外科实习教学中学生临床思维能力培养的探讨

目的探讨外科实习教学中提高医学实习生临床思维能力的教学方法和途径。方法选择在山东医学高等专科学校附属医院泌尿外科实习的山东医学高等专科学校2010级实习生40例为实验组,选择同期在临沂市中医医院泌尿外科实习的山东医学高等专科学校2010级实习生40例为对照组,实验组采用新的外科学实习带教方法,对照组采用传统带教方法,通过调查问卷,量化、分析两组外科实习前后临床思维能力的变化,分析医学实习生临床思维能力现状。结果实习前实验组和对照组临床思维能力考核成绩[（63.33±4.72）分、（62.67±5.67）分]比较差异无统计学意义（t=0.87,P〉0.05）;实验组实习后临床思维能力考核成绩为（79.52±4.83）分,实习后优于实习前,差异有统计学意义（t=14.20,P〈0.05）;对照组实习后临床思维能力考核成绩为（73.25±4.69）分,实习后优于实习前,差异有统计学意义（t=9.09,P〈0.05）;实习后实验组和对照组比较,实验组优于对照组,差异有统计学意义（t=5.53,P〈0.05）。实习生临床思维能力的调查结果显示,65.3%的调查者认为目前临床医学类实习生临床思维能力一般,27.4%的调查者认为目前临床医学类实习生临床思维能力差或者非常差。结论新的外科学实习带教方法有利于培养、提高学生的临床思维能力;带教老师重视、实习生的努力和相关制度的建设才能保障实习教学效果。

The research of development of clinical thinking ability in medical students in surgical practice teaching

Objective To research the teaching methods and ways of improving the clinical thinking ability in surgical practice teaching.Methods 40 medical interns of 2010 grades in Shangdong Medical College studied in Department of Urinary Surgery in Affiliated Hospital of Shangdong Medical College were selected as experimental group,40 medical interns of 2010 grades in Shangdong Medical College studied in Department of Urinary Surgery in Traditional Chinese Medicine Hospital in Linyi City were selected as control group;new ways of surgical teaching methods were used in experimental group,traditional ways of surgical teaching methods were used in control group.Changes of clinical thinking ability before and after the surgical practice was quantized and analyzed through the questionnaire,current situation of medical interns clinical thinking ability was analyzed.Results The difference of clinical thinking ability assessment scores between experimental group and control group before the surgical practice [（63.33 ±4.72）,（62.67± 5.67） scores] were not statistically significant（t = 0.87,P 0.05）;clinical thinking ability assessment scores in experi mental group after the surgical practice were（79.52±4.83） scores,the scores after the surgical practice were better than those before the surgical practice,the differences were statistically significant（t = 14.20,P 0.05）;clinical thinking ability assessment scores in control group after the surgical practice were（73.25 ±4.69） scores,the scores after the surgical practice were better than those before the surgical practice,the differences were statistically significant（t = 9.09, P 0.05）;the clinical thinking ability assessment scores after the surgical practice in experimental group were better than those in control group,the differences were statistically significant（t = 5.53,P 0.05）.Medical interns clinical thinking ability were deemed to be common by 65.3% investigators according to the survey results of medical interns clinical thinking ability,medical interns clinical thinking ability were deemed to be bad or very bad by 27.4% investigators according to the survey results of medical interns clinical thinking ability.Conclusion The new surgical teaching methods are better for improving the clinical thinking ability of medical students.The attention of teachers,the efforts of students and the system construction are the guarantee to improve practice teaching.