以系统-器官疾病为中心的实验诊断学教学体系改革的调研

Research on the Reform of System-Organ Disease Centered Teaching System of Laboratory Diagnostics

目的 通过调研对传统的《实验诊断学》教学体系和教学法改革,探讨以系统-器官疾病为中心的内容设置以及联合以问题为基础的学习(problem-based learning,PBL)和以案例为基础的学习(case-based learning,CBL)的必要性。方法选择2021年9月-2022年9月在哈尔滨医科大学附属第四医院见习的五年制临床医学本科生109人和检验科住培医师12人为研究对象,发放自制调查问卷。问卷涉及实验诊断学理论课和实验课课程内容安排、教学方式和课程发展等9个问题。结果 95.87%(116/121)被调研者认为有必要将实验诊断学教学改为以系统-器官疾病为中心的教学体系。90.91%(110/121)以上被调研者认为有必要引入PBL联合CBL教学法。更多住培医师希望课程加强实践操作、临床思维培养和检验新知识的介绍,高年级本科生希望加强临床思维的培养,而低年级本科生则更重视基础理论的学习。除了传统的课上讲授外,被调研者更愿意选择微课教学,住培医师相较于本科生更倾向于分组病例讨论模式。结论 建立以系统-器官疾病为中心的教学体系是《实验诊断学》课程教学发展的趋势。PBL联合CBL教学法、分组讨论、互动教学有利于调动学生学习的积极性,能够引导学生主动获取知识、解决临床实际问题,帮助医学生快速适应临床实践。

Objective To investigate the reform of the traditional Experimental Diagnostics teaching system and teaching method,to explore the necessity of the system-organ disease centered teaching system and the implementation of problem-based learning(PBL)combined with case-based learning(CBL)teaching method.Methods A total of 109 five-year medical students from the Fourth Affiliated Hospital of Harbin Medical University and 12 resident physicians in rotation in the clinical laboratory of the Fourth Affiliated Hospital of Harbin Medical University from September 2021 to September 2022 were recruited and distributed questionnaires.The questionnaire involves 9 questions,including content arrangement,teaching method and curriculum development of Experimental Diagnostics theory course and experimental course etc.Results 95.87%(116/121)of the respondents believed that it was necessary to change the teaching system of Experimental Diagnostics to one centered on systems-organ diseases.90.91%(110/121)of the respondents thought it was necessary to introduce PBL combined with CBL teaching method.More resident physicians hoped that the curriculum should strengthen practical operation,clinical thinking training and the introduction of new knowledge.Senior undergraduates hoped to strengthen the training of clinical thinking,while junior undergraduates payed more attention to the study of basic theories.In addition to the traditional methods,more respondents chose micro class teaching;compared to medical students,resident physicians preferred to case group discussion.Conclusion The investigation results show that it is the trend of the teaching development of Experimental Diagnostics to establish the content system centered on systemic-organ disease.PBL combined with CBL,group discussion and interactive teaching are beneficial to arouse students'enthusiasm in learning,guide students to actively explore and acquire knowledge,solve clinical practical problems,and help medical students adapt to clinical6 China Continuing Medical Education,Vol.16,No.17 practice quickly.