医学生心音听诊现状和培训需求调查分析

基础医学与临床 ›› 2021, Vol. 41 ›› Issue (12): 1856-1859.

医学生心音听诊现状和培训需求调查分析

林雪¹, 张潇², 刘继海³, 张晖³, 钱晓菁⁴, 肖冉⁵, 方理刚^1*

中国医学科学院北京协和医学院 1.北京协和医院心内科; 2.眼科; 3.急诊科,北京100730;
4.基础学院组胚教研室,北京 100005;
5.整形医院,北京 100041

收稿日期:2020-02-11 修回日期:2020-08-24 发布日期:2021-12-03
通讯作者: *fanglgpumch@qq.com
基金资助:
北京协和医学院2018年青年教育学者基金(2018zlgc0705);北京协和医学院教育教学改革基金(2016zlgc0107)

Investigation and analysis on the status of heart sound auscultation and training needs of medical students

LIN Xue¹, ZHANG Xiao², LIU Ji-hai³, ZHANG Hui³, QIAN Xiao-jing⁴, XIAO Ran⁵, FANG Li-gang^1*

1. Department of Cardiology; 2. Department of Ophthalmology; 3. Department of Emergency, Peking Union Medical College Hospital,CAMS & PUMC, Beijing 100730;
4. Department of Embryology, School of Basic Medicine, CAMS & PUMC, Beijing 100005;
5. Plastic Surgery Hospital, CAMS & PUMC, Beijing 100041,China

Received:2020-02-11 Revised:2020-08-24 Published:2021-12-03
Contact: *fanglgpumch@qq.com

摘要/Abstract

摘要： 目的明确目前心音教学需要改进的方向。方法对学习过诊断学的北京协和医学院学生进行问卷调研,同时调取两届医学生诊断学心音听诊部分试卷,并对两个住院医生小组进行访谈,调研医学生在心音听诊方面的掌握程度和学习问题。结果 47名学生回答了问卷,收集了两届医学生的诊断学心音部分的考试成绩共177份,两个访谈小组共10名住院医师参与了访谈。87.2%的学生认为临床工作中心音听诊很重要,诊断学对心音的教学主要是老师通过播放心音的录音和语言描述的方式来讲解,但只有约53.2%的学生学会小部分,4.3%的学生表示完全没有学会,心音病例考试中可以答对的学生占44%,近80%的医学生和住院医师对听懂心音没有信心。约有76.6%的学生会寻找专门的心音教学软件和音频进一步学习,但是仅有6.4%的学生认为此类教材和软件帮助很大,主要原因是辅助教材提供的心音失真。医学生希望教师提供有效的心音教科书,真实的心音数据库,和大量包括病史和影像学的病例以提高医学生的临床思维能力;医学生也希望获得更多的床旁听诊机会。结论此次调研说明了现有心音教学的弊病,并提出在后续教学工作中需要加以改进的环节。

关键词: 心音听诊, 教学改革, 临床思维

Abstract: Objective To clarify the current direction of improvement of heart sound auscultation teaching. Methods Questionnaire survey was conducted on the students of Peking Union Medical College who had studied diagnostics. At the same time, two tests of heart sound auscultation for medical students were collected. Two teams of residents were interviewed to investigate the mastery of medical students in heart sound auscultation and learning problems. Results Forty-seven students answered the questionnaire. A total of 177 test scores in the diagnostic heart sound section of the medical students of two grades were collected. Ten residents from the two interview teams participated in the interview. There are 87.2% of students think sound auscultation is very important in the clinical. The teaching of diagnostics for heart sounds is mainly explained by the teacher by demonstration of heart sound recordings and language descriptions, but only 53.2% of students learn some of the content and, 4.3% students said that they did not learn at all. There are 44% of the students who are able to answer correctly in the heart sound case examina- tions,nearly 80% of medical students and residents were not confident in understanding heart sounds. About 76.6% of students would look for special heart sound teaching software and audio for further study, but only 6.4% of students thought that such teaching materials and software were of great help, mainly due to the distortion of heart sounds provided by auxiliary teaching materials. Medical students hope that teachers provide effective heart sound software, real heart sound databases, and a large number of cases supplemented with medical history and imaging examination results to support their clinical reasoning; medical students also hope to obtain more bedside auscultation opportunities. Conclusions The article presented here showed shortcomings of the existing heart sound teaching, and provide some evidence from learners' side to improve learning outcomes.

Key words: heart sound auscultation, teaching reformation, clinical reasoning

中图分类号:

R540.4

林雪, 张潇, 刘继海, 张晖, 钱晓菁, 肖冉, 方理刚. 医学生心音听诊现状和培训需求调查分析[J]. 基础医学与临床, 2021, 41(12): 1856-1859.

LIN Xue, ZHANG Xiao, LIU Ji-hai, ZHANG Hui, QIAN Xiao-jing, XIAO Ran, FANG Li-gang. Investigation and analysis on the status of heart sound auscultation and training needs of medical students[J]. Basic & Clinical Medicine, 2021, 41(12): 1856-1859.

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