多元化临床检验诊断路径在《实验诊断学》教学中的应用

Application of multiple clinical pathway training in clinical teaching of Laboratory Diagnostics

目的探讨以多元化临床检验路径训练为核心的教学在实验诊断学教学中的应用。方法选择第二军医大学临床医学五年制大三学生为研究对象，按完全随机设计法进行分组，授课内容包括理论授课及实验课操作。实验组（n=25）采用多元化临床检验诊断路径教学，理论授课采用“模拟开单、模拟解释、模拟诊疗”模式进行，实验课操作采用动画视频教学结合具体操作的模式进行；对照组（n=25）采用传统教学，采用幻灯片教学和操作展示进行；授课结束后进行临床理论及病例分析、实验操作考核评估；对实验组进行教学满意度调查。应用GraphPad Prism5．0统计软件对数据进行处理，进行t检验。结果实验组学生的临床理论及病例分杯总分、实验操作考核总分均高于对照组【（81．84±7．21）vs．（76．24±6．98）；（42．00±2．79）VS．（37．00±3．71）]，差异有统计学意义。调查结果发现，实验组学生对多元化临床检验诊断路径教学的满意度较高，尤其是在理论知识及“场景式”教学方面，满意度均大于80％，认为有助于提高学习兴趣和自身临床思维能力。结论以多元化临床检验路径训练为核心的教学有助于掌握临床路径的基本理念，提升医学专业素质，增强学习兴趣和提高教学质量，规范教学行为，促进教学相长。

Objective To explore the application and significance of multiple clinical pathway training oriented teaching model, in clinical teaching of laboratory diagnostic. Methods Totally 50 medical students enrolled in the Second Military Medical University from September to December in 2015 were divided into experimental group and control group. The course consists of theoretical teaching and experimental operation. The pathway group （n=25） were introduced into multiple clinical pathway training oriented teaching method. The theoretical teaching was carried out by ＂simulation examination application, simulation interpretation and simulation diagnosis and treatment＂, while the experimental course was carried out by using video teaching combined with actual operation. The control group was taught by traditional teaching method using slide teaching and operation display. The theoretical test including case study and operational skill tests were performed among students in both groups after 10 class hours training. The satisfaction questionnaires were conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. Differences were compared with independent sample t testing using GraphPad Prism 5.0 statistical software. Results The medical records about professional theoretical test including case study and operational skill test in the pathway group were superior to those in the control group with significant statistical difference （both P〈0.05）. The records of medical students were （81.84 ± 7.21）, （42.00 ± 2.79） in the pathway group and （76.24 ± 6.98）, （37.00 ± 3.71） in the control group. The questionnaire result showed that the pathway group＇s satisfaction was high, especially with the theoretical knowledge and ＂scene＂ teaching （higher than 80%）. The pathway group believed that multiple clinical pathway training helped to improve learning interest and clinical thinking ability. Conclusions Multiple clinical pathway training oriented teaching model is helpful for the medical students to achieve the basic idea of clinical pathway, improve the professional ability, enhance the interest of learning and the quality of teaching, standardize teaching and promote teaching and learning.