崔鑫浩+吴妙霞+张欣选+董雪宁+黄惠欣+曾莉莉

[摘要]目的 探讨以案例为导向的标准化患者在呼吸内科教学查房中的应用效果。方法 选取2015年7月～2016年5月在我科实习的100名护生作为研究对象，按照随机数字表法分为实验组和对照组，各50例。对照组按常规教学方法进行查房，实验组应用以案例为导向的标准化患者，每周进行1次查房。1个月后统一进行考试，从而作出效果比较。结果 实验组的理论、操作考核成绩均优于对照组，差异有统计学意义（P<0.01）。实验组的各项护理教学查房评分优于对照组，差异有统计学意义（P<0.01）。结论 在呼吸内科教学查房中应用以案例为导向的标准化患者的方法优于单一常规的教学查房，有利于提高教学查房效果，值得推广应用。

[关键词]呼吸内科；教学查房；标准化患者；以案例为导向

[中图分类号] R424 [文獻标识码] A [文章编号] 1674-4721（2017）01（c）-0149-03

[Abstract]Objective To explore application effect of case-oriented standardized patients in nursing teaching rounds of the department of respiratory medicine.Methods 100 interns in the Department of Respiratory Medicine of our hospital from July 2015 to May 2016 were selected and divided into the control group and the experimental group according to the random number table method，50 cases in each group.The control group was given teaching rounds according to the conventional teaching methods，the experimental group was given case-oriented standardized patients，and the teaching rounds were conducted once a week.After a month，the examinations were taken uniformly，so that the comparison of effects could be made.Results The examination results of theory and the operation in the experimental group was better than that in the control group，with significant difference （P<0.01）.The score of each item of nursing teaching rounds in the experimental group was better than that in the control group，with significant difference （P<0.01）.Conclusion The method of applying case-oriented standardized patients in respiratory medicine is superior to the routine teaching round-ward，which is helpful to improve the effect of teaching rounds，it is worthy of promotion and application.

[Key words]Respiratory medicine；Teaching rounds；Standardized patient；Case-oriented

标准化患者是从事非医技工作的正常人或患者经过培训后能扮演患者，可以根据自己的感受在专门设计的表格上记录并评估医生的操作技能，充当评估者和教师[1]。由于患者对实习生缺乏信任，大部分会抵触实习生的操作，这导致教学查房成为一种形式[2]，且随着目前医疗环境的改变，患者的维权意识不断增强，可能会拒绝成为教学资源，这样难免影响临床教学的效果[3]。呼吸内科的病种在发生变迁，在本院肺癌以及其他肺部肿瘤患者显著增多，而其他以往常见病、多发病均明显减少，因此，在选择查房对象的时候，找到与教学大纲相吻合的病种作为教学对象就比较困难，这导致学生知识掌握不全面。在这种形势下，标准化患者就显示了其优越性。传统的临床教学法已经越来越难以适应现代医学教……