目的 探讨临床推理教学方式在医学生妇产科学见习教学中的应用效果。方法 2020年12月至2021年1月,以43名中山大学2017级五年制临床医学专业学生为研究对象,采用随机数字表法将其分为试验组19名学生和对照组24名学生,在妇产科学见习教学中分别实施临床推理教学和传统教学。见习结束后,采用批判性思维能力测量表对学生进行评价,同时比较两组学生出科考试成绩,组间比较采用t检验。结果 试验组学生批判性思维能力测量总体评分高于对照组[(284.89±35.73)分比(264.13±27.12)分],其中寻找真相、分析能力2个项目评分高于对照组[(36.26±6.11)分比(32.42±6.11)分,(44.42±5.99)分比(40.54±5.32)分],差异均具有统计学意义(均P<0.05)。试验组学生出科考试总成绩及病例分析题成绩高于对照组[(91.19±4.04)分比(88.14±3.46)分,(31.84±3.70)分比(28.23±4.23)分],差异均具有统计学意义(均P<0.05)。结论 临床推理式教学对学生批判性思维能力的培养具有积极作用,有助于激发学生寻找真相的欲望,提高学生对临床疾病的分析推理能力。
Objective To explore the influence of clinical reasoning teaching in probation teaching of gynecology and obstetrics for medical students. Methods From December 2020 to January 2021, 43 five-year program medical students enrolled in 2017 from Sun Yat-sen University were randomly divided into clinical reasoning teaching group (19 students, experimental group) and traditional teaching group (24 students, control group). The score of critical thinking disposition inventory-Chinese version(CTDI-CV) and score of test were compared after teaching by t-test. Results The total CTDI-CV score of the experimental group was higher than that of the control group after teaching, and the score of truth seeking and analysis ability was also better than that of the control group [(284.89±35.73) vs. (264.13±27.12), (36.26±6.11) vs. (32.42±6.11), (44.42±5.99) vs. (40.54±5.32), all P<0.05]. In addition, the total scores and case analysis scores of students in experimental group were higher than those in control group [(91.19±4.04) vs. (88.14±3.46), (31.84±3.70) vs. (28.23±4.23), all P<0.05]. Conclusions Clinical reasoning teaching in medical students has a positive effect on the cultivation of students' critical thinking ability. It can stimulate students' desire to find the truth, improve their ability of analyzing and reasoning about clinical diseases.
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