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从问诊反馈信息看中西医结合本科的见习教学方向

Reflections from Feedback Information on Teaching Direction of Medical History Inquiry for Integrated Traditional Medicine and Western Medicine Undergraduates in Clinical Practice

教育研讨 / 2021,3(2)：182-188 / 2021-04-26 416 380

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• 作者： 王小红      陈小燕      鲁可      陈婉玲      何兆初     
• 单位：

  广州医科大学附属第一医院诊断、内科教研室，广州

• 关键词： 问诊；临床见习教学；中西医结合本科
• Medical history inquiry; Clinical teaching for practice; Integrated traditional medicine and western medicine undergraduate
• 摘要： 目的：探讨中西医结合专业本科临床见习中问诊的教学改革方向。方法：采用自行设计的问卷调查分析方法，对203 名就读三四年级的中西医结合本科医学生进行见习问诊方面10 个问题的无记名调查，以及开放性问题的自由回答。结果：185 份有效答卷中，49.4% 的学生对临床见习问诊有心理和行为的准备，61.2% 的学生有自信心能做好问诊，遇上病人欠合作时49.4% 的学生不知道怎么处理，53.0% 的学生问诊会遗漏项目，35.3% 的学生对问诊后的病历书写存在心理抗拒，48.2% 的学生对写见习病历的意义不了解，62.2% 的学生在问诊过程中会比较中、西医的侧重点，55.7% 的学生对中西医结合问诊没有心得体会；开放性问题，如作为中西医结合专业的学生，你希望中西医结合问诊是什么样的方式最好？ 73% 学生认为最好的方式是先分别打好中、西医问诊的基础，在此基础上进行中西医结合的问诊见习。结论：中西医结合专业本科临床见习教学中存在较多问题，涉及面较广，尤其是中、西医同时存在的模式一定程度上增加了临床问诊学习及教学的难度。在改革方向方面，应着重加强学生们中西医结合问诊理论和实践的培养，进一步完善中西医结合问诊的思路及框架，积极摸索符合中西医结合专业特色的见习问诊教学模式，有助于提高从根源上改善该专 业见习问诊的教学效果。
• To explore the reform direction of clinical interviews teaching for practice students in Integrated Traditional Medicine and Western Medicine. Methods: A total of 203 junior or senior students, majored in Integrated Traditional Medicine and Western Medicine, were asked to respond anonymously to a self-designed questionnaire including 10 items about clinical skill of medical history taking and 1 item in the form of open-ended question. Results: The final eligible sample include 185 students. The proportion of students making advance preparation for clinical practice both mentally and behaviorally reached 49.4%. And 61.2% of students were fully confident of taking medical history perfectly. 49.4% of students showed no ideas to communicate well with uncooperative patients. 53.0% of students would miss part of medical history inquiry items; 35.3% had psychological resistance to electronic medical writing. During process of history taking in clinical practice, 62.2% of students would compare individual focus on traditional medicine and western medicine, respectively. Besides, as for the last open-ended question, 73% of students are apt to build a strong professional knowledge. Conclusions: There are some problems with the feature of extensive involvement existing in undergraduate teaching of integrated traditional medicine and western medicine in clinical probation, which not only makes teaching but also students’ learning much harder. We are required to stress students’ cultivation on Integrated Traditional Medicine and Western Medicine theory as well as clinical practice, to further improve students’ thought process and knowledge frame and to explore teaching mode actively consistent with the characteristics of Integrated Traditional Medicine and Western Medicine. All above may enhance teaching effect of medical history inquiry in clinical practice of Integrated Traditional Medicine and Western Medicine fundamentally.
• DOI： https://doi.org/10.35534/es.0302029
• 引用： 王小红， 陈小燕， 鲁可， 等． 从问诊反馈信息看中西医结合本科的见习教学方向［ J ］ ． 教育研讨，
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