目的 探究器官系统整合课程教学模式在八年制临床医学专业消化系统临床见习中的应用效果,为器官系统整合模式的教学改革提供参考。方法 2021年9至12月,选取北京大学医学部2018级和2019级八年制临床医学专业114名学生为研究对象,其中2019级58人采取器官系统整合课程教学模式,2018级56人采取传统教学模式,采用临床见习表现评估量表(分为主动性、医学基础课程掌握情况、临床医学课程掌握情况、临床思维能力和医学英语水平5个维度)对两组医学生在消化系统临床见习过程中的表现进行评价。采用配对样本t检验进行数据分析。结果 采用整合课程教学模式的学生其主动性维度评分高于传统教学模式组[(25.90 ± 2.56)分比(21.50 ± 5.34)分,P = 0.030],差异具有统计学意义;整合课程教学模式组的解剖与组织胚胎学[(8.40 ± 1.08)分比(6.90 ± 1.52)分,P = 0.020]和医学影像学[7.70 ± 1.16)分比6.50 ± 1.08)分,P = 0.028]评分均高于传统教学模式组,差异均具有统计学意义;在临床思维能力维度中,整合课程教学模式组得分低于传统教学模式组[(20.80 ± 2.25)分比(24.40 ± 3.95)分,P = 0.022],差异具有统计学意义;整合课程教学模式组和传统教学模式组在医学英语水平维度的评分[(7.50 ± 1.27)分比(8.00 ± 1.33)分]差异无统计学意义(P = 0.361)。结论 器官系统整合教学模式有助于提高医学生的学习积极性,有助于提升医学生对部分医学基础和临床理论课程内容的掌握,但在教学过程中应更加重视医学生临床思维能力的培养和提高其医学英语水平。

Objective To explore the application of organ-system-based integrated curriculum teaching mode on clinical clerkship of digestive system for eight-year program medical students,thus providing reference for the teaching reform. Methods From September to December 2021, 114 medical students from grade 2018 (58) and 2019 (56) of eight-year program in Peking University Health Science Center were selected as the research subjects joining an integrated teaching mode group and a conventional teaching mode group respectively, A prospective evaluation scale was developed containing five dimensions: initiative, basic medical courses, clinical medical courses, clinical reasoning capacity and medical English level in order to analyze the performance of medical students during clerkship rotation. The paired sample t test was used to compare the normal distribution data between groups. Results In the dimension of initiative, the scores of integrated curriculum teaching mode group were significantly higher than those of conventional teaching mode group [ (25.90±2.56)vs. (21.50±5.34), P=0.030]. The scores of two groups in anatomy and embryology [(8.40±1.08)vs.(6.90±1.52), P=0.020] and medical imaging [(7.70±1.16) vs.(6.50±1.08), P=0.028] in the integrated curriculum teaching mode group were also statistically significant.. In the dimension of clinical reasoning, the scores of integrated curriculum teaching mode group was significantly lower than those of conventional teaching mode group [(20.80±2.25)vs. (24.40±3.95), P=0.022]. In the dimension of medical English level, there was no significant difference between the two groups [(7.50±1.27) vs. (8.00±1.33), P=0.361]. Conclusions The organ-system-based integrated curriculum teaching mode improves learning enthusiasm of medical students and facilitates their mastery of basic and clinical knowledge. However, more attention should be paid to the capacity building of clinical reasoning and communication skill, and medical English education should be fully integrated.