呼吸内科临床路径式教学实施及效果分析

目的探讨分析临床路径式教学在呼吸内科学中的教学效果。方法以2007至2009年呼吸内科实习的70名临床医学专业本科学生为研究对象，利用随机数据表法分为对照组（35人）和试验组（35人）。对照组采用传统的临床教学方式。试验组实行临床路径（clinical pathway，CP）教学；5～6人1组，教师预先向各组提供1份统－CP文本，然后根据CP中诊断、鉴别诊断及治疗的固定程序展开渐进式的提问及讨论。实施一定周期后，通过实习考核、问卷进行评价，采用SPSS 17．0软件进行统计学分析。结果试验组总平均成绩为（90．00±4．00）分，对照组总平均成绩为（76．00±7．20）分，2组比较差异有统计学意义（P=O．001）。从激发学习兴趣（P=0.002）、提高分析问题能力（P=0．004）、提高自学能力（P=O．001）、加深理解基本概念（P=0．112）、提高创新能力（P=O．005）、提高学习效率（P=O．034）、提高临床综合能力（P=O．016）、提高语言表达能力（P=O．000）等方面对两种教学方式进行评价，显示临床路径式教学可显著提高教学效果。结论临床路径教学对培养学生诊断思维和解决临床实际问题能力具有明显的优势，其实施效果优于传统教学。

Effect analysis of clinical pathway teaching method in respiratory medicine

medicine. Methods Seventy clinical medical students of our department during 2007 to 2009 were randomly divided into two groups. The control group （35 students） was treated by traditional teaching ways, while the experimental group （35 students） was treated by clinical pathway teaching ways, with 5 to 6 students forming a small group. Teachers provided one copy of the CP version to each person in advance. Then progressive questions and discussions were conducted according to the diagnosis, dif- ferential diagnosis and treatment of CP. After its implementation for a certain time, students were co- mprehensively assessed by the practice examination and questionnaire and the statistical analysis was performed by using SPSS 17.0 version statistics software. Results The experimental group＇s total aver- age score was （90.00 ± 4.00） points, while the control group＇s total average score was （76.00 ± 7.20） points. There was significant difference between the two groups（P=0.001）. The effect of these two kinds of teaching was evaluated and compared in stimulating interest in learning（P=0.002）, improving the analytical ability （P=0.004）, improving self-study ability（P=0.001 ）, deepening the under-standing of the basic concepts（P=0.112）, improving the innovation ability （P=0.005）, improving the efficiency of learning （P=0.034）, improving clinical comprehensive ability （ P=0.016）, and improving the ability of language expression（P=0.000）, showing that teaching method of clinical pathway could significantly improve clinical teaching effect, and there was statistically significant difference between them. Conclusion Clinical pathway teaching has obvious advantages in cultivating students＇ diagnostic thinking and clin-ical ability to solve practical problems, and therefore it has better clinical teaching effect than the tra-ditional teaching method.