临床医学本科生进行微创外科教学的探讨

摘要

目的：探讨对临床医学本科实习生进行微创外科理念培养的必要性，并以腹腔镜外科技术为微创外科代表，辅以临床思维能力培养，探讨其在教学应用中的可行性。方法抽取2011年01月-2013年12月南通大学临床医学本科实习生60名，随机分为试验组（ n＝30）和对照组（ n＝30），试验组进行临床思维能力培养、微创外科基础知识学习、腹腔镜技能训练、动物实验、手术演示及现场观摩等培训，对照组未进行相关培训。比较培训后两组临床思维能力及腹腔镜操作能力以评估培训效果。结果试验组临床思维能力考核成绩优于对照组，差异有统计学意义（P＜0．05）。试验组的腹腔镜导航能力、有效动作能力、器械操作能力、感知能力及电刀使用能力均优于对照组，差异有统计学意义（P＜0．05）；剪切能力差异无统计学意义（P＞0．05）。结论临床医学本科生教育中，微创外科理念培养、腹腔镜基本技能培训并辅以临床思维能力培养的微创外科教学体系不仅有助于提高他们在该领域的认识水平及临床基本技能，同时也可启发科研思维并有利于其今后的研究生教育。%Objective To investigate the necessity of minimally invasive surgery teaching for clinical medical undergraduates and its feasibility in teaching of laparoscopic technology and cultivation of clinical thinking ability.Methods We selected 60 clinical medical undergraduate interns from Nantong University from January 2012 to December 2013 .They were randomly divided into experimental group ( n=30) and control group (n=30).The experimental group received training in clinical thinking ability, minimally invasive surgery basic knowledge, laparoscopic skills, animal experiments, operation demonstration and on-site observation while the control group did not receive any training.The two groups were compared in clinical thinking ability and laparoscopic skills so as to evaluate the training effects. Results We found that the experimental group had significantly higher scores in the clinical thinking ability test than the control group ( P <0 .05 ) .It also outperformed the control group in laparoscopic navigation ability, effective action ability, equipment operation ability, perception ability and electric knife-using ability ( all P <0.05 ) .They two groups did not differ in cutting ability ( P >0.05 ) . Conclusion This suggests that cultivation of minimally invasive surgery concept and training of basic laparoscopic skills combined with clinical thinking cultivation in minimally invasive surgery teaching for clinical medical undergraduates can not only improve their understanding and basic clinical skills in this field, but also inspire their scientific thinking for future graduate education.