临床路径式教学在胃肠外科临床教学中的应用

Application of the teaching method of clinical pathway in clinical teaching in department of gastrointestinal surgery

目的 研究临床路径式教学在胃肠外科研究生教学中的应用效果.方法 将2012年7月～2013年7月于解放军总医院普通外科实习的42名研究生随机分为临床路径组和常规教学组,每组各21名.临床路径组采用临床路径式教学法进行胃肠外科培训,常规教学组中采用常规方法进行培训,6个月临床实习后进行考试,考试内容包括病历书写、病例分析、临床操作、理论知识,比较两组的培训效果.结果 病例分析考试,临床路径组分数[（89.95±4.25）分]高于常规教学组[（83.86±5.07）分],两组相比,差异有高度统计学意义（P＜0.01）;病历书写、临床操作及理论知识考试,临床路径组分数分别为（90.43±4.25）、（87.23±5.13）、（85.52±5.84）分,常规教学组分别为（89.62±4.26）、（84.38±4.73）、（83.33±4.75）分,两组相比,差异均无统计学意义（均P＞0.05）.结论 临床路径式教学能提高胃肠外科研究生病例分析考试成绩,有利于增强临床思维和工作能力.

Objective To study the application effects of the clinical-pathway-based teaching in teaching postgraduate students in department of gastrointestinal surgery. Methods 42 graduate students from July 2012 to July 2013 in De partment of General Surgery of the General Hospital of PLA were randomly divided into clinical pathway group and routine group, 21 cases in each group, students in clinical pathway group were trained with the teaching method of clini cal pathway for gastrointestinal surgery training; Students in conventional teaching group were trained with conventional methods. Examination was used to compare the effect of each teaching method after 6 months. The examination consists of medical record writing, case analysis, clinical operation, theory of knowledge. Results The score of case analysis, clinical operation test in clinical pathway group [（89.95±4.25） scores] was higher than that of the conventional teaching group [（83.86±5.07） scores], the difference was high statistically significant （P 〈 0.01）; the scores of medical record writing, clinical operation, and theoretical knowledge test in clinical pathway group were （90.43±4.25）, （87.23±5.13）, （85.52±5.84） scores respectively, and those scores in conventional teaching group were（89.62±4.26）, （84.38±4.73）, （83.33±4.75） scores respectively, there were no statistically differences between the two groups （all P 〉 0.05）. Conclu sion The teaching methods of clinical pathway can improve the teaching effect of case analysis of postgraduate students in department of gastrointestinal surgery and can strengthen the ability of clinical thinking and working.