Talk about scientific teaching methods and methods
Surgery teaching process, the joint transportation of a variety of teaching methods and methods to enhance students' interest in learning, then talk about scientific teaching methods and methods.
Surgery is the study of the etiology of surgical diseases, pathology, clinical manifestations, diagnosis, treatment, prevention and surgical skills of the main clinical disciplines. Its content is divided into two parts: the general theory and each theory. The general theory includes asepsis, fluid disorders in surgical patients, blood transfusion, surgical shock, multiple organ dysfunction syndrome, anesthesia, critical care monitoring treatment and resuscitation, pain management, perioperative management, nutritional metabolism of surgical patients and surgical infections. The monographs include various diseases of the cranial brain, neck, breast, chest, abdomen, spine extremities and other parts of the organs. The study of Surgery is extensive, abstract and boring, and it is difficult to stimulate students' interest in learning. Therefore, teachers of surgery must apply a variety of teaching tools and methods in order to mobilize students to learn enthusiasm and initiative, and improve the quality of teaching of surgery.
1. Multimedia teaching.
Multimedia teaching is to computer technology as the core, in the teaching of the integrated use of text, images, audio, video and animation and other information carriers, to fully stimulate the visual organs and auditory organs of the educated, to mobilize the educated interest in learning and motivation, to improve the learning efficiency [1]. The use of multimedia for surgical teaching has the following advantages: (1) vividly display the teaching content. The traditional classroom teaching method of surgery is that the teacher uses the board, teaching wall charts, slides, teaching molds and other means to teach. As the concepts and clinical manifestations of many diseases in surgery are abstract, it is difficult for students to understand them by simply relying on the above teaching methods. Multimedia courseware through pictures, text, sound, video, animation, make the abstract content specific, visualization, easy for students to understand. In addition, multimedia courseware can also be played back and pause at any point, which helps students to review after class and strengthen their memory; (2) improve teaching efficiency. With the deepening of teaching reform, the number of teaching hours for each course is constantly decreasing. How to teach more teaching content to students within the limited teaching time is a challenge for every teacher. Traditional classroom teaching requires teachers to write the key points of knowledge in the preparation notes on the blackboard for students to record, which will shorten the teacher's explanation time. Multimedia courseware can show a large number of knowledge points in front of students in limited classroom time, which saves the teacher's time for writing on the board, and is conducive to expanding the teaching content, so that students can learn more knowledge in the classroom. At the same time, students in class only need to pay attention to the lecture, do not need to take classroom notes, after class copy of the teacher's multimedia courseware can be; (3) Surgery, including surgical operations, due to the limitations of the size of the operating room space and the operating room of the aseptic requirements, it is not possible to let all the students in the class into the operating room to watch the operation. Instead, multimedia equipment can be utilized to film the surgical area and then transmit the surgical procedure in real time to the classroom for students to watch through a television image relay system. Teachers in the operating room while operating while explaining, students in the classroom to watch, discuss, and at any time through the multimedia equipment to the operating room teachers to ask questions, you can achieve good teaching results; (4) multimedia teaching has the advantages of graphic and illustrative, can make the boring surgical teaching content become vivid and interesting, stimulate students' interest in learning, and help students to listen carefully during class, think positively, so as to achieve better learning results. This is the first time that I've ever seen a computerized version of the same thing, and I've never seen anything like it.
2. Utilizing the surgical website for teaching.
In recent years, with the rapid development of network technology, many medical schools have set up their own surgical website, which provides a good network platform for surgical teaching and is an important supplement to traditional classroom teaching. Network teaching spans the distance between teachers and students in time and space, breaks through the limitations of traditional face-to-face classroom teaching methods, extends the lecture classroom from the classroom to any location covered by the network, and at the same time greatly enriches the teaching resources, which has obvious advantages compared with traditional teaching methods [2], as follows: (1) Surgery teachers are all clinicians in hospitals, and in addition to their teaching work, they also have to undertake the hospital's medical tasks and clinical research work, which is quite busy. Moreover, a teacher is usually responsible for teaching only one chapter and goes to the hospital to work after teaching, so if students encounter problems after class, they cannot get answers from the teacher. Surgery website usually has a discussion forum, students can put forward the problems encountered in their study to the teachers through the discussion forum, and the teachers also answer the questions through the discussion forum, thus strengthening the communication between students and teachers; (2) Surgery has a lot of teaching content, and the number of classroom hours is relatively small. Therefore, teachers can only teach the key contents in the classroom, and it is too late to teach other related contents. After class, teachers can upload teaching courseware to the Internet for students to learn, expanding students' knowledge and improving their ability to learn independently; (3) With the rapid development of science and technology, the knowledge of surgery is constantly enriched and updated. In the classroom, teachers' teaching content is centered on textbooks, which are relatively old, and even for the latest version of textbooks, it usually takes 3 to 5 years, or even longer, from writing to reviewing and publishing the book [3]. After such a long publication cycle, the content of textbooks obviously lags behind the development level of contemporary surgery. Students simply mastering book knowledge can no longer keep pace with the development of Surgery and cannot meet the requirements of Surgery education in the new era. Therefore, teachers can introduce the latest development of surgery to students through the website, broaden students' horizons, stimulate students' interest in learning, motivate them to take the initiative to learn and acquire new knowledge, which will help to cultivate them into creative talents; (4) some students are working students, they work and study at the same time, and sometimes they can't come to the school to attend classes because of their work, so they can make up for the class through the online platform. Learning; (5) Establishing links between the school's Surgery website and famous foreign surgical websites, which facilitates students' direct access to foreign websites to learn new knowledge, and also improves students' English reading level; (6) Convenience and speed. According to the changes in the surgical science syllabus, teachers can update or supplement the teaching content on the Internet at any time.
