Objective To explore the strategies of improving the teaching quality of complete physical examination in diagnostics. Methods A total of 314 medical students' surveys relating to contents and skills of complete physical examination in Diagnostics were accomplished. Problems in the teaching quality of the complete physical examination were selected and countermeasures were determined by analyzing scores and performance of students. Results Among 192 items in a complete physical examination, students mastered poorly in 77 (40.1%) items, and especially poorly in 14. Skills of a comprehensive physical examination, including examination without repetition, inversion, omission and skills of palpation and percussion, were difficult to acquire. Conclusion It is helpful to improve the teaching quality of a complete physical examination by analyzing the problems in the physical examination to formulate the teaching objectives and optimize teaching methods.
As a crucial component of clinical medicine, the main task of diagnosis is to cultivate students’ ability to master systematic clinical thinking, disease diagnosis process, comprehensive analysis methods, and the ability to solve clinical problems. Introducing case-based clinical reasoning as a novel and advanced teaching method in the diagnosis course, in line with the comprehensive ability teaching objectives of the course, can provide students with a platform to apply learned knowledge in practical cases, enhance the fun and practicality of learning, improve students’ clinical thinking ability and practical skills, enable students to make quick and accurate judgments when facing complex cases, and ultimately enhance their ability to analyze and solve problems comprehensively. This article combines the experience of applying case-based clinical reasoning to undergraduate diagnosis at West China School of Medicine of Sichuan University, and explores the prospects of applying this teaching method in medical diagnostics.
Objective To explore the teaching effects of problem-based learning (PBL) in diagnostic practice teaching. Methods A total of 32 students enrolled into PBL group adopted the PBL teaching method based on certain cases in some sections while the other 210 students into the control group adopted the traditional teaching method. Their scores in the theory, the practice skill examination and the evaluation of the analytical ability of the medical records were compared. A questionnaire survey was measured in PBL group after class. Results There was no significant difference in scores of theory and practice skill examination in the two groups. The questionnaire survey revealed that the PBL method could improve the learning interest, independent study, b communication, analytical skills, and team spirit. However, there were defects in systematization of imparting knowledge. Conclusion The PBL method has an obvious advantage in diagnostic practice teaching.
Objective To summarize the research status and progress of imaging diagnosis of periampullary carcinoma. Methods The literatures on imaging diagnosis of periampullary carcinoma were reviewed. Results At present, the commonly used imaging diagnosis methods for periampullary carcinoma mainly include ultrasound, CT, MRI, and endoscopic retrograde cholangiopancreatography. Some other new imaging techniques had also been applied in the diagnosis and evaluation of periampullary carcinoma. Conclusions Different imaging methods have their own advantages and disadvantages in the diagnosis of periampullary carcinoma. Therefore, the detection rate and diagnostic accuracy of periampullary carcinoma can be improved by rational selection of imaging techniques or combined application of multiple techniques.
目的 探讨诊断学床旁见习教学中学患关系现状，为提高诊断学床旁教学质量提供应对策略。 方法 采用自行设计问卷，于2010年5月-2011年6月对80名临床医学专业三年级本科生以及同期在内科住院的100例患者分别进行不署名学患关系问卷调查（有效问卷率分别为91.3%和67%），同时对8名带教教师和7名临床主管医生进行个别访谈。 结果 学生问卷调查显示，79.5%的学生曾在床旁教学中遭遇患者不同程度的拒绝或不配合，大多数学生认为有被拒的心理准备和承受力。患者调查显示，82.1%的患者不愿意接受学生问诊查体，58.2%的患者表示即便给予一定经济补偿，也不愿配合教学。而对带教教师及临床主管医师访谈结果显示，当前床旁带教难度大大增加，学患关系紧张。 结论 现阶段学患关系紧张，根据其涉及原因，提出提升医务人员及医学生人文观念，推进医疗、教育体制改革，建立媒体监督机制，开展公众教育等多层面的应对策略，同时提出课程设置、教学模式、师资培养等具体教学应对举措。Objective To explore the present status of the relationship between students and patients in diagnostic bedside teaching, in order to promote the teaching quality. Methods From May 2010 to June 2011, self-made questionnaires were adopted to carry out an anonymous survey among 80 medical students in grade three or above and 100 inpatients to investigate the relationship between the students and the patients(with an effective questionnaire rate of 91.3% and 67% respectively). Eight tutors and 7 physicians concerned were taken in the individual interview. Results The survey showed that 79.5% of the students encountered refusal from patients in bedside teaching, and most of them believed that they had psychological preparation and endurance for the refusal. A total of 82.1% of the patients expressed their unwillingness to accept examination by clinical students, and 58.2% of the patients were unwilling to cooperate in the teaching even with an amount of economic compensation. The tutors and physicians concerned stated that the student-patient relationship was undesirable at present. Conclusions The relationship between students and patients in bedside teaching is strained at present. Based on the complicated reasons, we propose such coping strategies as promoting humanism among medical workers and students, pushing forward the medical and educational reform, building media supervision, developing public education, perfecting course design, teaching style, and cultivation of teachers, and so on.
