医疗纠纷案例分析结合PBL模式在骨科临床教学中的应用

Application of PBL mode integrated with medical dispute case analysis in orthopedic clinical teaching

目的通过临床典型医疗纠纷案例分析结合PBL模式在骨科学临床教学中的应用,来探讨该研究在临床教学中的效果及实际操作的可行性,及对学生的学习策略、学习动机、学习成绩产生的影响。方法将2012—2013年度在蚌医一附院骨科实习的84名临床医学专业五年制本科学生随机分为医疗纠纷案例分析结合PBL模式教学组和传统教学组,分别对2组进行骨科实习教学,实习结束后进行考核,通过比较学生考试成绩来评价教学成果,并通过问卷调查形式来评估2组学生的学习态度和接受程度。结果医疗纠纷案例分析结合PBL模式组成绩明显高于传统组,医疗纠纷案例分析结合PBL模式更能有效激发学生的学习兴趣和求知欲望,有助于提高学生分析、解决临床问题的能力和医患沟通技能,培养医疗纠纷防范意识和创新思维能力。结论大学教学改革的热点是教学方法的改革,目的在于提高学生的临床实践能力、综合知识和自主学习能力。以医疗纠纷案例为依托结合PBL教学模式的教学依据案例教学原则进行教学,强调在有意义的环境中学习,这不仅符合学习规律,有利于培养学生的临床实践能力,还能促进学生学科知识的增长和自主学习能力的提高,取得了很好的临床教学效果,受到学生的普遍好评,在教授专业知识同时向学生渗透医疗纠纷防范教育,为学生在临床实习和以后工作中尽可能减少医疗纠纷打下良好的基础,值得在外科教学及整个临床教学中应用和推广。

Objective To adopt the clinical typical case analysis of medical disputes combined PBL in orthopedic clinical teaching, and investigate the feasibility and practical effect of this teaching method, and the influences on the learning strategies, motivation, academic record of student. Methods Total 84 clinical medicine undergraduate students practiced in our department from 2012 to 2013 were assigned into study group and control group. The study group received PBL combined with clinical typical case analysis of medical disputes, while the control group received conventional teaching methods. After the clinical practice teaching, the test scores were used to evaluate teaching achievements. The questionnaires were employed to assess the learning attitude and acceptance. Results The score in the study group was significantly higher than that in the control group. PBL model combined with medical dispute case analysis stimulated the interest of students in learning and their desire for knowledge, and improved the ability of students to analyze and solve clinical problems and skills of doctor-patient communication, train their of awareness of prevention of medical disputes and creative thinking. Conclusion Hot spots of college teaching reform is the reform of teaching methods, the purpose of reformation is to improve the students＇ ability in clinical practice, comprehensive knowledge and self-learning. PBL combined with clinical typical case analysis of medical disputes is based on case teaching principles, emphasize on the learning in a meaningful context, which meet the laws of learning, help students develop the ability in clinical practice, also promote the growth of knowledge to improve student discipline and self-learning ability. This method has achieved good clinical teaching effectiveness, and is well received by students. The penetration of medical disputes prevention education for students in clinical practice together with the professional knowledge education will help the students to decrease the medical disputes in their works. It is worth application and promotion in the surgical teaching and clinical teaching.