疑难病例讨论式教学在消化内科临床教学中的应用

刘少锋; 左秀玲; 何池义; 牛小平

doi:10.16766/j.cnki.issn.1674-4152.002743

疑难病例讨论式教学在消化内科临床教学中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002743

1.
皖南医学院第一附属医院消化内科，安徽芜湖 241000
2.
皖南医学院第一附属医院教育处

基金项目:

安徽省高等学校省级质量工程项目 2020jyxm2110

详细信息

通讯作者:
刘少锋, E-mail: 2207117015@qq.com

中图分类号: R192 R57
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- 文章访问数: 238
- HTML全文浏览量: 69
- PDF下载量: 17
- 被引次数: 0
出版历程
- 收稿日期: 2021-12-11
- 网络出版日期: 2022-12-30

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

1.
Department of Gastroenterology, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China

摘要

摘要: 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培医师教学基地常规开展和实施。
- 疑难病例讨论 /
- 临床教学 /
- 住院医师 /
- 规范化培训 /
- 消化内科
Abstract: 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.
- Discussion teaching of difficult cases /
- Clinical teaching /
- Resident physician /
- Standardised training /
- Gastroenterology

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表 1 2016级及2017级住培学员关于疑难病例讨论式教学的问卷调查结果[人(%)]

Table 1. Questionnaire survey results of residential trainees of 2016 and 2017 on discussion teaching of difficult cases [cases (%)]

年级	人数	提高疑难疾病的诊治能力的评价			教学查房等其他方式无法替代	应作为固定教学方式
年级	人数	明显提高	有所提高	无作用	教学查房等其他方式无法替代	应作为固定教学方式
2016级	85	71(83.5)	14(16.5)	0	79(92.9)	85(100.0)
2017级	103	84(81.6)	19(18.4)	0	96(93.2)	103(100.0)

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参考文献(15)

