疑难病例讨论式教学在消化内科临床教学中的应用

目的 总结疑难病例讨论式教学在临床教学中应用的经验，并展望其推广价值，为专科医师培养基地的申请、评估做好准备工作。方法 通过回顾皖南医学院第一附属医院消化内科近5年来持续开展、探索和完善疑难病例讨论式教学的实践经验，对该教学方式的教学准备、教学实施过程和教学效果反馈结果进行总结。分析该教学方式的意义和优势，并展望其价值。教学效果的反馈采用开展小型师生座谈会和不记名调查问卷的方式进行。结果 疑难病例讨论式教学在实践过程中不断完善，并被纳入科室教学制度进行管理。相关制度对教学准备和教学过程制定了详细要求。师生座谈会一致认为该教学方式能够调动学员或住院医师学习的主动性和积极性，使他们更好地掌握理论知识、提高临床思维能力。教学效果反馈的问卷显示：80%以上的学员或住院医师认为疑难疾病的诊治能力得到明显提高；90%以上的学员或住院医师认为该教学方法具有教学查房等其他教学方式不可替代的作用；认为疑难病例讨论式教学应作为固定的教学方式。另外有少部分(1.2%)学员建议2个月开展一次，避免频次过多而导致一定程度上增加学习负担。结论 疑难病例讨论式教学是一种重要的临床教学方法，应当在住院规培医师和专科规...

Application of discussion teaching of difficult cases in clinical teaching of gastroenterology

  Objective  To summarize the experience of discussion teaching of difficult cases in clinical teaching, look forward to its popularization value, and prepare for the application and evaluation of specialist training base.  Methods  This paper reviewed the practical experience of the discussion teaching of difficult cases in clinical teaching of Department of Gastroenterology of the First Affiliated Hospital of Wannan Medical College over the past 5 years. Then, this paper summarized the teaching preparation, teaching implementation process and feedback results of the teaching effect. Finally, the significance and advantages of this teaching method were analysed and its value prospected. The feedback on the teaching effect was carried out using small teacher-student seminars and anonymous questionnaires.  Results  The discussion teaching of difficult cases had been continuously improved in the process of practice, and was incorporated into the Department Teaching System for management. The systems formulate detailed requirements for the preparation and process of teaching. The teachers and students agreed that this teaching method could mobilize the students' or residents' learning initiative and enthusiasm, so that they could better master theoretical knowledge and improve their clinical thinking ability. The questionnaire on teaching effect showed that more than 80% of students or residents believed that the ability to diagnose and treat difficult diseases had been significantly improved, more than 90% of the students or residents thought that the role of this teaching method cloud not be replaced by other methods such as teaching rounds. It is agreed that it should be used as a fixed teaching method. Moreover, a small number of students (1.2%) suggested that it should be carried out once every two months to avoid increasing the learning burden caused by excessive frequency.  Conclusion  The discussion teaching of difficult cases is an important clinical teaching method. It should be carried out and implemented in the teaching base for resident and standardised training hospitals.