Application of case analysis teaching method in basic medical teaching
Objective To explore the application effect of case analysis teaching method in basic medical teaching. Methods A total of 80 students from Class 20 14 clinical major 1 Class 2 were selected and divided into control group and observation group, with 40 cases in each group. The control group adopted conventional medical teaching mode, while the observation group adopted case analysis teaching method to carry out teaching activities. The final exam mainly examines the case analysis questions and makes a general evaluation with the tetrathlon assessment mechanism. The teaching effect of the two groups was evaluated by questionnaire survey and score analysis. Results Compared with the control group, the students in the observation group had better comprehensive academic performance and higher teaching satisfaction, with statistical significance (P < 0.05). Conclusion The application of case analysis teaching method in basic medical teaching is conducive to closely linking the knowledge points of teaching materials with clinical diseases, enhancing students' ability to apply what they have learned, experiencing the fun of creative learning and improving teaching satisfaction, which is worth popularizing.
Basic medical teaching; Methods; Case analysis method; Application effect
Compared with clinical subjects, basic medical subjects are more boring and abstract because of more contents, less class hours, and students often find it difficult and lack interest in learning [1]. Based on this, this paper studies the application effect of case analysis teaching method in basic medical teaching, guides students to integrate with clinical related cases, and realizes the effect of knowledge integration application, hoping to be helpful to teaching. The following report is now made.
1 data and methods
1. 1 general information
80 students from Class 20 14 1 class and Class 2 were selected for this study. The two classes are mixed with men and women, and there are 40 people in each group. There was no significant difference in general data between the two groups (P & gt0.05).
1.2 method
The control group adopted conventional medical teaching mode; The observation group carried out teaching activities through case analysis teaching method: (1) Research and preparation of case data. According to the teaching purpose, typical case materials are selected to ensure pertinence, which are divided into classroom case analysis, examples and deepening materials in turn. First, teachers read through the analysis teaching materials, actively grasp the relevant knowledge of clinical and nursing disciplines, clarify the principles of clinical nutrition knowledge and basic knowledge, find out the disease, examination and diagnosis data of specific cases, and establish the most targeted cases after summing up. After strictly screening the selected cases, teachers should carefully design classroom questions to stimulate students' thinking, and make multi-angle and diversified analysis of case data to realize the transfer and expansion of knowledge and stimulate students' interest in learning. (2) Classroom teaching design. First of all, we should combine the case data to determine the best display time. Through role-playing, printing paper materials, multimedia technology and other ways to show cases, lead students to experience the feelings of patients and doctors, let students actively participate in the classroom, and deepen their knowledge impression. When teachers use case materials in classroom examples, they can briefly describe the knowledge points first, and then guide students to make in-depth analysis according to the case materials, so as to strengthen students' memory and deepen their knowledge. After class, according to the relevant materials to deepen the learning content, guide students to think and discuss independently. (3) Stimulate students' enthusiasm by using the score incentive mechanism. The key to the application of case analysis teaching method in basic medicine lies in students' participation, which directly affects the effect of case analysis [2]. Teachers can analyze cases through group discussion and random individual questions, and connect knowledge points with the actual situation of cases. We can use the score incentive mechanism to stimulate students' enthusiasm for participation, and use the usual scores to measure whether students actively participate in the classroom. If you are not positive, you will never get too high a score.
Effect evaluation of 1.3
[3-4] Behavior observation, questionnaire survey and examination paper survey were used to evaluate the classroom enthusiasm or participation, teaching method satisfaction or knowledge mastery, and the effect of case analysis teaching method in the two classes in turn. In addition, students' academic performance is assessed by four assessment mechanisms, including the cumulative score of classroom participation activities, the level and standard of thesis writing, the level of case analysis and experimental results, accounting for 30%, 65,438+00%, 50% and 65,438+00% respectively.
1.4 statistical method
SPSS 16.0 statistical software was used for data analysis, and "X? S "means t-test; The counting data is expressed as a percentage (%), using x2 test, and the data is expressed as p.
