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Application of Ultrasonography Visualization Teachingin the Integration Course of Diagnostics and Ultrasonic Medicine for Eight-year Clinical Medicine Program Students
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摘要:
目的 对超声可视化教学在临床医学八年制医学生诊断学-超声整合课程中的应用效果进行评估，以期为优化教学方案提供参考。 方法 以电子问卷的形式对参加颈部及腹部超声可视化教学的北京协和医学院临床医学八年制医学生展开调查。通过自身对照的方式比较教学前后医学生对相关知识点掌握的正确率，以评估教学效果。同时收集医学生对课程的满意度及教学反馈。 结果 参与调查的临床医学八年制医学生共124人。其中北京协和医学院2017级临床医学八年制博士生107人，2019级“4+4”试点班博士生17人。同一名医学生颈部超声课程前后均填写的有效问卷116份(有效回收率为93.5%，116/124)，腹部超声课程有效问卷101份(有效回收率为94.4%, 101/107)。颈部超声课程教学后，2017级博士生中，68.8%(11/16)知识点掌握的正确率得到明显提高；2019级博士生中，66.7%(10/15)知识点掌握的正确率得到明显提高(P均＜0.05)。腹部超声课程教学后，2017级博士生和2019级博士生中，均有80%(4/5)知识点掌握的正确率得到明显提高(P均＜0.05)。课程满意度调查显示，99.1%(115/116)的医学生对颈部超声课程“非常满意”或“满意”，仅0.9%(1/116)对该课程“基本满意”；99.0%(100/101)的医学生对腹部超声课程“非常满意”或“满意”，仅1.0%(1/101)对该课程“基本满意”。21名医学生反馈了教学评价，认为超声可视化教学提高了学习主观能动性(52%，11/21)及学习效率(43%，9/21)，激发了学习兴趣(5%，1/21)；27名医学生对该教学模式提出了建议，其中以“增加课时”的占比最高(56%，15/27)，其次为“推荐学习资料”(26%，7/27)。 结论 超声可视化教学可提高临床医学八年制医学生学习主动性及学习效率，激发学习兴趣，促进其对相关知识点的掌握。 Abstract:Objective To evaluate the effect of ultrasonography visualization teaching in the integration course of diagnostics and ultrasonic medicine for eight-year clinical medicine program students and to provide reference for further optimization of the teaching program. Methods The study conducted a questionnaire survey with electronic questionnaire in the eight-year clinical medicine program students from Peking Union Medical College who participated in ultrasonography visualization teaching of neck and abdomen. We adopted self-control study(data from the questionnaires completed by the same student before and after the course) to compare the accuracy of each knowledge point before and after teaching to evaluate the teaching effect, and collected course satisfaction ratings and feedback from the students. Results A total of 124 eight-year medical students participated in the survey, with 107 cases eight-year clinical medicine program students in grade 2017, and 17 cases "4+4" pilot class students in grade 2019 from Peking Union Medical College. Altogether 116 valid questionnaires (the response rate was 93.5%, 116/124) were collected for neck ultrasound courses and 101 valid questionnaires (the response rate was 94.4%, 101/107) for abdominal ultrasound courses. After the teaching of neck ultrasound course, the correctness of 68.8%(11/16) and 66.7%(10/15) of the knowledge points was significantly improved for the grade of 2017 and 2019 medicine students, respectively (all P < 0.05); after the teaching of abdominal ultrasound course, the correctness of 80%(4/5) of the knowledge points was significantly improved for both the grade of 2017 and 2019 medicine students (all P < 0.05). Course satisfaction surveys showed that 99.1%(115/116)of the students were very satisfied or satisfied with the cervical ultrasound course, and 0.9%(1/116) were somewhat satisfied. As for the abdominal ultrasound course, 99.0% (100/101) of the students were very satisfied or satisfied and 1.0%(1/101) were somewhat satisfied. Twenty one medical students gave feedback on the evaluation of the course, believing that ultrasound visualization teaching improved learning initiative (52%, 11/21) and learning efficiency (43%, 9/21) and stimulated learning interest (5%, 1/21); 27 medical students made suggestions on the teaching mode, among which "increasing teaching hours" accounted for the highest proportion (56%, 15/27), followed by "recommending reference books" (26%, 7/27). Conclusion The ultrasonography visualization teaching improves the learning initiative and efficiency of eight-year clinical medicine program undergraduates, stimulates the learning interest, and promotes their mastery of relevant knowledge. -
Key words:
- ultrasonography /
- visualization teaching /
- medicine students /
- medical education
作者贡献：赵瑞娜负责论文撰写及颈部超声课程的问卷设计；王铭负责腹部超声课程的问卷设计；王欣负责课程组织及问卷收集；杨萌负责教学方案设计及论文修订；李建初、范洪伟、黄晓明负责指导研究设计并对课程的实施提供支持；李文波、苏娜、王亚红、朱沈玲、张晓燕、王莹、高璐滢、王若蛟参与教学课程及问卷审核。利益冲突：所有作者均声明不存在利益冲突 -
表 1 颈部超声课程教学前后医学生对知识点掌握正确率比较
知识点 教学前正确率(%) 教学后正确率(%) P值 1.超声检查甲状腺结节的适应证：临床触诊甲状腺肿大 94.0 100 0.016 2.超声检查甲状腺结节的适应证：体检发现甲状腺结节并进行结节良恶性鉴别 90.5 98.3 0.004 3.超声检查甲状腺结节的适应证：甲状腺结节随访 94.8 100 0.031 4.超声检查甲状腺结节的适应证：甲状腺癌术后监测 94.0 100 0.016 5.超声检查甲状腺结节的适应证：高危人群甲状腺癌筛查 91.4 98.3 0.008 6.超声检查甲状腺结节的适应证：辅助甲状腺及颈部淋巴结穿刺活检 99.1 100 ＞0.999 7.超声不能确诊甲状腺功能亢进症 84.5 96.6 0.001 8.超声检查在甲状腺疾病诊疗中的优势：无创 100 100 ＞0.999 9.超声检查在甲状腺疾病诊疗中的优势：无辐射 100 100 ＞0.999 10.超声检查在甲状腺疾病诊疗中的优势：便捷、经济 100 100 ＞0.999 11.超声检查在甲状腺疾病诊疗中的优势：高分辨率、实时成像 84.5 95.7 0.002 12.超声检查在甲状腺疾病诊疗中的优势：诊断准确性高 66.4 96.6 ＜0.001 13.识别低回声甲状腺结节图像 94.8 94.8 ＞0.999 14.诊断为甲状腺肿大的超声标准是前后径大于2 cm 40.5 98.3 ＜0.001 15.正常淋巴结的超声表现为长径与短径比值大于2 57.8 95.7 ＜0.001 16.颈部中央区淋巴结与侧方淋巴结的超声分界为颈总动脉内侧缘* 24 83 ＜0.001 *2017级博士生新增知识点 
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表 2 腹部超声课程教学前后医学生对知识点掌握正确率比较
知识点 教学前正确率(%) 教学后正确率(%) P值 1.肝内门静脉与肝静脉呈非平行分布 66.3 99.0 ＜0.001 2.肝弥漫性病变便捷、实用的影像学检查方法是超声成像 99.0 100 ＞0.999 3.门静脉的血流方向为入肝血流 86.1 97.0 0.007 4.如果同时有钡餐与超声检查，应该先进行超声检查 72.3 96.0 ＜0.001 5.随年龄增加，超声检查可见人体胰腺回声增强 65.3 89.1 ＜0.001
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