构建以病例为中心的临床思维培养路径探索和实践

Exploration and Practice of Constructing a Case Centered Clinical Thinking Training Path

临床思维能力是临床工作人员根据患者临床相关信息确立诊断、鉴别诊断从而做出治疗决策及预后评估的思维能力。具备成熟的临床思维能力是医学生向临床医生转变的重要标志。传统实习阶段面临临床环境的随机性、信息收集的局限性、效果反馈的滞后性等问题,不能充分发挥信息化在临床教学实践环节的效能。通过构建以病例为中心的临床思维系统创新实习路径,规范病例讨论过程,学生通过临床思维训练系统可以依次进行问诊、体格检查、辅助检查、处置行为,系统能根据学生的选择进行评分,充分发挥信息化在临床教学实践环节的效能,拓展医学生临床思维的深度和广度。

Clinical thinking ability is the staff to establish diagnosis and differential diagnosis based on patients'clinical related information so as to make treatment decisions and prognosis evaluation.Having mature clinical thinking ability is an important sign for medical students to transform into clinicians.The traditional practice stage is faced with such problems as the randomness of the clinical environment,the limitations of information collection,and the lag of effect feedback,which can not give full play to the effectiveness of informationization in clinical teaching practice.Through the construction of case centered clinical thinking system and innovative practice path,the process of case discussion is standardized.Through the clinical thinking training system,inquiry,physical examination,auxiliary examination and disposal behaviors can be carried out in turn.The system will score according to students'choices,give full play to the effectiveness of information in clinical teaching practice,and expand the depth and breadth of medical students'clinical thinking.