Clinical Comprehensive Ability Research Articles

Application of flipped classroom teaching method based on ADDIE concept in clinical teaching for neurology residents

BackgroundAs an important medical personnel training system in China, standardized residency training plays an important role in enriching residents’ clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents’ independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching.MethodsThe participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed.ResultsThe theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001).ConclusionBased on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents’ autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability.

Application of a new multi-element integrated teaching mode based on bite-sized teaching, flipped classroom, and MOOC in clinical teaching of obstetrics and gynaecology.

Effective clinical medical student education includes attention to teaching approaches. This study assessed the impact of a new multi-element teaching mode that utilizes Bite-Sized Teaching, flipped classroom, and MOOC on learner perception in an Obstetrics and gynaecology clerkship. A Two-stage crossover design study was conducted of a multi-element teaching mode compared to traditional teaching mode in an academic year. Participants included Ninety-six medical students practicing obstetrics and gynecology in our hospital, randomly divided into two groups respectively underwent multi-element teaching mode and traditional teaching mode. After each semester, a final test (including theoretical and clinical practical test) was conducted.When an academic year was completed, post intervention survey assessed learner perceptions of the intervention. In order to comprehensively test students' performance after study, we take theoretical and practical examinations. The theoretical examination mainly tests students' grasp of basic knowledge points, while the practical examination focuses on the examination of students' diagnosis and treatment of diseases. There were statistically significant differences both in the theoretical and clinical practical scores between the new multi-element integrated teaching mode and the traditional teaching mode, specifically as follows: In the end of first semester, the theoretical scores of the two groups were respective 43.75 ± 3.42 vs. 42.07 ± 2.90, and clinic practical test scores were respective 44.93 ± 2.42 vs. 43.37 ± 2.52; In the end of second semester, the theoretical scores of the two groups were respective 44.30 ± 2.69 vs. 42.25 ± 3.39, and clinic practical test scores were respective 43.79 ± 2.25 vs. 41.93 ± 2.80.(p < 0.05). The results of questionnaires demonstrated that 80.21% of the students showed preference for the new multi-element integrated teaching mode comparing to traditional teaching methods. The new multi-element integrated teaching mode is well accepted by the students and can improve the students' mastery of knowledge, and can improve the students' clinical comprehensive ability. The new multi-element integrated teaching mode is shown more preference than traditional teaching mode in the teaching of Obstetrics and Gynaecology. Further long term study is needed carried out to consolidate our conclusion. The new multi-element integrated teaching mode may have positive effects on clinical teaching of Obstetrics and Gynaecology.

A novel strategy combining Mini-CEX and OSCE to assess standardized training of professional postgraduates in department of prosthodontics

ObjectiveMini clinical evaluation exercise (mini-CEX) and objective structured clinical examination (OSCE) are widely acknowledged as effective measures of resident standardization training (RST) in European and American countries. However, in China primary mini-CEX and OSCE forms are mainly limited in undergraduate clinical examination. Little knowledge is available regarding the validity and right way of mini-CEX /OSCE evaluation system in advanced dental clinical education so far. This study aimed to explore whether combination of mini-CEX and OSCE represents a global-dimension assessment for postgraduate clinical competence in RST.MethodsPostgraduates who received RST from June 2017 to June 2019 were selected and evaluated by modified mini-CEX/OSCE scales. Each student received evaluations at least twice in the initial and final stages of training (tested every 4 months). A questionnaire was conducted to investigate the satisfaction with the arrangement of RST.ResultsMini-CEX/OSCE test results indicated that postgraduates have significantly improved their comprehensive competence in RST projects in the department of prosthodontics (P < 0.05). Compared to other master of Stomatology students, postgraduates taking up prosthodontics master’s degree have made more progresses through a training period of up to 1 year and four sessions of face-to-face feedback tutoring (P < 0.05). Survey results revealed high level of satisfaction on clinical practice evaluation.ConclusionModified mini-CEX/OSCE combined evaluation system is an effective and reliable assessment tool for clinical comprehensive ability in the RST of professional graduates and can fully highlight their respective advantages on the improvement of students’ clinical competency, especially after several rounds of assessments.

