临床路径在胸外科实习教学中的应用

目的探讨临床路径在胸外科实习教学中的应用价值和实施效果。方法将在胸外科进行实习的临床医学专业本科生76人随机分为两组；针对实验组学生（35人），制定详细的教学路径表，指导学生按照教学路径表进行临床实习；针对对照组学生（41人），实施传统临床带教。两组学生实习期满后统一进行考试，各项成绩比较采用两独立样本t检验。结果实验组学生的临床病例分析成绩和总成绩分别为（42．26±3．93）分、（81．69±6．16）分，明显高于对照组[（38．88±4．76）分和（77．39±6．83）分]，差异有统计学意义（P值分别为0．001、0．006）。结论在胸外科实习教学中应用临床路径可以提高教学效果；应结合实践，不断完善临床路径教学及其考评方法。

Application of clinical pathway in clinical practice teaching of thoracic surgery

Objective To probe into application of clinical pathway on clinical practice teach- ing in thoracic surgery, and evaluate its effect. Methods 76 students were randomized into two groups： 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway; and the other 41 students were control group. The final examination included four parts： ①theoretical examination account for 20% of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ② clinical operational skills test account for 30% of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera- tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [ （42.26 ± 3.93） points and （81.69 ± 6.16） points, respectively]were obviously higher than that in control group[（38.88 ± 4.76） points and（77.39 ± 6.83） points, respectively]; There were significant differences between the two groups （P values was 0.001 and 0.006, respectively）. Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord- ing to teaching practice.