神经系统解剖结构复杂,神经外科的显微及精细操作比例高,急危重症多,常涉及多系统病变和多学科交叉的领域,其临床学习难度较大,而八年制临床医学专业(简称八年制)学生在神经外科临床学习的时间短,这对临床教学和学习都提出了较高的要求。本文通过文献查阅,分析国内医学院校现行神经外科临床实习中存在的问题及其原因,结合北京协和医院的教学实践,探讨针对八年制学生神经外科临床教学改革建议。利用自主学习平台,使医学生提前了解神经外科并树立明确的学习目标;进行科研指导,引导学生正确处理科研与临床学习的关系;采取“医学生助教”和“分段式主刀”制度,提高医学生基本操作技能,为八年制学生毕业后进入神经外科从事临床工作打下良好的基础。

The anatomical structure of the nervous system is complex, the proportion of microscopic and fine manipulations of neurosurgery is high, and there are many acute and critical illnesses, often involving multi-system lesions and multi-disciplinary fields. Thus, the clinical learning of neurosurgery is difficult. However,the eight-year program students in the clinical neurosurgery have insufficient study time,this puts forward higher requirements for clinical teaching and learning. This paper analyzes the problems existing in the current clinical practice of neurosurgery in domestic medical colleges and the causes of the problems by reviewing the literature combined with discussing teaching practice of Peking Union Medical College Hospital, and probes into suggestions for the clinical teaching reform of neurosurgery for eight-year program students. It is recommended to use the self-learning platform to enable medical students to understand neurosurgery in advance and establish clear learning goals; conduct scientific research guidance to guide students to correctly handle the relationship between scientific research and clinical learning; adopt medical student teaching assistant and segmented chief surgeon system to improve the basic operation skills of medical students, and lay a good foundation for the eight-year students to enter the neurosurgery to engage in clinical work after graduation.