应用临床路径指导研究生临床实践的探索

To explore the application of clinical pathway on guiding clinical practice

目的探索应用临床路径教学法指导医学生临床实践的效果。方法首都医科大学附属北京天坛医院临床实习的2011~2012级40名医学研究生,根据随机数字表按1：1随机分成应用临床路径组及非临床路径组各20名,出科时进行闭卷考试和填写调查问卷,应用非参数检验和卡方检验进行统计分析。结果完成出科考核和填写问卷调查的人员各40人（100%）。临床路径组出科考核中位成绩（99）优于非临床路径组出科考核中位成绩为（86.50）（P〈0.01）。临床路径组调查问卷结果认为学习效率提高为18人,多于非临床路径组认为学习效率提高的8人（P〈0.01）。在独立获取临床有效信息能力提高方面临床路径组人数为20人,多于非临床路径组人数的10人（P〈0.01）。结论临床路径教学法对医学研究生的规范化、科学化的临床思维培养具有重要的作用。

Objective To explore the effect of teaching method with clinical pathway to guide the clinical practice of medical students. Method 40 graduate students of Beijing Tiantan Hospital associated Capital Medical University from 2011 to 2012, who were randomly divided into clinical pathway group and non clinical path group according to 1：1. There were 20 individuals in each group. Everyone attended the test on completion of a course and fit out questionnaire investigation.Non parametric test and Chi square test were used for statistical analysis. Result All individuals completed the examination and questionnaire investigation. The median score of the clinical pathway group on completion test was better than non clinical pathway group（99：86.50, P 0.01）. The questionnaire showed that the learning efficiency in clinical pathway group improved more significantly than non clinical pathway group（18：8,P0.01）.The ability of independent access to clinical information in clinical group improved more effectively than non clinical pathway group（20：10,P 0.01）. Conclusion The teaching method with clinical pathway was very important for medical postgraduate students to train the standardization, scientific clinical thinking.