[1]	张伟, 居益君, 陈露, 等. 分级诊疗背景下构建疑难病引导服务中心的探索与实践[J]. 江苏卫生事业管理, 2020, 31(9): 1178-1180. doi: 10.3969/j.issn.1005-7803.2020.09.019 ZHANG W, JU Y J, CHEN L, et al. Exploration and practice of building difficult disease guidance service center under the background of hierarchical diagnosis and treatment[J]. Jiangsu Health System Management, 2020, 31(9): 1178-1180. doi: 10.3969/j.issn.1005-7803.2020.09.019
[2]	郎卫红, 白瑞敏, 李金龙, 等. 专业认证标准下规范化临床技能培训中心建设的探索与实践[J]. 赤峰学院学报(自然科学版), 2021, 37(11): 64-67. doi: 10.3969/j.issn.1673-260X.2021.11.017 LANG W H, BAI R M, LI J L, et al. Exploration and practice on the construction of standardized clinical skill training center under professional certification standard[J]. Journal of Chifeng University (Natural Science Edition), 2021, 37(11): 64-67. doi: 10.3969/j.issn.1673-260X.2021.11.017
[3]	邵伟华, 韩晓黎, 陈虹. CBL教学模式在呼吸与危重症医学科专科医师规范化培训中的应用[J]. 现代医药卫生, 2020, 36(20): 3338-3340. doi: 10.3969/j.issn.1009-5519.2020.20.048 SHAO W H, HAN X L, CHEN H. Application of CBL teaching model in standardized training of respiratory and critical care medicine specialists[J]. Journal of Modern Medicine & Health, 2020, 36(20): 3338-3340. doi: 10.3969/j.issn.1009-5519.2020.20.048
[4]	余姣, 李成忠, 薛建亚, 等. 基于CBL+PBL的创新能力培养模式在病例讨论教学中的应用探索[J]. 中国高等医学教育, 2019(9): 70-71, 94. doi: 10.3969/j.issn.1002-1701.2019.09.034 YU J, LI C Z, XUE J Y, et al. Application of innovation ability education pattern based on CBL and PBL in the case discussion teaching[J]. China Higher Medical Education, 2019(9): 70-71, 94. doi: 10.3969/j.issn.1002-1701.2019.09.034
[5]	张萍. 建立专科医师培训考核制度的思考[J]. 中华实用诊断与治疗杂志, 2019, 33(5): 510-511. doi: 10.13507/j.issn.1674-3474.2019.05.028 ZHANG P. Thoughts on establishing the evaluation system of specialist training[J]. Journal of Chinese Practical Diagnosis and Therapy, 2019, 33(5): 510-511. doi: 10.13507/j.issn.1674-3474.2019.05.028
[6]	韩慧萍. 新模式疑难病例讨论在老年科临床教学中的效果观察[J]. 人人健康, 2019(24): 81. https://www.cnki.com.cn/Article/CJFDTOTAL-RRJK201924115.htm HAN H P. Observation on the effect of new model of difficult case discussion in geriatric clinical teaching[J]. Health for Everyone, 2019(24): 81. https://www.cnki.com.cn/Article/CJFDTOTAL-RRJK201924115.htm
[7]	王梦阳, 栾国明. 文献学习结合病例分析报告会在神经科临床教学中的应用[J]. 继续医学教育, 2017, 31(12): 18-19. doi: 10.3969/j.issn.1004-6763.2017.12.010 WANG M Y, LUAN G M. The application of journal club combined with case discussion in the clinical teaching of neurology[J]. Continuing Medical Education, 2017, 31(12): 18-19. doi: 10.3969/j.issn.1004-6763.2017.12.010
[8]	张勃华, 姜昌镐. 自然辩证法与医学相结合: 临床思维的讨论[J]. 吉林医学, 2019, 40(1): 173-175. https://www.cnki.com.cn/Article/CJFDTOTAL-JLYX201901082.htm ZHANG B H, JIANG C G. Combining Dialectics of Nature with medicine: A discussion of clinical thinking[J]. Jilin Medical Journal, 2019, 40(1): 173-175. https://www.cnki.com.cn/Article/CJFDTOTAL-JLYX201901082.htm
[9]	韩天栋, 宋健, 田野. 住院医师规范化培训中辩证思维能力的培养[J]. 医学与哲学, 2020, 41(8): 26-29. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX202008006.htm HAN T D, SONG J, TIAN Y. The cultivation of dialectical thinking ability in the standardized training of residents[J]. Medicine and Philosophy, 2020, 41(8): 26-29. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX202008006.htm
[10]	李妍妍, 张阳阳. 唯物辩证思维在普通内科临床带教中的应用[J]. 教育教学论坛, 2021(20): 21-24. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJU202120006.htm LI Y Y, ZHANG Y Y. Application of materialistic dialectical thinking in clinical teaching of general internal medicine[J]. Education Teaching Forum, 2021(20): 21-24. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJU202120006.htm
[11]	唐欢, 曹明燕, 张子阳, 等. "传帮带"模式应用于肾内科住培生培养的探讨[J]. 医学食疗与健康, 2021, 19(8): 164-165. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSL202108082.htm TANG H, CAO M Y, ZHANG Z Y, et al. Discussion on the application of "guide" mode to resident culture in nephrology department[J]. Medical Diet and Health, 2021, 19(8): 164-165. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSL202108082.htm
[12]	杜晓明, 曾靖, 刘玲芳, 等. 浅谈超声诊断疑难病例讨论制度在住院医师规范化培训中的应用[J]. 中国研究型医院, 2021, 8(2): 9-12. https://www.cnki.com.cn/Article/CJFDTOTAL-YJXU202102005.htm DU X M, ZENF J, LIU L F, et al. Discussion on the application of the discussion system of difficult cases in the standardized training of resident doctors[J]. Journal of Chinese Research Hospitals, 2021, 8(2): 9-12. https://www.cnki.com.cn/Article/CJFDTOTAL-YJXU202102005.htm
[13]	曾莉, 向波, 徐畅, 等. 区域疑难病例讨论在小儿外科住院医师培养中的实践[J]. 继续医学教育, 2020, 34(10): 19-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202010011.htm ZENG L, XIANG B, XU C, et al. The practice of regional difficult case discussion in the residency training of pediatric surgery[J]. Continuing Medical Education, 2020, 34(10): 19-21. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202010011.htm
[14]	赵海燕, 樊东升. 多种模式疑难病例讨论在神经科临床教学的应用[J]. 中国临床医生杂志, 2018, 46(1): 120-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS201801048.htm ZHAO H Y, FAN D S. Application of multimodal discussion of difficult cases in clinical teaching of neurology department[J]. Chinese Journal for Clinicians, 2018, 46(1): 120-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS201801048.htm
[15]	杜思霖, 李信友, 周旸, 等. 疑难病例讨论在医学影像技术专业实习教学中的价值[J]. 继续医学教育, 2021, 35(4): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202104010.htm DU S L, LI X Y, ZHOU Y, et al. The values of difficult cases discussion in practice period among the medical imaging technologists[J]. Continuing Medical Education, 2021, 35(4): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY202104010.htm