1、浙江医学教育 2023 年 2 月第 22 卷第 1 期ZJ Med Edu，Feb 2023，Vol.22，No.1教学方法床旁立体教学方法在心血管重症监护专科临床教学中的应用效果夏珂1，2李非1，2赵震宇3杨天伦1，21中南大学湘雅医院心内科，长沙 410078;2中南大学湘雅医院内科学教研室，长沙410078;3中南大学湘雅医院临床药理研究所，长沙 410078通讯作者:夏珂，Email:【摘要】目的探讨床旁立体教学方法在心血管重症监护专科临床教学中的应用效果。方法选择在中南大学湘雅医院心血管重症监护专科培训的 65 名住院医师为研究对象，将其随机分为试验组和对照组。试验组 33 名住院
2、医师，采用床旁立体教学方法(联合并融会贯通“基于问题学习教学方法、基于案例学习教学方法、Seminar 教学方法、临床路径教学方法”);对照组 32 名住院医师，采用传统教学方法。教学结束后，采用问卷调查和出科考试方式，评估并比较两组住院医师不同教学方法的实施效果。结果首先，试验组中认为自己各方面临床能力(检索文献、结合指南诊疗、结合量表评估疾病严重程度、临床思维、临床诊断、临床治疗、团队合作)有所提高的住院医师占比明显高于对照组住院医师(P0.05)。其次，试验组中认为其对各种严重心血管重症监护专科突发状况的处理能力(急性心衰、急性冠脉综合征、急性肺栓塞、高血压危象、低血压休克、室上性心律失
3、常)有所提高的住院医师占比明显高于对照组住院医师(P0.05)。再次，试验组中认为其对心脏重症患者各系统严重合并症的处理能力(合并呼吸系统疾病、消化系统疾病、糖尿病、多器官功能不全、酸碱失衡、营养不良、严重感染)有所提高的住院医师占比明显高于对照组住院医师(P0.05)。最后，试验组住院医师的出科考试成绩显著高于对照组住院医师(P0.05)。结论床旁立体教学方法在心血管重症监护专科的临床教学中取得了良好的效果。试验组绝大多数住院医师认为，实施立体教学方法提高了他们的学习兴趣和各种临床能力，提高了他们处理各种严重心血管重症监护专科突发状况、心脏重症患者各系统严重合并症的能力;同时，提高了他们的出
4、科考试成绩。床旁立体教学方法值得在心血管重症监护专科的临床教学中加以推广和应用。【关键词】床旁立体教学方法;心血管重症监护专科;住院医师;临床教学;应用效果【中图分类号】-05基金项目:中华医学会医学教育分会和中国高等教育学会医学教育专业委员会 2020 年度医学教育研究重点立项课题:“心音数据库建立及其在心脏听诊教学中的作用”(20A0034);中南大学 2020 年教学改革课题:“床旁立体教学法在心血管内科临床教学中的应用探讨”(2020JY151);2020 中南大学线上金课:“诊断学 A:诊断学之心电图、心脏听诊视听教学”(220101Z10)DOI:10.20019/ki.1672-
5、0024.2023.01.037 07Application of bedside stereo-teaching method in clinical teaching of cardiac intensive care specialtyXIA Ke1，2，LI Fei1，2，ZHAO Zhenyu3，YANG Tianlun1，21Department of Cardiology，Xiangya Hospital，Central South University，Changsha 410078，China;2Departmentof Internal Medicine，Xiangya H
6、ospital，Central South University，Changsha 410078，China;3Institute ofClinical Pharmacology，Xiangya Hospital，Central South University，Changsha 410078，ChinaCorresponding author:XIA Ke，Email:【Abstract】ObjectiveTo explore the application effect of bedside stereo-teaching method in clinicalteaching of car
7、diovascular intensive care specialty.Methods65 residents who entered the cardiovascular intensivecare specialty，Xiangya Hospital，Central South University，were selected as the research objects and randomly73浙江医学教育 2023 年 2 月第 22 卷第 1 期ZJ Med Edu，Feb 2023，Vol.22，No.1divided into the experimental group
8、 and the control group.33 residents in the experimental group adopted Bedsidestereo-teaching method(combining and mastering“problem-based learning teaching method，case-based learningteaching method，seminar teaching method and clinical pathway teaching method”);The control group，32residents，adopted t
9、raditional teaching methods.After the study，questionnaire survey and examination beforeending study in cardiac intensive care specialty were used to compare and evaluate the effect of different teachingmethods between the two groups of residents.esultsFirst of all，the proportion of residents in the
10、experimentalgroup thought that their clinical abilities(literature retrieval，diagnosis and treatment with guidelines，evaluation ofdisease severity with scales，clinical thinking，clinical diagnosis，clinical treatment and teamwork)had beenimproved was significantly higher than that of in the control gr
11、oup(P0.05).Secondly，the proportion of residentsin the experimental group thought that their ability to deal with various emergencies in cardiovascular intensive carespecialty(acute heart failure，acute coronary syndrome，acute pulmonary embolism，hypertensive crisis，hypotension shock，supraventricular a
12、rrhythmia)had been improved was significantly higher than that of in thecontrol group(P0.05).Thirdly，the proportion of residents in the experimental group thought that their ability todeal with various severe complications of other systems(respiratory diseases，digestive diseases，diabetes，multipleorg
13、an dysfunction，acid-base imbalance，malnutrition，severe infection)had been improved was significantly higherthan that of in the control group(P0.05).Finally，the scores of the residents in the experimental group weresignificantly higher than the control group(P0.05).ConclusionsBedside stereo-teaching
14、method has achievedgood results in clinical teaching of cardiovascular intensive care specialty:a higher proportion of residents think thatstereo-teaching method has improved their learning interest and various clinical abilities，improved their ability todeal with various emergencies in cardiovascul
15、ar intensive care specialty and various serious complications of othersystems in patients with severe heart disease，and improved their examination results.Bedside stereo-teachingmethod is worth popularizing and applying in clinical teaching of cardiovascular intensive care specialty.【Key words】Bedsi
16、de stereo-teaching method;Cardiovascular intensive care specialty;esident physician;Clinical teaching;Application effectFund program:2020 Key Topics of Medical Education esearch Project of Chinese Medical AssociationMedical Education Branch and China Association of Higher Education Medical Education Specialized Committee:“Establishment of Heart Sound Database and Its ole in Heart Auscultation Teaching”(20A0034);Central SouthUniversity s 2020 Teaching eform Topic:“Discussion on the Application of
