縣級(jí)醫(yī)院神經(jīng)內(nèi)科臨床實(shí)習(xí)帶教中存在的問(wèn)題及對(duì)策

蔡天燕 楊丁彥 陳萬(wàn)志

[摘要] 臨床實(shí)習(xí)是培養(yǎng)醫(yī)學(xué)生臨床思維能力的主要途徑。該文指出當(dāng)前縣級(jí)醫(yī)院神經(jīng)內(nèi)科醫(yī)學(xué)生臨床實(shí)習(xí)中普遍存在的問(wèn)題是學(xué)生對(duì)實(shí)習(xí)重視度不夠，患者對(duì)于實(shí)習(xí)生接受程度不高，帶教教師的能力限制及責(zé)任心不強(qiáng)。提出神經(jīng)內(nèi)科臨床實(shí)習(xí)帶教中的主要對(duì)策是重視崗前培訓(xùn)，重視學(xué)生的基本操作規(guī)范及技能的培養(yǎng)，加強(qiáng)病歷書寫的基本功培訓(xùn)，同時(shí)要科學(xué)帶教充分調(diào)動(dòng)學(xué)生在學(xué)習(xí)上的積極性和主動(dòng)性，從而形成神經(jīng)內(nèi)科特有的臨床思維，為其成為合格臨床醫(yī)師打下堅(jiān)實(shí)的基礎(chǔ)。

[關(guān)鍵詞] 縣級(jí)醫(yī)院;神經(jīng)內(nèi)科;臨床實(shí)習(xí);問(wèn)題;對(duì)策

[中圖分類號(hào)] R-4 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1672-5654（2020）03（a）-0014-03

[Abstract] Clinical practice is the main way to cultivate medical students' clinical thinking ability. This article pointed that at present， the common problems in the clinical practice of neurological medical students at county level hospitals are that students do not pay enough attention to internships， patients do not have a high degree of acceptance of interns， and their ability to teach teachers is not limited and they are not responsible. The main countermeasures in the clinical practice teaching of neurology are to attach importance to pre-job training， attach importance to the training of students' basic operating standards and skills， strengthen the training of basic skills in writing medical records， and at the same time， they must educate students to fully motivate and take initiative In order to form a clinical thinking unique to neurology， it lays a solid foundation for becoming a qualified clinician.

[Key words] County-level hospital; Neurology; Clinical practice; Problems; Countermeasures

神經(jīng)病學(xué)被很多人認(rèn)為是最難且最苛求的醫(yī)學(xué)專業(yè)之一。首次進(jìn)入神經(jīng)內(nèi)科的實(shí)習(xí)生容易受到挫折，在短暫接觸神經(jīng)解剖、神經(jīng)生理、神經(jīng)病理、神經(jīng)遺傳和細(xì)胞生物學(xué)之后，他們可能就已經(jīng)被神經(jīng)系統(tǒng)的復(fù)雜性嚇住了，從而使臨床思維難以形成[1]。縣級(jí)醫(yī)院神經(jīng)內(nèi)科臨床實(shí)習(xí)帶教中除了大多數(shù)醫(yī)院所存在的普遍問(wèn)題外，還有其特有的問(wèn)題。該文主要針對(duì)縣級(jí)醫(yī)院神經(jīng)內(nèi)科臨床實(shí)習(xí)帶教中存在的問(wèn)題及對(duì)策進(jìn)行探討。

1 ?神經(jīng)內(nèi)科醫(yī)學(xué)生在臨床實(shí)習(xí)中所普遍存在的問(wèn)題

1.1 ?實(shí)習(xí)生考研率增加

很多實(shí)習(xí)生畢業(yè)后只能考慮進(jìn)縣級(jí)或社區(qū)醫(yī)院，且目前很多縣級(jí)醫(yī)院也開(kāi)始把研究生作為主要招收對(duì)象，使得很多醫(yī)學(xué)生不得不選擇走考研之路，有統(tǒng)計(jì)顯示臨床醫(yī)學(xué)是考研率最高的專業(yè)。……