2 discussion
The fundamental purpose of case teaching method is to emphasize the application of basic medical disciplines in clinical practice. Most students hope to be close to clinical practice and promote the integration of knowledge through clinical pathology and physiological problems. The teaching of case analysis just satisfies students' curiosity in the learning process, and then has a clearer understanding of the relationship between professional goals and what they have learned, which is more conducive to the understanding of concepts [5]. This study focuses on case analysis teaching, with the support of multimedia technology, designs the teaching links of each part, takes students as the main part of the classroom, guides students to actively consult materials, analyze and solve problems, and strengthens their ability of analysis and inquiry. At the same time, case analysis teaching is conducive to improving the purpose and pertinence of learning. It is an active teaching mode. Students are no longer passively accepting knowledge, but are diligent in thinking and exploring and actively exploring new knowledge. Judging from the results of this study, the students in the observation group have better comprehensive scores and higher teaching satisfaction at the end of the middle term, which is statistically significant compared with the control group (P
refer to
[1] Xu Yongfen, Yu Guodan, Fan Hao, et al. Learning experience of case analysis medical teaching [J]. Education and Teaching Forum, 20 13, 16 (23): 99- 100.
[2], Dai, et al. Application of teaching method in clinical biochemistry teaching [J]. Journal of Bengbu Medical College, 2013,38 (4): 486-488.
[3] Yan Xuebo. The necessity and experience of typical case analysis and discussion in clinical respiratory medicine teaching [J]. Medical Information (Interim Journal), 201,24 (1): 274.
Zhu Zicheng, Wen Yuechun, Wang Lin, et al. Application of multimedia case teaching in ophthalmology teaching [J]. Practical blindness prevention technology, 20 15,10 (4):172-174.
Dong, Li Zhouru, Yin Wenjiang, et al. Discussion on the application of forensic medicine teaching method reform under the background of clinical medical professional certification [J]. Medical Information, 2015,32 (45): 9-10.
Clinical medical graduation thesis 5000 words 4
Analysis of the present situation of medical students' clinical thinking ability of traditional Chinese medicine and its training countermeasures
By analyzing the problems existing in the clinical thinking ability of students majoring in traditional Chinese medicine, this paper puts forward some improvement measures from the aspects of mastering the basics, familiarizing with classics, learning medical plans and teaching methods, teaching teachers and teaching platforms, so as to solve the shortage of clinical thinking ability of medical students and cultivate high-quality senior talents of traditional Chinese medicine.
[Keywords:] Chinese medicine; Clinical thinking; Current situation; Countermeasures
Clinical thinking of traditional Chinese medicine refers to the thinking activities of doctors in judging and analyzing the nature and laws of diseases, formulating the principles of treatment and prevention of diseases and prescribing drugs in the process of clinical diagnosis and treatment [1].
The holistic view of TCM determines its macroscopic understanding of human physiological and pathological phenomena.
Traditional Chinese medicine has always attached importance to understanding the physiological and pathological laws of human body with a holistic, systematic and dynamic method, and distinguishing the yin and yang attributes of human organs and tissues and their correlation with the physiological and pathological conditions of the body.
Traditional Chinese medicine clinical diagnosis and treatment thinking has its own characteristics. Investigating, diagnosing and treating diseases from the relationship between the whole and the part of the human body, between the viscera, between the human body and nature, and between the human body and society is the concrete embodiment of the universal connection thinking in traditional Chinese medicine.
Correct clinical thinking of TCM plays a decisive role in clinical diagnosis and treatment.
The cultivation of clinical thinking ability of medical students is a long-term process. It is important and difficult to make students have the ability to analyze, solve and work independently.
Current status of 1
1. 1 The culture mode is single and outdated.
At present, China's higher medical education adopts the educational model of "unified teaching materials and unified syllabus", which generally emphasizes teaching and ignores learning; Instill more than enough, inspire less; The tendency to attach importance to knowledge transmission and neglect ability training.
