早期接触临床是医学生的重要启蒙课程。2022年12月,本研究以74篇八年制临床医学专业学生早期接触临床课程总结文本作为研究资料,借助MAXQDA软件进行质性文本分析,通过三段式编码形成框架,根据代码频率与覆盖率进行教学成效分析,最终对照教学目标形成解释分析模型。研究结果显示,早期接触临床课程通过言传身教、观察交流、模拟演练等多种形式的教学方式方法,提升了学生对于病人照护、沟通合作、职业素养、知识技能、终生学习的核心胜任力认知,明晰了职业认知与职业规划。通过质性文本分析,本研究形成了早期接触临床课程成效评估框架、可视化教学目标与学生收获的关联逻辑,进而提出早期接触临床课程设计的完善建议:优化课程安排,注重教学方法的均衡性;重视师资培训,加强胜任力与临床场景的融合;加强小组学习,提升临床体验的充分性。

Early exposure to clinical courses is an important introductory course for medical students. In December 2022, this study used 74 clinical eight-year medical students′ early clinical experience reflection texts as research data, and conducted qualitative text analysis using MAXQDA software. A framework was formed after three-stage coding, and teaching effectiveness analysis was conducted based on code frequency and coverage. Finally, an explanatory analysis model was formed based on learning objectives. Through various teaching methods such as verbal and nonverbal communication, simulated practice, and observation and communication, early exposure to clinical courses enhanced students′ cognition of core competency in patient care, communication and cooperation, professional ethics, knowledge and skills, and lifelong learning, and clarified career cognition and planning. This paper proposes an evaluation framework for the effectiveness of early exposure to clinical courses, a visualization of the logical relationship between learning objectives and student gains, and suggests improvements for the design of early clinical courses, including (1) optimizing course arrangements and balancing teaching methods, (2) emphasizing on teacher training and strengthening the integration of competency and clinical scenarios, and (3) promoting group study and enhancing the fullness of clinical experience.