临床实习案例库在肛肠外科教学中的应用

Clinical Internships Teaching Application in the Anorectal Surgery

目的评价临床实习案例库在肛肠外科教学中的应用效果,评价其应用价值,总结教学经验。方法 2013年—2014年,至医院肝肠外科实行学生50名,将学生随机分为传统组、改进组各25例,传统组据以往的科室带教经验进行实习教学,案例主要涉及的经典患者包括直肠癌、混合痔、肠梗阻、结肠癌四个病种5~10个,改进组案例库在200~300个之间,并通过软件建立阅片系统,进行交互式阅片、模拟训练,为学生提供自由阅片平台,对比相关指标。结果实习后,传统组与改进组CTDI-CV评分高于实习前、改进组高于传统组,改进组理论、实践测试水平高于传统组,改进组总体评价、学习难度、师生交流、同学交流、学习趣味性评分高于传统组,差异具有统计学意义（P〈0.05）;改进组认为案例少4.0%、有从其他渠道获取案例行为16.0%发生率低于传统组88.0%、76.0%,差异具有统计学意义（P〈0.05）。结论案例库的建立为肝肠外科临床实习教学提供了新的途径,丰富了教学内容、形式,提高了教学质量。

Qbjective To evaluate clinical internships application in anorectal surgery teaching effect, and its value, and summarize teaching experience. Methods 2013-2014, deeply surgery 50 students to the hospital, according to grade, students were randomly divided into conventional group, improvement group, traditional group according to the former department teaching experience to carry on practice teaching, classic cases mainly involved patients including colorectal, mixed hemorrhoid, intestinal obstruction, colon four diseases 5-10, putted forward improving group between 200-300, and through the software to establish a system of reading and reading interactive simulation training, free reading platform for students,comparing related indicators. Results After the internship, traditional group and improvement group CTDI-CV score higher than before, improvement group was higher than traditional group, improvement group theory, the practice test level higher than traditional group, improve the overall evaluation, group learning difficulty, communication between teachers and students, students exchanges, learning interesting score higher than traditional group, difference has statistical significance（P 0.05）; Improvement group think case has 4.0% less, from other sources for behavior incidence of 16.0% 88.0%, 76.0%less than traditional group, difference had statistical significance（P 0.05）. Conclusion Internships established provides a new way for surgery clinical practice and improve teaching quality.