转化理念结合病例讨论在胃肠外科教学中的应用

Application of case-based discussion combined with translational medicine in clinical teaching of gastrointestinal surgery

目的探讨转化医学理念结合病例讨论在胃肠外科临床教学中的应用。方法第二军医大学临床医学本科系2007、2008级学员各100名，每年级分为试验班50名，对照班50名；其中试验班又分为讨论班和综合班，各25名。讨论班采用病例讨论教学进行授课，综合班采用转化医学理念结合标准化病例讨论教学法；对照班采用传统教学法。结果试验班学员的成绩明显优于对照班；问卷调查显示90％的学员认为综合教学法优于传统法。试验班较对照班对临床问题探索的兴趣显著增加（90％ vs．50％）；医学职业的使命感和责任心明显加强（86％VS．64％）；科研思路的提炼能力明显提升（80％ vs．48％）；自身能力和素质得到提高（76％vs．50％）；学习深度和广度明显增加（80％ vs．52％）；自主学习与独立思考的意识增强（88％ vs．54％）。其中综合班在科研思路、自身能力和素质以及学习的深度及广度、自主学习与独立思考方面进步更加明显。结论转化医学结合病例讨论教学突破了传统教学法，更适应现代医学教学的要求，取得更好的教学效果，可在教学改革中进一步推广。

Objective To explore the application of case-based discussion combined with translational medicine teaching method in clinical teaching of gastrointestinal surgery. Methods Total-ly 100 undergraduates of clinical medicine in grade 2007 and 100 undergraduates in grade 2008 from the second military medical university were divided into experimental class（ 50 students, 25 in discus-sion class and 25 in comprehensive class） and control class （50 students）. Method of case-based dis-cussion was applied in discussion class; method of case-based discussion combined with translational medicine was employed in comprehensive class and traditional method was used in control class. Re-sults Scores in experimental class were superior to those in control class; questionnaire survey showed that 90% students thought the new model was better than the traditional model; the interests of students in exploring clinical problem in experimental class were increased （90% vs. 50% ） ;the sense of mis- sion and responsibility was strengthened （86% vs. 64% ） ;the scientific research thinking was more ac- tive （80% vs. 48% ） ; the individual ability and quality were enhanced （76% vs. 50% ）, the depth and width of study were markedly increased （80% vs. 52% ） , the consciousness of independent study and thinking was strengthened （88% vs. 54% ）. Comprehensive class had more obvious improvements in scientific research thinking, individual ability and quality, depth and width of study, independent study and thinking. Conclusions The new teaching model which combined translational medicine with case discussion breaks through the traditional model and adapts to the requirements of modem medi-cine, it can enhance the teaching effect and worth promoting in educational reform.