3. Actively carry out surgical laboratory teaching [4].
Surgery is a major clinical discipline with surgery as the main means of treatment. Surgical laboratory as an important part of surgical teaching, its main purpose is to cultivate students' surgical operation ability. The traditional surgical teaching mode favors the teaching of theoretical knowledge, and does not pay enough attention to the cultivation of surgical operation skills. As a result, students have poor hands-on ability after entering the clinic, and it is difficult for them to adapt to the clinical work. How to improve the quality of surgical laboratory teaching and enhance students' surgical operation skills is an important issue for teachers. Combined with the actual situation of our school, we adopt the principle of gradual and orderly progress and divide the surgical laboratory teaching into three steps, which has achieved good results. Step 1: Learning of preoperative preparation and surgical operation skills, including how to correctly change hand-washing clothes and pants, shoes, wear a good mask and hat, surgical hand-washing, entering the simulated operating room (laboratory), wearing surgical gowns, wearing sterile gloves and other preoperative preparations, as well as surgical instruments identification and use, disinfection of the surgical area, spreading of towels, incision, haemostasis, ligature, separation, suture, dressing change, removal of sutures and other surgical operation skills. This stage allows students to learn and practice these surgical operation skills initially through teacher demonstration, explanation, and the combination of multimedia teaching courseware. Step 2: Reinforcement of surgical operation skills . Training. An operation often needs to be practiced repeatedly and diligently in order to achieve proficiency in ? actual combat? real use. Some students feel that this stage of practice is relatively boring and easily bored. Teaching should pay attention to mobilize the students' subjective initiative, such as carrying out some small competitions, organizing mutual discussion, mutual learning and mutual aid, to improve the interest in learning. Teachers do not let go of the eyes, encourage students to boldly and carefully operate, correct their shortcomings and errors in a timely manner. Step 3: animal simulation surgery training. Simulated surgery with rabbits to create the same atmosphere as the operating room, emphasizing that simulated surgery on laboratory animals, just like surgery for patients in the clinic, must strictly abide by the rules of asepsis and the basic principles of surgery, and at the same time, more effective training of surgical operation skills. Each student in the surgical process are rotated to different surgical roles, such as respectively as the lead surgeon, assistant, etc., which not only enables students to obtain different experiences and skills in different surgical positions, but also enables students to understand that surgery is a collaborative and strong labor, and that they must have a good teamwork spirit.
4. Problem-based teaching.
Surgery is a highly practical subject. The traditional teaching mode of surgery is lecture-based teaching, that is, teachers speak, students listen, students passively accept knowledge, and the ability to flexibly apply knowledge in practice is poor [5]. Specifically manifested in the clinical internship: although students remembered the etiology, pathology, clinical manifestations, diagnosis, differential diagnosis and treatment of surgical diseases and other aspects of theoretical knowledge, but when faced with a patient, it appears to be disordered thinking, and can not make a correct diagnosis and treatment of the disease [5]. 1969, Barrows, an American professor of neurology, pioneered the problem-based teaching model at McMaster University in Canada [6]. teaching model [6]. This teaching mode breaks the traditional lecture-based teaching method and advocates the patient's disease problem as the basis for student self-study, discussion as the main body, and the teacher's participation in guiding, which mobilizes the enthusiasm and initiative of students' learning and cultivates the students' ability to solve practical problems.
