典型案例联合实践教学在儿科临床教学中的应用研究

Application of typical case combined with practice teaching in pediatric clinical teaching

目的探讨典型案例联合实践教学在儿科临床教学中的应用。方法选取济宁医学院附属医院2019年9月至2020年1月儿科专业临床实习生80名作为研究对象,按照随机数字表法将其分为观察组(n=41)与对照组(n=39)。对照组采用常规带教,观察组采用典型案例联合实践教学模式。培训16周后,比较两组学生理论知识成绩、实践操作[直接观察操作技巧(direct observation of procedural skill,DOPS)评估、迷你临床评估演练(mini-clinical evaluation exercise,Mini-CEX)]评分与总体成绩。采用SPSS 19.0进行t检验、卡方检验或秩和检验。结果实习后,两组学生理论成绩中儿科常见疾病、疾病临床特点、发病原理、治疗方案、并发症均有提高,且观察组均高于对照组(P<0.05);实习后,两组DOPS评分、Mini-CEX评分均上升,且观察组高于对照组(P<0.05);实习后,观察组总体成绩优秀率为87.80%(36/41),高于对照组的69.23%(27/39);调查发现,观察组认为教学方案可以加深知识掌握程度、提高实习兴趣、提高综合能力、提高实习效率、提高临床思维能力的人数多于对照组。结论典型案例联合实践教学能够有效加深实习生对临床儿科理论知识的理解,提高实践操作能力,激发学习兴趣。

Objective To explore the application of typical case combined with practice teaching in the pediatric clinical teaching.Methods A total of 80 clinical interns majoring in pediatrics who practiced in the Affiliated Hospital of Jining Medical University between September 2019 and January 2020 were selected as the research subjects,and they were randomly divided into observation group(n=41)and control group(n=39).The control group adopted conventional teaching while the observation group were given typical case combined with practice teaching model.After 16 weeks of training,the theoretical knowledge,practical operation[direct observation of procedural skill(DOPS)evaluation,and mini-clinical evaluation exercise(Mini-CEX)]and overall performance were analyzed in the two groups of students.SPSS 19.0 was used for t test,chi-square test and rank sum test.Results After the internship,the theoretical scores of common pediatric diseases,clinical disease characteristics,etiopathogenesis,treatment regimen and complications were enhanced in the two groups,and the above scores in observation group were higher than those in control group(P<0.05).Besides,the DOPS scores and Mini-CEX scores of the two groups were increased,and the scores were higher in observation group than in control group(P<0.05).Furthermore,the overall excellent rate of the observation group was 87.80%(36/41),which was higher than 69.23%in control group(27/39).Survey found that the number of interns who believed that the teaching regimen could deepen the knowledge mastery degree,increase the internship interest and improve the comprehensive ability,internship efficiency and clinical thinking ability was more in observation group than in control group.Conclusion Typical case combined with practice teaching can effectively deepen the interns'understanding of theoretical knowledge of clinical pediatrics,improve the practical operation ability and arouse the interest in learning.