外科学教学中医患沟通能力培养途径探索及实践

Exploration and Practice of the Approach of Physician-patient Communication Ability Training in Surgery Teaching

目的探讨在外科学翻转教学中应用医患沟通角色扮演和微课进行医学生医患沟通能力培养的效果及存在问题。方法采用实验对照的方法,选取甘肃中医药大学中医学五年制本科2014级80名学生和2013级71名学生作为研究对象,分别采用翻转课堂、医患沟通角色扮演、微课相结合的教学方法及LBL、PBL、CBL相结合的混合式教学方法。课程结束后,对两组学生的SEGUE评分和教学效果问卷调查进行比较分析。结果实验组学生对教学效果的评价优于对照组,差异均具有统计学意义(P <0.01)。实验组SEGUE量表中的医患关系的建立、信息收集、信息给予、理解患者、结束问诊5个方面评分及总分均优于对照组,差异均具有统计学意义(P <0.01)。结论医患沟通角色扮演和微课在外科学翻转教学中的应用有助于提高医学生的医患沟通能力并带动其他核心能力的提升,教学实施可行、合理、有效,且符合"以学生为中心"的教学理念。

Objective To explore the effects and problems of the roleplaying of physician-patient communication and micro-lessons in physicianpatient communication ability training with surgery flipped teaching.Methods Using the method of experiment and control,80 students of the five-year undergraduate course of traditional Chinese medicine in Gansu University of Traditional Chinese Medicine in 2014 and 71 students in 2013 were selected as the subjects of study.The teaching methods of flipping classroom,role playing of doctor-patient communication,microclass and LBL,PBL and CBL are adopted respectively.At the end of the course,the SEGUE score and teaching effect questionnaire of the two groups were compared and analyzed.Results The evaluation of the teaching effect of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.01).The score and total score of the SEGUE scale in the experimental group were better than those in the control group in the establishment of doctor-patient relationship,information collection,information giving,understanding of patients,and end of inquiry,the difference was statistically significant(P<0.01).Conclusion The application of role-playing of physicianpatient communication and micro-lessons in surgery flipped teaching could improve physician-patient communication ability and the other medical students’core competences.It was feasible,reasonable,effective and in accordance with the"student-centered"teaching philosophy.