目的 探讨案例体验教学方式在培养临床医学专业学位研究生应变和沟通能力中的效果。 方法 选取2018年4月至2018年9月在北京大学第三医院外科系统轮转实习的90名专业学位研究生(硕士研究生54名和博士研究生36名)为研究对象。随机将这些研究生分为试验组和对照组各45名。在外科学沟通能力教学中,试验组采用案例体验教学方式,研究生根据医疗纠纷案例自导自演,体验情景,探讨冲突的原因,并由专家点评指导。对照组采用传统教学方式,即学习案例材料。教学结束后,采用自制问卷调查教学效果。 结果 试验组研究生与对照组研究生选择处理冲突的方式明显不同:忍让[15.6%(7/45)比48.9%(22/45)]、求助[77.8%(35/45)比24.4%(11/45)]、当面力争[6.7%(3/45)比26.7%(12/45)],其差异具有统计学意义(P=0.024)。84.4%(38/45)的试验组研究生表示通过学习掌握了一定的沟通和处理纠纷的方式。 结论 案例体验教学方式可以使专业学位研究生更直观地学习处理医疗纠纷的方式,进而提高其医患沟通和处理纠纷的能力。

Objective To study the application effect of the “case experience” model in improving the adaptability and communication ability of medical graduate students. Methods A total of 90 professional postgraduate students who were internships in the surgical system of our hospital from April to September 2018 were selected as subjects. There were 45 cases for the experimental group and the control group respectively. The students in the experimental group self-directed and acted according to the medical conflict cases, experiencing the situation, and discussing the cause of the accident or dispute, and were consulted by the experts of the medical department. The control group directly studied the case text material. Questionnaires were used to analyze and compare the teaching effects of the two groups of students. Results Compared with the control group, there was a significant difference in the way the students in the experimental group chose to deal with physiotherapy conflicts:exercise forbearance[15.6%(7/45)vs 48.9%(22/45)], seek help[77.8%(35/45) vs 24.4%(11/45)],face to face[6.7%(3/45) vs 26.7%(12/45)],(P=0.024).84.4%(38/45)experimental group studentshad got a more reasonable treatment. Conclusions The “case experience” model allows students to more intuitively understand the causes of medical malpractices or disputes, and learn the methods and techniques of treatment to enhance the conflicts dealing and communication skills of medical graduate students.