The role of case nursing teaching method in training nursing students′ clinical comprehensive ability

Objective To study the effect of special case nursing teaching method on improving the clinical practice ability and comprehensive ability of nursing interns. Methods In January 2017, the teaching method of specialized case nursing was implemented in Heze Municipal Hospital, Shandong Province. Before and after the implementation of the teaching method (January 2016 to December 2017), 65 nursing interns were selected to be included in the reference group and the research group respectively. The scores of medical examination, other evaluation and self-evaluation of the two groups were counted and compared. Results In terms of academic, practical and case analysis scores, the research group had (87.50±0.52), (88.45±0.63) and (84.48±0.36) scores respectively, while the control group had (76.82±0.62) , (80.56±0.45) and (73.35±0.43) scores respectively. The research group had higher scores than the control group, with a difference between the two groups, there was statistical significance (t=95.174, 73.489, 143.115, all P<0.01). In terms of his evaluation results, the scores of other evaluation satisfaction, holistic nursing ability, communication ability, discovery and problem solving ability of nursing students in the study group were (9.62±0.34), (9.45±0.63), (9.38±0.36) and (9.20±0.16) respectively, while those in the control group were (8.28±0.32) , (8.56±0.45) , (8.05±0.43) and (8.12±0.23) , there were significant differences between the two groups (t = 8.290-27.797, all P<0.01). In terms of self-assessment scores, the study group scored (8.45±0.26) , (8.78±0.32) , (8.55±0.43) , (8.74±0.34) , (9.32±0.27) , (8.46±0.33) , (8.72±0.31) respectively on the satisfaction of teachers, the recognition of teaching methods, professional identity, internship harvest, the improvement of holistic nursing ability, the improvement of discovery and problem solving ability and the improvement of communication ability. The scores of the control group were (9.35±0.40) , (7.56±0.45) , (7.15±0.63) , (7.26±0.61) , (8.26±0.32) , (7.06±0.30) , (7.37±0.69) ,the differences between the two groups were significant (t=14.389-25.309, all P<0.01). Conclusion Specialized case nursing teaching method can not only improve the theoretical knowledge, operation and case analysis ability of nursing interns, but also improve their comprehensive abilities of holistic nursing, communication, problem finding and problem solving. It can also improve the professional identity of nursing students, the satisfaction of medical staff and patients, which is beneficial to the professional development of nursing students in clinical work. Key words: Student, nursing; Specialist case nursing teaching; Clinical practice ability; Comprehensive ability

Application of clinical nursing teaching model based on Mini-Clinical Evaluation Exercise in teaching rounds of nursing students

Objective To explore the application effect of Mini-Clinical Evaluation Exercise(Mini-CEX) in clinical teaching rounds of nursing students, and to provide reference for improving the quality of clinical teaching. Methods A total of 120 nursing students from June 2017 to June 2018 were divided into control group and intervention group by the time of practice with 60 cases each. The control group adopted traditional nursing teaching rounds, while the intervention group adopted Mini-CEX-based nursing teaching rounds. The comprehensive results of nursing students′practice, Mini-CEX and autonomous learning ability of the two groups were compared and analyzed. Results The overall evaluation of Mini-CEX of nursing students was (7.23 ± 0.51) in the intervention group and (5.27 ± 1.12) in the control group, and the difference was statistically significant (t=12.337, P <0.01). The excellent rate of nursing students was 58.3%(35/60) in the intervention group and 30.0%(18/60) in the control group, and the difference was statistically significant (χ2=10.914, P <0.01). The total score of autonomous learning ability was (114.85 ± 6.27) in the intervention group and (90.78 ± 8.22) in the control group, and the difference was statistically significant (t=18.034, P < 0.01). The comprehensive results of nursing students′ practice was (87.04 ± 6.46) in the intervention group and (74.35 ± 6.04) in the control group, and the difference was statistically significant (t=11.115, P< 0.01). Conclusions Clinical teaching rounds based on mini-clinical exercise assessment scale can improve the clinical comprehensive service ability, self-learning ability and humanistic care ability of intern nurses. Key words: Mini clinical exercise; Student nurse; Teaching ward round; Intervention effect

