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.

[1]	谭树芬, 何利平, 杨琳琳, 杨谢兰, 杨宏英, 姚明姣, 李树清. TBL与工作坊整合教学法在妇科肿瘤学临床教学中的应用[J]. 基础医学与临床, 2024, 44(7): 1054-1057.
[2]	陈素辉, 徐虹, 张亚敏, 孙华, 李颖, 吴群励. 北京协和医学院护理学院中医针灸学教学改革[J]. 基础医学与临床, 2024, 44(1): 136-140.
[3]	吴薇, 仇文颖, 钱晓菁, 徐园园, 陈咏梅. 组织学实验课多种教学模式的尝试与效果分析[J]. 基础医学与临床, 2023, 43(11): 1738-1742.
[4]	单莹, 金滢, 顾宇, 王巍, 李艳, 潘凌亚. 临床医生主导的医学影像学教学改革初步探索[J]. 基础医学与临床, 2022, 42(8): 1322-1324.
[5]	王亚红, 张莉, 王莹, 张一休, 武玺宁, 高璐滢, 陶葸茜, 李建初. 分层分级的进阶式培养模式在超声住院医师规范化培训中的应用[J]. 基础医学与临床, 2021, 41(8): 1220-1223.
[6]	董海涛, 赵继志, 万阔, 吴效民, 张宇, 夏甜, 郭春岚. 仿头模拟教学在住院医师口腔修复教学中的应用探索[J]. 基础医学与临床, 2021, 41(8): 1231-1233.
[7]	陈适, 罗云云, 白皙, 潘慧, 朱惠娟. 计算机临床思维训练在罕见病临床思维教学上的应用价值[J]. 基础医学与临床, 2021, 41(6): 914-917.
[8]	王欣, 王铭, 赵峻, 王亚红, 吕珂, 朱庆莉, 李建初, 姜玉新, 杨萌. 北京协和医学院超声诊断教学需求的问卷调查及反馈分析[J]. 基础医学与临床, 2021, 41(3): 452-455.
[9]	谭树芬, 严志凌, 陈静, 杨琳琳, 张勺, 杨宏英. 临床妇科肿瘤学跟进式CBL理论课与PBL实践课教学法的应用[J]. 基础医学与临床, 2021, 41(2): 301-303.
[10]	亚白柳, 成洪聚, 于婷, 刘文彦. 文献讲解在生理学教学中的应用[J]. 基础医学与临床, 2020, 40(9): 1266-1268.
[11]	刘韵一, 冯铁男, 朱荣嘉, 谭靖宇, 翁律侃. 如何给医学生开设医学统计学课程的初探[J]. 基础医学与临床, 2020, 40(4): 566-569.
[12]	黄晶晶, 孙宏莉, 范洪伟, 谢秀丽, 张占杰, 徐英春. 临床微生物学教学模式改革探索[J]. 基础医学与临床, 2020, 40(3): 419-422.
[13]	焦谊, 梁小弟, 陈艳, 努尔比耶·努尔麦麦提, 关亚群. 翻转课堂在医学生物化学实验教学中的应用与探索[J]. 基础医学与临床, 2020, 40(10): 1431-1434.
[14]	祖丽胡玛尔·艾斯卡尔, 许佩佩. 血液科规范化培训虚拟模拟诊疗结合PBL教学模式的初探[J]. 基础医学与临床, 2020, 40(10): 1453-1456.
[15]	严紫艳梁玉凤刘奔波宋凤梅张朝晖黄波. 临床医学类学生对卫生学课程认知情况及教学满意度调查[J]. 基础医学与临床, 2019, 39(4): 594-598.