CAJ | 학술논문

目的：探讨提高救援医学专业学生急性中毒课程的教学效果。方法选择2013年3至6月进入临床实习的30名救援医学专业学生为研究对象。随机平均分为2组：实验组采用基于案例实习（跟踪式），以实习科室遇到的中毒病例为起点，顺时或逆时追踪患者病情的发生、发展，从而获取患者的完整病历资料。对照组采用传统转科实习（轮转式），以实习科室遇到的中毒病例为起点和终点，获取患者中毒的病历资料。教学结束后通过考试和问卷调查比较2种实习方式的临床教学效果。数据使用SAS 9.2软件进行统计分析，两组间均数比较采用t检验，计数资料采用χ2检验，P<0.05为差异有统计学意义。结果在同一实习期内学生人均学习的病例数，实验组多于对照组[（15±3）例 vs.（9±5）例，P＜0.01]；期末技能考试成绩，实验组明显高于对照组[（79.1±6.9）分vs.（66.2±6.7）分，P＜0.01]；理论考试成绩，两组间比较差异无统计学意义[（88.4±5.7）分vs.（87.8±6.3）分，P＞0.05]，但年级平均成绩比上一年有明显提高[（88.1±6.0）分 vs.（79.3±12.8）分，P＜0.01]。问卷调查结果显示：在认同跟踪式实习方式的10个优势方面，师生综合满意度分别为95.3%（143/150）和93.3%（140/150）。结论基于案例学习的跟踪式实习，实现了以授课、问题为基础的教学方法的良好结合，有利于培养和锻炼医学生学以致用的能力。
목적：탐토제고구원의학전업학생급성중독과정적교학효과。방법선택2013년3지6월진입림상실습적30명구원의학전업학생위연구대상。수궤평균분위2조：실험조채용기우안례실습（근종식），이실습과실우도적중독병례위기점，순시혹역시추종환자병정적발생、발전，종이획취환자적완정병력자료。대조조채용전통전과실습（륜전식），이실습과실우도적중독병례위기점화종점，획취환자중독적병력자료。교학결속후통과고시화문권조사비교2충실습방식적림상교학효과。수거사용SAS 9.2연건진행통계분석，량조간균수비교채용t검험，계수자료채용χ2검험，P<0.05위차이유통계학의의。결과재동일실습기내학생인균학습적병례수，실험조다우대조조[（15±3）례 vs.（9±5）례，P＜0.01]；기말기능고시성적，실험조명현고우대조조[（79.1±6.9）분vs.（66.2±6.7）분，P＜0.01]；이론고시성적，량조간비교차이무통계학의의[（88.4±5.7）분vs.（87.8±6.3）분，P＞0.05]，단년급평균성적비상일년유명현제고[（88.1±6.0）분 vs.（79.3±12.8）분，P＜0.01]。문권조사결과현시：재인동근종식실습방식적10개우세방면，사생종합만의도분별위95.3%（143/150）화93.3%（140/150）。결론기우안례학습적근종식실습，실현료이수과、문제위기출적교학방법적량호결합，유리우배양화단련의학생학이치용적능력。
Objective To explore the teaching effect of acute poisoning course among students majoring in rescue medicine. Methods From March to June 2013, 30 students majoring in rescue medicine were randomly divided into two groups for the clinical practice. Case-based learning was used in experimental group and cases was tracked from one department to another in chronological order or in reverse order to explore the cause of poisoning and the development of disease and to ob-tain the complete medical records of patients. Traditional rotating internship was used in control group. Poisoning cases in the department were taken as the starting point and end point and the medical records of patients were obtained. The clinical teaching effect was compared between the two groups through questionnaire survey and final examination. The data were calculated by SAS 9.2 software, mean comparison between the two groups was conducted by t test and enumeration data were analyzed by chi-square test. P<0.05 stands for statistically significant difference. Results The number of cases in the experimental group was more than that in the control group during the same internship period ((15±3) vs. (9±5),P<0.01). Skill score of experimental group was significantly higher than that of the control group((79.1±6.9) vs. (66.2±6.7), P<0.01). Theory examination results between two groups had no obvious difference((88.4±5.7) vs. (87.8±6.3),P>0.05),however, theory examination results were increased significantly in this year compared with those of previous year((88.1±6.0) vs. (79.3±12.8), P<0.01). Questionnaire survey demonstrated that teachers and students' satisfaction were 95.3%(143/150) and 93.3%(140/150) respectively regarding the ten advantages of the track-ing type internship. Conclusions Tracking type internship with poisoning case-based learning is a good combination of lecture-based learning and problem-based learning. It is helpful to cultivate and exercise students' ability to apply the knowledge.