以症状为导向的临床横向思维培养在妇科实习带教中的应用研究

Application of symptom-oriented clinical lateral thinking training in gynecology internship teaching

目的探讨以症状为导向的临床横向思维培养在妇科实习带教中的应用价值。方法选取166名于武汉大学人民医院妇I科实习的2017级及2018级临床医学5年制学生,将各年级学生随机分为试验组和对照组,其中2017级试验组43人、对照组46人,2018级试验组37人、对照组40人,试验组均采用以症状为导向的临床横向思维培养模式,对照组均采用传统教学。实习结束后采用出科考核和满意度调查的方法对教学质量予以评估。数据分析采用SPSS 24.0统计学软件进行t检验。结果将各年级两组学生的出科考核成绩分别比较,理论知识考试成绩相近;但病史采集、查体及病历分析能力成绩比较,试验组成绩要优于对照组(P<0.05),如2017级学生病历分析能力成绩:试验组(37.34±1.08)分vs.对照组(32.18±1.32)分;各年级两组学生满意度分别比较,试验组学生医患沟通、获取有效信息、临床病历分析、自学、查阅资料及团队协作能力较对照组高(P<0.05),激发学生学习兴趣的满意度明显高于对照组(P<0.05)。结论以症状为导向的临床横向思维培养模式有助于学生掌握妇科疾病的诊断思路和治疗原则,更有效地培养学生临床分析能力,提高医患沟通、获取有效信息、自学、查阅资料等能力,激发培养学生学习兴趣。

Objective To explore the value of symptom-oriented clinical lateral thinking training in gynecology internship teaching.Methods We enrolled a total of 166 medical students of the five-year program of grades 2017 and 2018 who would participate in internships at the First Department of Gynecology of Renmin Hospital of Wuhan University.They were randomly divided into experimental group and control group,with 43 students of grade 2017 and 37 students of grade 2018 in the experimental group and 46 students of grade 2017 and 40 students of grade 2018 in the control group.The experimental group was taught using a symptom-oriented clinical lateral thinking training mode,and the control group was taught using a traditional teaching mode.At the end of the internship,the teaching quality was evaluated by means of an exam and satisfaction survey.The data were analyzed using the t test with the use of SPSS 24.0.Results For both grades 2017 and 2018,the two groups had similar scores of theoretical knowledge,but the experimental group had significantly higher scores of medical history taking,physical examination,and medical record analysis compared with the control group(P<0.05);for example,among students of grade 2017,the score of medical record analysis was(37.34±1.08)in the experimental group and(32.18±1.32)in the control group The experimental group had significantly higher degrees of satisfaction than the control group in terms of doctor-patient communication ability,effective information acquisition ability,clinical case analysis ability,self-learning ability,literature search and review ability,team cooperation ability,and learning interest motivation(all P<0.05).Conclusions The symptom-oriented clinical lateral thinking training mode can help students master the diagnosis and treatment principles of gynecological diseases,improve their abilities of clinical analysis,doctor-patient communication,effective information acquisition,self-learning,and literature search and review,and motivate their interest in learning.