诊断学教学中医学生临床思维能力培养的探索

目的 探讨实施诊断学案例教学对培养医学生临床思维能力的效果.方法 将在中山大学附属第三医院进行诊断学见习的2006级临床医学专业130名学生随机分为实验组(66名)和对照组(64名),两组学生分别采用典型案例教学方法及传统教学方法.教学结束后,对两组学生的病例考核成绩、平时考核成绩、体格检查考核成绩、标本考核成绩、理论考核成绩、病例分析考核成绩和总成绩进行比较.结果 比较实验组与对照组学生的病例考核成绩、平时考核成绩、体格检查考核成绩、标本考核成绩,其差异均无统计学意义;而实验组学生的理论考核成绩、病例分析考核成绩和总成绩则优于对照组学生,其差异具有统计学意义,P＜0.05.问卷调查结果显示:84.4%的学生对案例教学评价"很好",12.5%的学生对案例教学评价"好",3.1%的学生对案例教学评价"一般".结论 开展案例教学有助于医学生对物理诊断和实验诊断教学内容的连贯理解和掌握,有利于医学生临床思维能力的培养,有利于诊断学教学质量的提高.

Culturing on the ability of clinical thinking in practicing lessons of diagnostics

Objective For the current shortcomings in clinical probation of diagnostics, cussed the effect of case-based teaching in practicing lessons of diagnostic was discussed. Methods 130 students were randomly divided into two groups. 66 students in the experimental group were used case-based teaching,64 students in the control group were used traditional teaching. A comparison was made between the two groups in terms of the scores. Results It showed that there were no significant differences in scores of diagnostics, including the scores of histories, physical examination, samples between the experimental group and the control group. The scores of theories, case-analyzing and total scores obtained by experimental group were higher than those by the control group, P ＜ 0.05. The questionnaires showed that the casebased teaching was welcome by the students. The manner' s satisfactions was 84.4%, 12.5% ,3.1%.Conclusions The methods of case-based teaching helped the students well understand and master the contents of physical and laboratory diagnostics, enhance the ability of clinical thinking as well as promoting the teaching qualities of diagnostics.