Overemphasizing that students must have solid basic medical knowledge, but ignoring the cultivation of students' clinical thinking ability; Ignoring the cultivation of students' communication ability and information acquisition ability; As a result, medical students' book knowledge and clinical practice ability are seriously out of touch.
Some students don't know how to apply the theoretical knowledge they have learned to solve practical medical problems, and they are helpless, let alone make correct judgments and treatments in a timely and decisive manner according to local conditions.
1.2 The thinking method is mechanically simple.
Everything changes and develops, and disease is also a pathological process of development and change.
In clinic, some students make a diagnosis directly only by observing the data collected for the first time, without careful scrutiny and comprehensive analysis.
Some students randomly choose the patient's medical history, signs or auxiliary examination materials based on intuitive impression.
Taking the data that can support one's own diagnosis as the main basis for judging the disease, and deleting some data that does not support one's own diagnosis at will can easily lead to one-sidedness of diagnosis.
Some students don't know the procedure of clinical diagnosis thinking, and often collect information in disorder, with different priorities, or simply rely on advanced examination methods without scientific reasoning and analysis, and rely too much on relevant data or results provided by some examinations to directly draw a disease diagnosis.
These mechanical and simple ways of thinking are too hasty and easy to lead to malpractice and mistreatment.
1.3 One-sided thinking and lack of systematicness.
Students lack the ability of transverse comparison and comprehensive analysis of symptoms, signs, examinations and diseases, and often diagnose diseases mechanically according to the typical performance in books or always influenced by the initial diagnosis; In the process of diagnosis and treatment thinking,
Without considering the dynamic development of the disease, we only pay attention to the treatment methods or drugs, but ignore the personality characteristics of patients and the development stage of the disease; When dealing with patients in the ward, too much respect for teachers will also have no opinion on treating patients.
Lack of active thinking, dare not express their views in combination with the overall situation of patients, and show blind obedience and dependence in clinical thinking [2].
Some students only grasp the superficial characteristics of clinical symptoms and signs, but can't grasp the main contradiction of things through the analysis of phenomena, and use clinical medical knowledge to comprehensively analyze various phenomena, lacking the habit and ability of comprehensive judgment, which also makes clinical diagnosis lack of systematicness and can't stand scrutiny [3].
1.4 Clinical teaching teachers lack of sense of responsibility.
The clinical practice time of medical students is mostly about one year, so it is very important to teach teachers.
Some teachers have not put enough energy into clinical teaching because of their busy work.
Some teachers have not worked long hours and lack due clinical experience and accumulation; Others are not strict with students, lack of teaching methods and weak sense of innovation; Teaching rounds are simple, cases are randomly selected, there are no typical demonstration characteristics, dialectical thinking is unclear, treatment principles are improper, it is difficult for students to learn knowledge from them, and there is a lack of training and cultivation of clinical thinking ability of traditional Chinese medicine.
2. Training countermeasures
2. 1 master the characteristics of TCM diagnosis and treatment
The clinical thinking method of traditional Chinese medicine is to analyze and summarize the data collected by four clinics, analyze various symptoms, understand the location, nature, etiology and pathogenesis of lesions, judge the pathological relationship between zang-fu organs and yin-yang and five elements, analyze the relationship between healthy qi and pathogenic qi, and identify the corresponding "syndrome".
In the treatment, according to the different pathogenesis of the disease, the treatment methods and schemes are determined to achieve the balance of yin and yang in the body.
Therefore, in the clinical diagnosis and treatment of traditional Chinese medicine, we must follow the clinical thinking method of traditional Chinese medicine, combine disease differentiation with syndrome differentiation, learn to use "treating the same disease with different treatment" and "treating different diseases with the same treatment", and give Chinese medicine prescriptions to the judged "syndrome" [4].
Medical students must master the characteristics of clinical diagnosis and treatment of traditional Chinese medicine in order to correctly diagnose and treat diseases and improve their comprehensive clinical application ability.
