中华医学教育杂志

中华医学教育杂志 ›› 2025, Vol. 45 ›› Issue (10): 769-773.DOI: 10.3760/cma.j.cn115259-20241101-01135

• 临床教学 • 上一篇    下一篇

8-3-2融合问诊策略在病史采集教学中的应用

孙俊生1, 袁富珍1, 姚丁烨1, 张迩耀1, 任菁菁2   

  1. 1广州中医药大学深圳临床医学院 深圳市龙岗中心医院全科医学科,深圳 518116;
    2浙江大学医学院附属第一医院全科医学科,杭州 311100
  • 收稿日期:2024-11-01 发布日期:2025-09-28
  • 通讯作者: 任菁菁, Email: 3204092@zju.edu.cn
  • 基金资助:
    广州中医药大学教学质量与教学改革工程项目(广中医校办[2024]278号);广东省本科高校教学质量与教学改革工程项目(粤教高函〔2023〕4号);深圳市龙岗区医学重点学科建设经费资助(2024-2027);国家自然科学基金(72274169)

Exploration of the 8-3-2 integrated consultation strategy in medical history taking education

Sun Junsheng1, Yuan Fuzhen1, Yao Dingye1, Zhang Eryao1, Ren Jingjing2   

  1. 1Department of General Practice, Longgang District Central Hospital of Shenzhen & Shenzhen Clinical College of Medicine, Guangzhou University of Chinese Medicine, Shenzhen 518116, China;
    2Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
  • Received:2024-11-01 Published:2025-09-28
  • Contact: Ren Jingjing, Email: 3204092@zju.edu.cn
  • Supported by:
    Guangzhou University of Chinese Medicine Teaching Quality and Teaching Reform Project (GZUCM Office Document [2024] No.278);Teaching Quality and Teaching Reform Project for Undergraduate Universities in Guangdong Province (Guangdong Higher Education Letter [2023] No.4); Funding for the Construction of Key Medical Disciplines in Longgang District, Shenzhen (2024-2027); National Natural Science Foundation of China (72274169)

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摘要： 本研究针对现有病史采集教学模式中存在的问题,创新性地提出了8-3-2融合问诊策略。该策略整合了传统问诊的8个要素、想法—担忧—期望问诊的3个维度以及开放性和闭合性问诊的2种技巧,构建了一种系统化的病史采集框架。设计了PROVIDe实施步骤,通过思维导图教学、情景记忆法和情景演练等方法在教学实践中进行应用。初步教学实践结果显示,医学生接受培训前后在病史采集能力评分上有明显提升[(7.13±1.46)分比(10.94±1.60)分,P<0.001]。8-3-2融合问诊策略为医学生提供了一个更加系统的现病史采集框架,有效地促进了医学生临床思维能力和医患沟通技能的提升,为病史采集教学改革提供了新的思路和方法。

关键词: 临床医学, 病史采集, 融合问诊策略, 教学方法

Abstract: Aiming to address the existing problems in medical history taking education, this study innovatively proposes the 8-3-2 integrated consultation strategy. This strategy incorporates eight elements of traditional consultation, three dimensions of ICE (Ideas, Concerns, and Expectations) consultation, and two techniques of open-ended and closed-ended questioning, establishing a systematic framework for medical history taking. The PROVIDe implementation steps were designed and applied in teaching practice through methods such as mind mapping, scenario-based memorization, and scenario practice. Preliminary results showed that trained interns demonstrated significant improvement in their medical history taking ability scores [(7.13±1.46) vs.(10.94±1.60),P<0.001]. The 8-3-2 integrated consultation strategy provides medical students with a more systematic framework for present illness history taking, effectively enhancing their clinical thinking abilities and doctor-patient communication skills, thus offering new insights and methods for reforming medical history taking education.

Key words: Clinical medicine, Medical history taking, Integrated consultation strategy, Teaching methods

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