Try to talk about the application of case analysis teaching method in the teaching of basic medicine
Abstract PurposeTo study the application effect of case analysis teaching method in the teaching of basic medicine. Methods 80 cases of students from the 1st and 2nd classes of clinical majors of the class of 2014 were selected for inclusion in this study, and they were set up as the control group and the observation group, each with 40 cases. The control group adopts the conventional teaching mode of medicine, and the observation group carries out teaching activities through the case study teaching method, the final examination mainly examines the case study test questions, and the overall evaluation is carried out by the four all-round assessment mechanism, and the questionnaire survey as well as the analysis of the results are utilized to assess the teaching effect of the two groups. Results compared with the control group observation group students learning comprehensive achievement is better, teaching satisfaction is higher, the difference is statistically significant (P<0.05). Conclusion In the basic medical teaching application of case analysis teaching method is conducive to the textbook knowledge and clinical disease closely linked as one, the students for the application of knowledge strengthened, and experience the fun of creative learning, teaching satisfaction and subsequently increased, it is worth promoting the application.
Keywords: basic medical teaching; method; case study method; application effect
The basic medical disciplines due to the more content and relatively few hours, compared with clinical disciplines seem more boring and abstract, students often find it difficult to learn, and lack of interest in learning [1]. Based on this, this paper studies the application effect of case analysis teaching method in basic medical teaching, guiding students with clinically relevant cases, realizing the integration of knowledge, learning and applying the effect, hoping to help teaching. It is reported as follows.
1 Data and Methods
1.1 General Information
80 students from the 2014 class of clinical specialties 1 and 2 were selected for inclusion in this study, and the two classes were mixed gender, which were set up as a control group and an observation group, each with 40 cases. The general information of the students in the two groups was compared, and the difference was not statistically significant (P>0.05).
1.2 Methods
The control group adopts the regular teaching mode of medical science; the observation group carries out teaching activities through the case study teaching method: (1) Research and preparation of case materials. In accordance with the teaching purpose to select typical case data, to ensure relevance, in turn, divided into classroom case analysis, examples and deepen the information. First of all, the teacher will carry out in-depth reading and analysis of the teaching materials, actively master the relevant knowledge of clinical and nursing disciplines, clarify the knowledge of clinical nutrition and the basic knowledge of the principle, find out the disease, test and diagnostic data of specific cases, and then summarize and establish the most relevant cases. After strictly screening the selected cases, teachers should carefully design classroom questions to stimulate students' thinking, analyze the case data from multiple angles and diversified, realize the migration and expansion of knowledge, and stimulate students' interest in learning. (2) Classroom teaching design. First of all, it should be combined with the case data to confirm the best time to show the case, through role-playing, issuing paper materials and multimedia technology to show the case, leading the students to experience the feelings of the patient and the physician, so that they can actively participate in the classroom to deepen the impression of knowledge. Teachers in the classroom examples of the application of case data can first make a brief account of the knowledge points, and then combined with case data to guide students to analyze in-depth, in order to strengthen students' memory and deepen the knowledge learned. After the class, according to the deepening of learning content related information to guide students to independent thinking and discussion. (3) The use of score incentive mechanism to stimulate students to participate in the enthusiasm. The key to the application of basic medical case analysis teaching method lies in the degree of student participation, which directly has an important impact on the effect of case analysis [2]. Teachers can conduct case analysis through group discussion, random individual questions and other ways to link the knowledge points with the actual situation of the case. Can use the score incentive mechanism to stimulate students to participate in the enthusiasm, with the usual points to measure whether the students in the classroom active participation, for those who are not active even if the score is high will not pass.
1.3 Effectiveness evaluation
[3-4] The use of behavioral observation, questionnaire survey method and the examination method of the examination paper in order to evaluate the degree of students' classroom motivation or participation, the degree of satisfaction with the teaching methodology or the degree of knowledge mastery, and the effect of the two-shift case study teaching method. In addition, a four-pronged assessment mechanism was adopted to assess the students' learning performance, including the cumulative score of classroom participation activities, the level of writing papers and standards, the level of case analysis standards, and experimental results, with the weights of the four being 30%, 10%, 50%, and 10% respectively.