The problem-based teaching model can be followed? Teachers give cases and ask questions? Student self-study? Classroom discussion? Teacher summarization? These four steps are implemented [7]. Step 1: Teacher gives a case and asks questions. Such as learning surgical diseases? Acute perforation of gastroduodenal ulcer? When the teacher provides students with the following case before class: Wang, male, 45 years old, farmer. Complaints: abdominal pain, abdominal distension with intermittent vomiting for three months, severe pain for 12 hours. 3 months, the patient often feel vague pain in the epigastric region, fullness and bloating, every 1 to 3 days to vomit acidic food residues once. Stools were once a day, yellow in color. Recently, the vomiting was aggravated, and the patient vomited food from the same meal and every other meal, with a strong acidic odor. On the morning of the day of admission, he suddenly felt persistent pain in the upper abdomen, not radiating to the back of the shoulders, which was tolerable at first, and then worsened in the evening, so he was admitted to the hospital as an emergency. The patient was healthy in the past, but in the past 10 years, he often felt vague pain and discomfort in the epigastrium when he ate or drank improperly, and he had a history of acidity and belching, but he never vomited blood or had black stools. Physical examination: temperature 38.0OC, pulse 140 beats/min, respiration 21 beats/min, blood pressure 80/50mm Hg. Acute severe illness, dehydration, no yellowing of the sclera, no cardiopulmonary distinction. Abdominal muscles were obviously tense, abdominal breathing was weakened, and there was pressure and rebound pain throughout the abdomen, most notably in the upper abdomen. Blood tests: white blood cell count 13?109/L, neutrophils accounted for 94%, red blood cell count 5?1012/L. According to the teaching objectives, the teacher put forward the following questions: (1) to make a preliminary diagnosis, listing the diagnostic basis; (2) what diseases need to be differentiated from; (3) to further clarify the diagnosis, what are the necessary tests to be done? (4) If the diagnosis is confirmed, what is the treatment plan? Step 2: Student self-study. In response to the problems in the case, students go to the library or go online to check books and references to seek knowledge to solve the problems. Step 3: Classroom discussion. In the classroom, students first group discussion, each student around the problem to express their own views, but also can put forward their own confusion. Then, each group selects a representative to summarize the results of the group discussion and speak to the class. During the students' discussion, the teacher records the different points of view and questions. Step 4: Teacher's summary. At the end of the discussion, the teacher comments on the students' presentations, answers the questions raised and gives the correct answers to the questions. The problem-based teaching mode leads to problems through surgical cases, and students learn independently around the problems, and after consulting books, journals, and other materials, they obtain the knowledge hidden behind the problems and apply what they have learned to solve practical clinical problems. This teaching mode is closest to the clinical approach to surgical problems, and it can improve students' ability to solve problems in clinical practice.
5. Standardized patient teaching.
The last year of medical students' study is to leave school and enter the hospital for clinical internship. Clinical internship is a bridge between basic theory and clinical practice, laying the foundation for medical students to become a qualified physician after graduation [8, 9]. Therefore, clinical internship is an important stage in training medical talents. When medical students first start their clinical internship, they will more or less cause inconvenience to patients and even increase their pain because they are not skillful in physical examination. Therefore, many patients are unwilling to accept their consultation and physical examination, which will greatly reduce the learning opportunities for medical students and affect the quality of clinical internship. In order to make up for the lack of students' clinical hands-on opportunities, medical schools can recruit some people with high comprehensive quality for the society and conduct training, so that they can become standardized patients, able to accurately imitate the clinical symptoms and signs of patients, for the training of students' basic clinical skills, which is a new way of training clinical practice skills in line with the international standards [10]. Through standardized patient teaching, students not only improve their clinical skills, but also learn to respect patients, enhance their ability to communicate with patients, and lay a solid foundation for future clinical work.
6. Establish a comprehensive assessment system.
The traditional surgical assessment is based on theoretical exams, and students tend to get high scores by rote memorization, which is not conducive to the development of students' operational skills and analytical and problem-solving abilities. Therefore, the assessment method should be reformed to assess students' learning from various aspects. Comprehensive assessment includes the written examination of surgical theoretical knowledge, the operational examination of surgical skills, and the assessment of analyzing and problem solving ability. The assessment of analyzing and problem-solving ability includes students' performance in group discussion during problem-based teaching, learning records during clinical internship, and students' achievements in scientific and technological innovation activities. Through the above comprehensive assessment, students' theoretical knowledge, operational skills and analytical and problem-solving abilities are comprehensively assessed, and students are urged to develop comprehensively and improve their overall quality.
In short, in the process of teaching surgery, the joint use of multimedia, surgical laboratory teaching, problem-based teaching, standardized patient teaching, comprehensive assessment and other teaching methods and methods, not only can enhance the students' interest in learning, improve the theoretical knowledge, but also strengthen the students' practical ability, laying the groundwork for the future clinical work.
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