周　力　续　畅　陈　晖▲.首都医科大学附属北京友谊医院心血管内科，北京　00050；.首都医科大学附属北京友谊医院中药剂科，北京　00050

循证医学应用于心血管内科教学的效果评价与探讨

周力1续畅2陈晖1▲
1.首都医科大学附属北京友谊医院心血管内科，北京100050；2.首都医科大学附属北京友谊医院中药剂科，北京100050

目的 分析循证医学应用于心血管内科的教学效果，为改进教学方法、提高教学效果提供依据。方法51名七年制临床医学生作为研究对象。对照组采用传统临床教育模式进行带教培养；试验组在传统临床教育模式下，进行循证医学的知识传授与训练。在实习结束后，对两组学生进行心血管内科相关基础知识、临床技能、科研设计、病历书写等方面进行考核，对比两组各项考试成绩，分析是否存在差异性。两组“非常满意”的比率比较，差异无统计学意义（P＞0.05）。结果 在基础知识与病历书写方面，对照组与试验组差异无统计学意义；在临床技能方面，试验组的成绩高于对照组，差异有统计学意义（P＜0.05）；而在科研设计方面，试验组的成绩同样高于对照组，差异有高度统计学意义（P＜0.01）。两组“非常满意”的比率比较，差异无统计学意义（P＞0.05）。结论 将循证医学应用于心血管内科乃至各科临床教学中去，对医学生临床诊治、科学研究、人文关怀及个人发展均具有较强的促进作用。

循证医学；心血管内科；医学教育；效果评价；改革方向

［Abstract］Objective To analyze the effects of evidence-based medicine in the teaching of cardiovascular medicine，so as to provide basis for improving teaching method and enhancing teaching effects.Methods 51 students in 7-year clinical medicine were selected as research subjects.The control group was given traditional clinical education mode for teaching and training；the experiment group was further given the teaching and training of evidence-based medicine on the basis of traditional clinical education mode.After the internship，assessments including basic knowledge，clinical techniques，design of scientific research，writing of medical records and other aspects related to cardiovascular medicine were performed in both groups of students，assessment results were compared between the two groups，and whether there were differences were analyzed.Results In basic knowledge and writing of medical records，there was no significant difference between the control group and the experiment group；in clinical techniques，the assessment result in the experiment group was higher than that in the control group，and the difference was statistically significant（P＜0.05）；in the design of scientific research，the assessment result in the experiment group was also higher than that in the control group，and the difference was statistically significant（P＜0.01）.Conclusion Application of evidence-based medicine in the clinical teaching of cardiovascular medicine and other subjects have stronger promoting effects on the clinical diagnosis and treatment，scientific research，humanity and individual development for medical students.

［Key words］Evidence-based medicine；Cardiovascular medicine；Medical education；Evaluation of effects；Reform direction

1992年Gordon Guyatt于JAMA杂志首次提出“循证医学（evidence-based medicine，EBM）”这一概念，是指应用现有最为可靠的研究证据，结合医师的临床技能及既往经验，在尊重患者的个人意愿的前提下，对患者做出的医疗决策与诊治方案［1］。……