1.4 Statistical methods
SPSS16.0 statistical software was applied to analyze the data, and the measurement data was expressed as "x?s", using t-test; the count data was expressed as percentage (%), using x2 test, and the difference was statistically significant with P<0.05.
2 Discussion
The fundamental purpose of the case teaching method is to emphasize the key points of the application of basic medical disciplines in clinical practice, and most of the students want to be close to clinical practice, and to promote the integration of knowledge through clinical pathology as well as physiological problems. Case study teaching satisfies the curiosity of students in the learning process, which leads to a clearer understanding of the professional goals and the connection of the knowledge learned, and is more conducive to the comprehension of the concepts involved [5]. This study is based on case study teaching, through multimedia technology support to design the teaching links of each part, so that the students as the main body of the classroom, guiding students to actively consult the information, analyze and solve problems, and strengthen their analytical ability to explore. At the same time, case study teaching is conducive to improving the purpose and relevance of learning, is an active teaching and learning mode, students are no longer passive to receive knowledge, but to think and explore, and take the initiative to research and explore new knowledge. From the results of this study, students in the observation group have better midterm and end-of-term comprehensive learning achievements and higher satisfaction with teaching, and the difference is statistically significant compared with the control group (P<0.05). It suggests that the use of case study teaching method to carry out basic medical teaching effect is satisfactory. In summary, the application of case study teaching method in basic medical teaching is conducive to the textbook knowledge and clinical diseases closely linked as a whole, the students for the application of knowledge to strengthen the ability to experience the joy of creative learning, teaching satisfaction with the increase, it is worth promoting the application.
References
[1] Xu Yongfen, Yu Guodan, Fan Hao, et al. Case study medical teaching learning experience[J]. Education Teaching Forum,2013,16(23):99-100.
[2]WANG Qi,CHEN Hui,DAI Hanjing,et al. Application of PBL teaching method in teaching biochemistry in clinical medical specialty[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 (Zhongdian),2011,24(1):274.
[4]Zhu Zicheng,Wen Yuechun,Wang Lin,et al. Application of multimedia case teaching in ophthalmology teaching[J]. Practical Blindness Prevention Technology,2015,10(4):172-174.
[5]Dong Guokai,Li Zhouru,Yin Wenjiang,et al. Discussion on the application of forensic medicine teaching method reform in the context of clinical medicine specialty accreditation[J]. Medical Information,2015,32(45):9-10.
Clinical medicine thesis 5000 words Article 4
Analysis of the current situation of the clinical thinking ability of Chinese medicine for medical students and the cultivation countermeasures
[Abstract] By analyzing the problems in the clinical thinking ability of Chinese medicine majors, it is proposed that from the mastery of the fundamentals, familiarizing with the classics, learning medical cases and teaching methods, Teaching faculty, teaching platform and other aspects of improvement, so as to solve the situation of medical students' lack of clinical thinking ability in Chinese medicine, and cultivate high-quality senior talents in Chinese medicine.
[Keywords] Chinese medicine; clinical thinking; status quo; countermeasures
Clinical thinking in Chinese medicine refers to the thinking activities of doctors in the process of clinical diagnosis and treatment, applying their own mastery of Chinese medicine theories and their own practical experience, in the process of judging and analyzing the nature of disease, the law of pathogenesis, and formulating the principles of treatment, prevention of disease and prescription of medication [1].
The holistic view of TCM determines the macroscopic nature of its understanding of human physiology and pathology.
Traditional Chinese medicine has always attached importance to the use of a holistic, systematic and dynamic approach to understanding human physiology and pathology, focusing on distinguishing between the internal organs and tissues of the human body in the yin and yang, five elements and the correlation between the attributes of the body and the physiology and pathology of the organism.
Chinese medicine clinical diagnosis and treatment thinking has its own characteristics, from the human body as a whole and local, between the internal organs and tissues, between the human body and nature, the human body and the social aspects of the connection between the examination, diagnosis, treatment of disease, is the universal connection thinking in Chinese medicine, the specific embodiment.
The correct clinical thinking of Chinese medicine plays a decisive role in clinical diagnosis and treatment.
The cultivation of medical students' clinical thinking ability is a long-term process, so that students have the ability to analyze problems, solve problems and work independently is the key to the teaching of Chinese medicine, but also where the difficulty lies.
