消化系统整合课程的实践与思考

Practice and exploration of integrated digestive system course

目的探讨医学生临床学习阶段消化系统课程的整合及其教学效果。方法选择2014年4月～12月在上海交通大学附属第一人民医院进行内科学和外科学学习的临床医学专业学生为研究对象，将其分为两组，上海交通大学医学院2011级五年制临床医学专业33名学生为实验组，南京医科大学2011级七年制临床医学专业26名学生为对照组。在学习消化系统内容时，实验组采用整合式课程教学形式，对照组采用传统课程教学形式。课程结束后，对师生进行相关的问卷调查，并分析和比较两组学生的理论考核成绩（消化系统知识内容）。结果实验组师生对消化系统整合式课程的内容设置、授课形式持肯定态度；学生对师资匹配表示满意，临床教师认为其授课能力有所提高，并期望通过培训进一步提高授课技巧。在内科学消化系统知识的理论考核中，实验组学生的成绩（25．85±4．42）分高于对照组学生的成绩（24．92±3．69）分，两者差异无统计学意义（P〉0．05）；在外科学消化系统知识的理论考核中，实验组学生的成绩（39．82±8．05）分低于对照组学生的成绩（46．69±3．31）分，两者差异具有统计学意义（P〈0．05）。结论临床学习阶段课程整合教学形式有助于提高医学生的学习效率和临床思维能力；同时，课程教学效果的提升需要通过建立保障机制、加强师资培训、改进评价方式等加以实现。

Objective To explore how to integrate the digestive system course in clinical study and compare the teaching effect. Methods Medical students studied in Shanghai General Hospital affilia- ted to Shanghai Jiao Tong University from April to December 2014 were divided into two groups. The group of 33 students of 2011 undergraduate of five-year program of Shanghai Jiao Tong University School of Medi- cine was the participating group. The group of 26 students of 2011 undergraduate of seven-year program of Nanjing Medical University was the control group. The participating group accepted the study of integrated digestive system course, while the control group accepted the classic digestive system course. The students were required to do questionnaires and have tests about their clinical theory on digestive system while the courses were finished. The data were collected and statistically analyzed. Results The teachers and students of the participating group took the positive attitude to the contents and teaching form of the inte- grated digestive system course. The teachers hope to improve their teaching skills. With respect to the as- sessment of the knowledge about the digestive system, the scores about the participating group were higher than the control group in traditional internal medicine digestive system examination （ 25.85 ± 4. 42 ） vs （24. 92 ± 3.69 ）, P 〉 0. 05, while the scores about the participating group were significantly lower thanthe control group in traditional surgery digestive system examination （39. 82 ± 8.05 ） vs （46. 69 ± 3.31 ）, P 〈 0. 05. Conclusions System integrated course is helpful to improve medical students＇ learning efficien- cy and clinical thinking ability. The teaching effect of system integrated course may be improved by estab- lishing supporting policies, strengthening teacher training and improving evaluation system.