精准医疗时代背景下医学分子生物学实验设计的探讨

Research on the experimental design of medical molecular biology in the era of precision medicine

目的：通过设计综合实验，将精准医疗理念融入医学分子生物学实验教学，并探讨其效果。方法选择第四军医大学2012级和2013级八年制临床医学专业66名学生为教学对象；2013级36名学生为实验组，采用精准医疗相关的综合实验设计，将传统实验教学内容融会贯通；2012级30名学生为对照组，采用传统实验教学。教学结束后对两组学生实施实验理论和技能考核；通过问卷调查，让学生评估自身所受教学方法的效果；并统计两组学生课后提问次数≥1次的人数，以评估其学习积极性。采用SPSS 15.0，对两组学生各项数据行t检验或卡方检验。结果考核结果表明，实验组学生的理论与技能平均成绩均优于对照组；尤其在综合实验设计的考核部分，两组学生成绩分别为（16.7±2.04）分和（13.9±2.87）分，差异有统计学意义（P=0.000）。问卷结果显示，实验组学生对自身所受教学在提高学习兴趣、对精准医疗的认识、对临床科研的认识、创新能力、知识掌握程度等方面的满意度高于对照组，差异具有统计学意义（P〈0.05）。而学习积极性方面，实验组学生提问人数与比例高于对照组（P=0.000）。结论以精准医疗为切入点开展医学分子生物学综合性实验教学，可使各知识点不再孤立、碎片化；从而激发学生的学习兴趣，有利于学生形成与精准医疗时代特征相适应的临床思维，提高科研素养，培养创新意识。

Objective Through the design of comprehensive experiments, the precise medical philo-sophy was put into the medical molecular biology experimental teaching, and to explore its effect. Methods Eight-year medical students of Grade 2012 and Grade 2013 in the Fourth Military Medical University were chosen as the teaching subjects. Experimental group consisted of 36 students of Grade 2013, while control group consisted of 30 students of Grade 2012. Precision medicine-based learning was applied in experimental group while traditional learning method was adopted by the control group. At the end of the course, students of two groups were implemented theoretical and experimental skills assessment; through questionnaire students were required to evaluate the effect of teaching methods and the number of two groups of students who asked questions after class greater than or equal to 1 times was counted to evaluate the students＇ learning enthusiasm. SPSS 15.0 software was used to make t test and Chi-square analysis for the data of thestudents. Results The assessment results showed that the experimental group was better than control group, especially in the section of comprehensive experimental design [（16.7 ± 2.04） vs. （13.9 ± 2.87）, P=0.000]. The results from questionnaire showed that the satisfaction degree of experimental group was also higher than that of control group in many respects, including learning interests, innovation capability, knowledge mastery, cognition of precision medicine and clinical research, satisfaction with the teaching method （P〈0.05）. And students＇ learning enthusiasm and the proportion of the number of students asking questions in the experimental group were higher than the control group （P=0.000）. Conclusions Precision medicine-based learning not only changes the situation of slavish imitation and passive acceptance in traditional learning, but also arouses students＇ interest in study and helps students to cultivate clinical thinking, which is com-mensurate to the characteristics of precision-medicine era.