0.05).The dysphagia symptom scores of the two groups were improved,the score of observation group was(6.13±2.58),and that of control group was(4.52±2.39),and the difference between the two groups was statistically significant(t=7.280,P<0.05).Conclusion On the basis of conventional rehabilitation,training of dysphagia combined with pressing needle embedding needle for acupoint can better improve the symptoms of stroke patients with dysphagia,and has good safety,which has the feasibility of clinical application.