神经内科临床实习生临床思维能力培养实践

目的 探讨提高神经内科临床医学实习生临床思维能力的方法。方法 选择2017年至2018年临床医学实习生为研究对象，2018年为试验组（98人），2017年为对照组（95人）。试验组实施临床思维能力培养，对照组采用传统常规的方法培养。实习结束前，采用自制的《临床医学实习生临床思维能力调查问卷》进行调查，评价教学效果。使用SPSS 14.0进行t检验和卡方检验。结果 试验组与对照组均存在临床思维的片面性、表像性、定势性、被动性、懒惰性、简化性、混乱性等问题，试验组存在的临床思维方面问题较对照组明显下降（P<0.001），其中试验组的临床思维的片面性、表像性、定势性、被动性、懒惰性方面与对照组比较差异有统计学意义（P<0.05）。除语言沟通与表达能力外，试验组的其他临床思维能力自评得分与对照组比较差异都有统计学意义（P<0.05）。试验组的出科考核成绩与对照组比较差异也有统计学意义（P<0.05）。结论 临床医学生在神经内科实习阶段实施临床思维训练，有利于培养学生的临床思维能力，提高人才培养质量。

Training practice of clinical thinking ability of clinical interns in neurology department

Objective To explore the methods of improving the clinical thinking ability of clinical medical interns in neurology department.Methods Clinical medical interns from 2017 to 2018 were selected as the research subjects. The clinical medical interns in 2018 and in 2017 were set as the experimental group (98 people) and the control group (95 people). In the clinical practice of the neurology department, the experimental group was trained in clinical thinking ability, and the control group was trained by the traditional methods. Before the end of the internship, the self-made Clinical Medical Interns Clinical Thinking Ability Questionnaire was used to evaluate the teaching effect. SPSS 14.0 was used for t-test and Chi-square test.Results The experimental group and the control group had the problems of one-sidedness, appearance, fixedness, passivity, laziness, simplification, confusion of clinical thinking. The clinical thinking problems in the experimental group were significantly improved than those in the control group (P<0.001). There were significant differences in clinical thinking between the experimental group and the control group in terms of one-sidedness, appearance, fixedness, passivity and laziness (P<0.05). In addition to language communication and expression ability, the self-assessment score of clinical thinking ability in the experimental group was statistically different from that in the control group (P<0.05). Compared with the control group, there were also significant differences in the examination results of the experimental group (P< 0.05).Conclusion The implementation of clinical thinking training in neurology practice is conducive to cultivating students'' clinical thinking ability and improving the quality of personnel training.