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Evaluation of the Implementation Effect of "Early Contact with Clinical Curriculum" in Eight-year Clinical Medical Students
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摘要:
目的 对“早期接触临床”课程在临床医学八年制医学生中的实施效果进行评价。 方法 2021年11月，以电子问卷的形式对完成“早期接触临床”课程的北京协和医学院2018级临床医学八年制医学生展开调查。采用5分制李克特量表对课程总体、临床医学生核心学习目标认知度提升情况，以及课程设置需求度和获益度进行定量评估，其中李克特量表评分≥4分为“比较提升/需求/获益”。 结果 参与调查的2018级临床医学八年制医学生共75人，回收有效问卷63份(84.0%)。课程总体评估方面，“早期接触临床”课程目标达成度评分为(4.37±0.77)分，课程在基础医学阶段的重要性评分为(4.48±0.78)分，课程对医生职业的认知提升度评分为(4.16±0.75)分。课程对临床医学生核心学习目标认知度提升方面，7个维度的认知度均获得了一定程度的提升，其中职业价值/态度/行为/伦理[(4.27±0.81)分]和医患沟通技能[(4.16±0.85)分]均为“比较提升”。课程设置需求度方面，91.7%(11/12)的课程为“比较需求”，需求度居前3位的课程依次为门诊观摩[(4.76±0.50)分]、病房观摩[(4.73±0.60)分]、医患沟通[(4.65±0.57)分]；课程设置获益度方面，66.7%(8/12) 的课程为“比较获益”，获益度居前3位的课程依次为医患沟通[(4.73±0.48)分]、病房观摩[(4.65± 0.63)分]、门诊观摩[(4.51±0.88)分]。 结论 在基础医学阶段开设“早期接触临床”课程可提升临床医学八年制医学生核心学习目标的认知度，课程设置具有较好的需求度和获益度，达到理想的教学效果。 -
关键词:
- "早期接触临床"课程 /
- 基础医学阶段 /
- 核心学习目标认知度 /
- 需求获益度
Abstract:Objective To evaluate the implementation effect of "Early contact with clinical curriculum" among eight-year clinical medical students. Methods The electronic questionnaire was conducted among the eight-year clinical medical students in grade 2018 of Peking Union Medical College who completed "Early contact with clinical curriculum" in Nov 2021. The 5-points Likert scale was used to quantitatively assess the overall effects, the improvement of cognitive level of core learning objectives in these medical students, as well as the demands and benefits of course design. The Likert scale score of ≥4 was considered "more improved/demands/beneficial". Results A total of 75 eight-year clinical medical students in grade 2018 were enrolled, and 63 valid questionnaires were collected (84.0%). In terms of the overall assessment of the program, the goal achievement rate of "Early contact with clinical curriculum" was [(4.37±0.77) points], the course importance in the basic medical learning stage was [(4.48±0.78) points], and the improvement of physician profession cognition was [(4.16±0.75) points]. Among the cognitive level of core learning objectives in medical students, all seven dimensions were improved to some extent, in which professional values/attitudes/behaviors/ ethics [(4.27±0.81) points] and physician-patient communication skills [(4.16±0.85) points] were "more improved". In terms of demands for the curriculum, 91.7%(11/12) of the courses showed "more demands", and the top three courses with high demands were outpatient observation [(4.76±0.50) points], ward observation [(4.73±0.60) points], and physician-patient communication [(4.65±0.57) points]. In terms of benefits of curriculum, 66.7% (8/12) of the courses was rated "more beneficial", and the top three courses with high benefits were physician-patient communication [(4.73±0.48) points], ward observation [(4.65±0.63) points], and outpatient observation [(4.51±0.88) points]. Conclusion "Early contact with clinical curriculum" in the basic medical learning stage could improve the cognitive level of core learning objectives in eight-year clinical medical students, the curriculum had higher demands and brought more benefits, thus achieving an ideal teaching effect. 作者贡献：谭蓓负责研究实施与评估、数据分析、论文撰写；李玥负责研究设计与指导、论文修订；魏怡真负责研究实施与评估；王巍、郭娜负责研究实施和指导；黄宇光负责研究设计指导。利益冲突：所有作者均声明不存在利益冲突 -
表 1 “早期接触临床”课程设置需求度和获益度评分
“早期接触临床”课程设置 理论课学时 实践课学时 需求度(x±s, 分) 获益度(x±s, 分) P值 课程介绍及参观院史馆/病历展 1 2 3.51±1.08 3.44±1.01 0.652 职业形象与职业素养 1 0 4.08±0.90 4.02±0.85 0.451 临床护理 1 0 4.30±0.73 4.17±0.89 0.483 院内感染与防护 1 0 4.37±0.70 4.11±0.81 0.882 医保政策解读 1 0 4.16±0.75 3.78±0.96 0.017 医学生早期职业规划 1 0 4.48±0.64 4.08±0.96 0.175 病房观摩 0 6 4.73±0.60 4.65±0.63 0.241 门诊观摩 0 6 4.76±0.50 4.51±0.88 ＜0.001 安全医疗行为与法律 1 0 4.29±0.71 3.97±0.93 0.048 医患沟通 0 3 4.65±0.57 4.73±0.48 0.150 舒缓医学 1 2 4.29±0.85 4.38±0.77 0.647 校外实践 0 6 4.51±0.78 3.71±1.18 ＜0.001 
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