个体化医学理念在胃肠外科胃癌课程临床教学中的实施

Implementation of personalized medicine concept in the clinical teaching of gastrointestinal surgery

目的：探讨个体化医学理念在胃癌课程临床教学中的应用价值。方法将2008级本科学员共100人随机分为实验班（50人）和对照班（50人）。实验班在胃癌临床教学中引入个体化医学的理念和方法，实施个体化医学教学；对照班进行常规教学。通过问卷调查和答题考核评估教学效果，结果分别采用t检验和卡方检验进行统计学分析。结果课程满意度问卷调查结果显示：88人（88%）对新的教学方式有浓厚兴趣，91人（91％）认为新教学方式更好。课程效果问卷调查显示：实验班50人中，44人（88%）认为新教学方式能增加探索临床问题的兴趣、43人（86%）认为能优化胃癌疾病诊治流程、40人（80%）认为能增强医患沟通、42人（84%）认为能拓宽诊治思路、45人（90%）认为能增强医学哲学辩证思维能力，相对于对照班学生评价自身所受教学方式在各调查项目上的选择情况[24人（48%）、23人（46%）、26人（52%）、25人（50%）、26人（52%）]，差异均有统计学意义（P＜0.05）。实验班考核平均成绩为（86.26＆#177;5.72）分，相比对照班的（77.00＆#177;6.16）分，差异有统计学意义（P=0.000）。结论在胃癌教学中贯彻个体化医学理念，体现了个体化医学发展的要求，对于临床教学改革具有一定的指导意义，值得推广。

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class （EC） and control class （CC）, with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students （88%） were inter-ested in the new course, 91 students （91%） thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC：44 students （88%） thought that the new course could increase interests of clinical question;43 students （86%） thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students （80%） thought that the new course could strengthen the communication between doctors and patients; 42 students （84%） thought that the new course could widen the minds in diagnosis and treatment;45 students （90%） thought that the new course could enhance the ability of dialectical thinking;while in＆amp;nbsp;CC, the proportions of the above issues were 24（48%）, 23（46%）, 26（52%）, 25（50%） and 26（52%） （all P＆lt;0.05）. Furthermore, there were statistical difference in auerage scores bertween EC and CC [（86.26 ＆#177;5.72） vs. （77.00 ＆#177;6.16）] （P=0.000）. Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.