1 current situation
1.1 training mode single obsolete
At present, China's higher medicine, more than adopting a "unified textbook, unified syllabus" education model, there is a general emphasis on teaching more than enough, emphasis on learning; more than the indoctrination, not enough enlightenment; heavy knowledge transfer, light ability to cultivate the tendency.
Over-emphasis on students must have a solid basic knowledge of medical science, while ignoring the training of students' clinical thinking ability; ignoring the training of students' communication skills and access to information; resulting in the existence of a serious disconnect between the book knowledge of medical students and the ability to clinical practice,
Some students do not know how to apply the theoretical knowledge to solve the actual problem of medical treatment, helplessness,
Some of them have no idea of how to apply theoretical knowledge to solve the actual problem of medical treatment.
1.2 Thinking mechanically and simply
Everything is changing and developing, and the disease is also a pathological process of development and change.
In the clinic, some students only based on the first collection of information, dynamic observation, not carefully scrutinized, comprehensive analysis, and directly make a diagnosis.
Some students rely on intuitive impression, the patient's history, signs or auxiliary information arbitrarily.
To be able to support their own diagnosis of the information as the main basis for judging the disease, and some do not support their own diagnosis of the information arbitrarily deleted, which is likely to lead to one-sided diagnosis.
Some students are not clear about the process of clinical diagnostic thinking, and often collect information in an unclear, different order of priority, or simply rely on advanced means of examination, do not carry out scientific reasoning and analysis, too much trust in some of the relevant data provided by the examination or the results of the direct diagnosis of diseases.
These mechanical and simple thinking methods are too hasty and can easily lead to misdiagnosis.
1.3 One-sided thinking and lack of systematicity
Students lack the ability to make lateral comparisons and comprehensive analyses of symptoms, signs, tests, and diseases when making diagnoses, and they often diagnose diseases based on typical performances in books or have been influenced by the initial diagnosis, which is rigidly applied; and in the process of diagnostic and treatment thinking, they
do not take into account the dynamic development of the disease, and only pay attention to treatment methods or medications. Only pay attention to the **** of the treatment method or drug, but ignored the patient's personality characteristics and the disease is in what stage of development; in the wards to deal with the patient, the excessive reverence for the teacher will also have no their own point of view on the treatment of the patient,
lack of proactive thinking, do not dare to combine with the overall situation of the patient's own point of view, showing blind obedience and dependence on the clinical thinking [2].
Some students only grasp the clinical symptoms, signs and symptoms of the surface characteristics, can not see through the phenomenon of the essence of the deep analysis, to seize the main contradiction of things, the use of clinical medical knowledge of a variety of phenomena for a comprehensive analysis of the lack of comprehensive judgment of the habit and ability, but also make the clinical diagnosis of the lack of systematic, can not stand up to the scrutiny of the [3].
1.4 Lack of responsibility of clinical teaching teachers
Most of the medical students' clinical internship time is about one year, and the teaching teachers are very important.
Some teachers do not devote enough energy to clinical teaching because of their busy work.
Some teachers do not work long hours, lack of clinical experience and accumulation; some lack of strict requirements for students, lack of teaching methods, not strong sense of innovation; teaching room simple, choose cases casually, no typical exemplary features, identification of ideas is not clear, the treatment principle is not appropriate, etc., the students are difficult to learn from the knowledge, and lack of training and cultivation of clinical thinking ability of Chinese medicine.
2.
2 Countermeasures
2.1 Mastering the characteristics of Chinese medicine
The clinical thinking method of Chinese medicine is to analyze and summarize the information collected from the four diagnostic methods through the method of "systematic synthesis", analyze the various symptoms, understand the location, nature, cause and mechanism of the disease, and judge the organs and organs with the attributes of yin and yang and the five elements. The method is to analyze the data collected by the four diagnostic methods, to analyze the symptoms, to understand the location, nature, cause and mechanism of the disease, to determine the pathological relationship between the internal organs and tissues with the attributes of yin and yang and five elements, and to analyze the relationship between the body's positive qi and the prevalence of disease and evil, and to identify and attribute the corresponding "evidence.
In the treatment, according to the different mechanisms of disease, to determine the treatment method and program, to achieve the balance of yin and yang in the body.