A mean of systematic review of diagnostic tests based on The Bayes Library of Diagnostic Studies and Reviews (2nd edition 2002) and Bayes Library are introduced to Chinese readers who are interesting on diagnostic test and screening systematic review.
Objective To evaluate the teaching effect of case-based learning (CBL) combined with team-based learning (TBL) pedagogy in laboratory diagnostics education. Methods The data of the undergraduate clinical-medical students who completed the laboratory diagnostics course between September 2021 and July 2023 at West China School of Medicine of Sichuan University were retrospectively collected. Among them, the undergraduates of grade 2020 adopted the CBL+TBL combined pedagogy, while the undergraduates of grade 2019 assumed the traditional lecture-based learning (LBL) teaching method. Based on the cluster sampling method with the whole grade as the sampling unit, comparative effectiveness was assessed via examination scores and questionnaire feedback. Results A total of 303 students received the CBL+TBL teaching method (CBL+TBL group), while 289 students received the LBL teaching method (LBL group). Compared with the LBL group, the CBL+TBL group had higher scores on the clinical case discussion (90.28±4.05 vs. 88.39±5.19, P<0.001) while lower scores on the theoretical quiz (83.89±12.55 vs. 88.77±10.46, P<0.001). The overall performance of the CBL+TBL group was worse than the LBL group (61.28±3.83 vs. 61.98±3.98, P=0.028). A total of 161 valid copies of questionnaire were collected from the CBL+TBL group. Among them, more than 70% of the students believed that CBL+TBL pedagogy could improve learning motivation, independent learning ability, and team communication and assistance ability. Compared with the LBL teaching mode, 74.5% of the students preferred the CBL+TBL pedagogical approach. Conclusion The CBL+TBL pedagogy can help to improve autonomic learning, teamwork, and problem-solving ability, and a combination with LBL teaching may be utilized to enhance theoretical scores.
ObjectiveTo explore the present national status of diagnostic teaching as well as to investigate the opinions on teaching operation such as overall course planning, so as to provide references for the formulation of national diagnostic teaching standard in the future.MethodsSelf-made questionnaires were adopted to carry out an anonymous survey among the teachers from 50 different medical colleges and universities who worked on diagnostic teaching throughout the country from October 2016 to September 2017.ResultsA total of 100 teachers were investigated. The diagnostic teaching departments where 59 respondents worked in were formed by a few fixed teachers plus teachers in rotation. The requirement of rotation time as well as the setting up of lecture-internship ratio in each school were quite various. Forty-seven respondents agreed that the ideal lecture-internship ratio should be internship more than lecture. As for the instruments of clinical skill room, only 40% of the respondents agreed that their diagnostic departments were equipped with a steady standardized patient (SP) team, which was also the reason why SP teaching was the least utilized teaching method during internship (47%). The respondents had various opinions on whether the final exam should weigh more than 50% in the subject score. Above these, the planning and expectations of the respondents on diagnostic course were mostly in consensus.ConclusionsThe development of diagnostic course including teaching staff, teaching content and teaching condition, etc. among each medical colleges and universities was not balanced. It’s quite necessary to formulate a unified and reasonable standard to normalize the teaching staff constitution, teaching planning and set-up as well as teaching condition so as to guarantee the teaching quality.