2.2 Strengthen the training of classical knowledge
To train students' basic skills, we should pay attention to reviewing and learning classical theoretical knowledge, including the study of classical works such as synopsis of the golden chamber, treatise on febrile diseases, treatise on febrile diseases and Neijing.
Read more medical records of predecessors, gradually digest them into your own things, and study the experiences and lessons of famous doctors in the past dynasties in diagnosing and treating diseases, so that the original scattered, disorderly and mixed knowledge can be systematized and organized, and then an organic knowledge system can be established. Reading more medical records is an effective way for students to establish clinical thinking as soon as possible [5].
At the same time, it is also very important to copy prescriptions with famous old Chinese medicine practitioners, especially to learn some old Chinese medicine practitioners' experience of four diagnosis and dialectical thinking, which is of great benefit to future clinical practice.
Realizing the cognitive process of theory, practice, re-theory and re-practice will lay a solid foundation for the establishment of his clinical thinking of traditional Chinese medicine and gradually form a perfect clinical thinking of traditional Chinese medicine.
2.3 adopt problem-based learning (PBL).
In the process of clinical teaching, PBL teaching method can well combine theory with clinical practice.
Make students learn to integrate theory with clinic in the process of thinking and cultivate their clinical thinking ability [5].
PBL teaching method can give students full opportunities to discuss problems; The purpose of "problem-centered, student-centered and teacher-led" makes students have a clear purpose and a higher enthusiasm for participation; The highest requirement of "multidisciplinary integration as the core" gives students a broad imagination, which is not only an invisible pressure,
At the same time, it is also an infinite motivation for them to actively review multidisciplinary knowledge; Through the way of "asking questions, discussing, presenting and summarizing", students' ability to think, explore, discover, analyze and finally solve problems can be continuously stimulated, which can better cultivate students' innovative thinking and communication skills.
2.4 Clinical medical record analysis
Clinical medical record learning is a unique inheritance learning method of TCM, and its existence is closely related to the complexity and experience of clinical diagnosis and treatment of TCM.
In the teaching process of clinical main courses, the use of classical medical case teaching can more vividly show the valuable experience of doctors in past dynasties, make future generations take fewer detours in clinical practice, especially the diagnosis and treatment methods and dialectical thinking of famous old Chinese medicine practitioners, and play a better demonstration role in cultivating students' clinical thinking of traditional Chinese medicine.
Similarly, clinical case discussion is also an indispensable and important link in medical work.
Through the discussion of different cases, we can deepen students' understanding of the occurrence, development and treatment of diseases, master the correct diagnosis and treatment process of diseases at a deeper level, and cultivate students' clinical thinking ability, comprehensive analysis ability and practical work ability [6].
2.5 Application of Virtual Reality Technology in Medical Education
Virtual reality technology is widely used in medical education at present.
In this regard, the University of Chicago and the University of Hamburg in Germany have made CT and MRI sectional images into three-dimensional visual virtual human anatomical maps for anatomy teaching and after-school training of medical students.
In the aspect of surgical simulation, Tsinghua University successfully developed a surgical simulation system, which was realized by computer. In the aspect of acupuncture simulation teaching, Shanghai University of Traditional Chinese Medicine and Tianjin University of Traditional Chinese Medicine established a three-dimensional human acupuncture model, which made full use of the good human-computer interaction system and achieved satisfactory results in the simulation teaching of medical undergraduates [7].
These teaching research results provide conditions for medical students' skills training, and the experimental teaching platform has been continuously developed and expanded. However, these studies are limited to the cultivation of clinical operation skills, and there are few similar reports and applications in the simulation teaching of clinical thinking ability.
The cultivation of clinical thinking ability of traditional Chinese medicine is a difficult and hot spot in medical education. After years of unremitting efforts by many experts, our school is committed to the research and development of clinical thinking ability of traditional Chinese medicine, and is currently undertaking key projects of higher education in Jiangsu Province. The research and development achievement "TCM clinical thinking ability training platform" has played an important role in the cultivation of TCM clinical thinking ability of medical students.
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