随患者轮转科室(追踪实习)中医脑病临床实习随机平行对照研究

A Randomized Parallel Controlled Study of Clinical Practice of Chinese Encephalopathy with the Rotation of the Patients

[目的]观察测随患者轮转科室(追踪实习)中医脑病临床实习效果。[方法]使用随机平行对照方法,将中医脑病科74名医学本科院校学生按抽签方法简单随机分两组。对照组37名传统实习-按科室轮转,按病房→针灸室→运动治疗室轮转实习,每周一次病例讨论,一次小讲课。实验组37名追踪实习-随患者诊疗移动,"病房→康复室"或"重症监护室→病房→康复室"跟随患者流动实习(不囿于某个诊疗科室),全程动态追踪患者诊疗过程,记录患者全程资料,直至出院,每三天集中汇报一次病况,带教老师组织分析讨论,总结经验和教训。脑病科总实习时间均为2个月。观测临床技能、临床思维能力。实习2个月,判定效果。[结果]临床技能、临床思维能力考核成绩实验组明显高于对照组(P<0.05),理论知识考核无明显差异(P>0.05)。[结论]随患者轮转科室(追踪实习)中医脑病临床实习,提升临床思维能力,全面掌握疾病诊疗能力,效果满意,值得推广。

[Objective] Observation of the patient with the rotation of the department （tracking practice） clinical encephalopathy clinical practice effect. [Methods] Using random parallel control method, 74 students of Chinese medicine encephalopathy were randomly divided into two groups according to the method of lottery. The control group of 37 traditional internships-according to the department rotation, according to the ward→acupuncture room→exercise treatment room rotation practice, once a week case discussion, a small lecture. The experimental group of 37 follow-up practice-with the patient diagnosis and treatment movement, ＂ward→ rehabilitation room＂ or ＂intensive care unit→ward→rehabilitation room＂ follow the patient flow practice （not confined to a clinic）, the whole process of tracking the patient diagnosis and treatment process, Record the entire patient information, until discharged, every three days to report a condition, with teachers to organize analysis and discussion, sum up experience and lessons learned. The total internship time of eneephalopathy is 2 months. Observation of clinical skills, clinical thinking ability. Internship 2 months to determine the effect. [Results] There was no significant difference between the two groups （P〉0.05）. There was no significant difference in the clinical knowledge and clinical thinking ability between the experimental group and the control group （P〈0.05）. [Conclusion] With the patient rotation department （tracing practice） Chinese medicine encephalopathy clinical practice, to enhance the clinical thinking ability, a comprehensive grasp of disease diagnosis and treatment capacity, satisfactory results, worthy of promotion.