Therefore, in the clinical diagnosis and treatment of Chinese medicine, it is necessary to follow the clinical thinking method of Chinese medicine, combining the identification of diseases with the identification of evidence, and learning to use the "different treatment for the same disease" and "the same treatment for different diseases" to give the "evidence" for the judgment. The "evidence" is given to the Chinese medicine treatment method and prescription [4].
Medical students must master the clinical diagnosis and treatment characteristics of Chinese medicine, in order to correctly diagnose and treat the disease, and improve the ability of comprehensive clinical application.
2.2 Strengthen the training of classical knowledge
To train the basic skills of students, it is important to emphasize the warmth and study of classical theoretical knowledge, including the study of classic works such as "The Essentials of the Golden Chamber", "The Treatise on Typhoid Fever", "Temperatures and Diseases", and "The Internal Canon".
Read more medical cases, gradually digested into their own things, study the experience and lessons of famous doctors in the past generations of diagnosis and treatment of diseases, so that the original scattered, disordered, mixed pile of knowledge systematization, rationalization, and then set up an organic knowledge system, read more medical cases for the students to establish a clinical thinking as early as possible is not an effective way [5].
At the same time, it is also very important to follow the famous old Chinese medicine practitioners to copy the prescription, especially to learn the experience of some old Chinese medicine practitioners in the four diagnostic and diagnostic thinking on the future clinical benefit.
The realization of theory, practice, theory and practice of the cognitive process, to lay a solid foundation for the establishment of the clinical thinking of Chinese medicine, and gradually form a perfect clinical thinking of Chinese medicine.
2.3 Adoption of problem-based learning (PBL)
In the process of clinical teaching, the theory and clinical practice can be well combined by adopting the PBL teaching method.
So that students learn to link theory to clinical practice in the process of thinking, and develop clinical thinking ability [5].
PBL teaching method can fully give students the opportunity to explore the problem; to "problem as the center, the student as the main body, the teacher as a guide" purpose to make the students purpose is clear, participate in the enthusiasm is higher; to "multidisciplinary synthesis as the core" of the highest requirements to give students a broad range of clinical practice and clinical thinking ability [5]. The students' innovative thinking and communication skills can be better cultivated.
2.4 Clinical Case Analysis
Clinical case study is a special inheritance learning method in Chinese medicine, and its existence is closely related to the complexity and experience of Chinese medicine clinical diagnosis and treatment.
In the teaching process of the main clinical courses, the use of classical medical case teaching can more vividly show the valuable experience of generations of doctors, so that future generations in the clinical less detour, especially the diagnosis and treatment methods and identification of the ideas of famous old Chinese doctors, to train students in Chinese medicine clinical thinking, and to play a better demonstration role.
Similarly, clinical case discussion is an important and indispensable part of medical work.
Through the discussion of different cases, students deepen their understanding of the occurrence, development and treatment of diseases, grasp the correct diagnosis and treatment process of diseases from a deeper level, and train students' clinical thinking ability, comprehensive analysis ability and practical work ability in Chinese medicine [6].
2.5 Application of virtual reality technology in medical education
Virtual reality technology is now widely used in medical education.
In this regard, the University of Chicago in the United States and the University of Hamburg in Germany have used CT and MRI cross-sectional images to make three-dimensional visualization of virtual human anatomy atlas for anatomy teaching and after-school training of medical students.
In terms of surgical simulation, the surgical simulation system was successfully developed by Tsinghua University, which is implemented by computer-assisted roles; in terms of acupuncture simulation teaching, Shanghai University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine and so on, have established a three-dimensional human acupuncture model, and fully utilized a good human-computer interaction system, and have obtained a satisfactory result in the simulation teaching of undergraduates in medicine [7].
All these teaching research results have provided conditions for medical students' skill training, and the experimental teaching platform has been developing and growing, but 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.
Clinical thinking ability training in Chinese medicine is the difficulty and hot spot of medical education, our school after many years of unremitting efforts of many experts, is committed to the research and development of clinical thinking ability in Chinese medicine, is currently undertaking the Jiangsu Provincial Higher Education Project key issues, research and development of the results of the "clinical thinking ability training platform for Chinese medicine", "clinical thinking ability training platform for medical students". The results of the research and development of "Chinese medicine clinical thinking ability training platform" play an important role in the cultivation of Chinese medicine clinical thinking ability of medical students.
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