The Significance of Evaluation Index System in Medical Education

On the base of analysis of literature, the evaluation of teaching effect is mainly based on students' theoretical knowledge, operational skills and confidence level. The traditional teaching method has been influenced by intelligent simulation teaching method. Questionnaires are often distributed to the participating students after class to obtain students' feelings and recognition of simulation teaching. Due to the large clinical heterogeneity in the assessment content, an objective and comprehensive evaluation index system hasn’t been established in China. With the development of medical simulation education in recent years, some domestic scholars began to study the evaluation index system of clinical comprehensive ability of medical students and nursing students.

Application of mini-clinical evaluation exercise to improve the clinical comprehensive ability of junior nurses in the emergency department

Application of mini-clinical evaluation exercise to improve the clinical comprehensive ability of junior nurses in the emergency department

Application of micro-lectures combined with high simulation human in clinical skills teaching for nursing students

Objective To explore the effect of micro-lectures withadvanced simulation man in improving the practical skills teaching of nursing students, so as to promote the students' post competency. Methods Totally the 186 nursing internswere divided into control group and observation group by random number method with 93 people in each group. The control group used the traditional teaching modein the teaching of practical skills.The observation group used the micro-lectures with high simulation teaching.Comparing the two groups of nursing students comprehensive assessment test simulation results in the theory, skills, scenarios, and nursing students the evaluation of the curriculum. Results The scores of the two groups were all above the qualification line, but the scores of the observation group were significantly higher than those of the control group (P<0.05). The theoretical examinations and the situation simulation comprehensive testswas (77.89±7.79) , (75.60±7.92) points in control group, and (93.87±3.90) , (92.87±4.08) points in observation group, there was significant difference between two groups (t=17.67, 18.70, all P=0.000) . The curriculum evaluation results of improving learning initiative, active curriculum atmosphere, clear operation demonstration, exercise clinical thinking, improve the clinical interest were 81.72% (76/93) , 72.04% (67/93) , 93.55% (87/93) , 60.22% (56/93) , 67.74% (63/93) in control group, and 96.77% (90/93) , 95.70% (89/93) , 100.00% (93/93) , 92.47% (86/93) , 98.92% (92/93) in observation group, there was significant difference between two groups (χ2=20.39, P=0.016) . Conclusions The effect is significant of micro-lectures combined with high simulation of human using in clinical skills teaching. Thismold can conducive to the cultivation of clinical thinking of nursing students, and improve clinical comprehensive ability, and promote the promotion of nursing students post competency. Key words: Nursing professional interns; Clinical basic skills; Scenario simulation; Post competency; Micro-lectures

Construction and practice of new standardized training method for newly recruited nurses based on competency

Objective To establish a new scientific and rational training method based on the competency for newly recruited nurses and evaluate its training effect. Methods According to the requirements of Syllabus Standardized Training for Newly Recruited Nurses (Trial) , a new method of standardized training for newly recruited nurses was established with competency as the guide. The teaching model of internet combined with traditional education was adopted to 24 new nurses recruited in September 2015 (observation group) . The theory, operation, clinical practice ability and competency of nurses were assessed before and after the training, which were compared with another 24 new nurses recruited in September 2014 (control group) . Results There was no significant difference in the theory, operation, clinical comprehensive ability and competency score of nurses in the two groups before the training (P>0.05) . After the training, scores of theory, operation, clinical comprehensive ability and competency of nurses in the observation group were higher than those of the control group. The differences were statistically significant (P<0.05) . Conclusions The competency-oriented standardized training for newly recruited nurses is more suitable for clinical practice. Internet teaching has expanded the learning time and space for new nurses, which can effectively improve the competency and clinical practice ability of newly recruited nurses. Key words: Inservice training; New recruited nurse; Competence; Standardized training; Assessment

Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine.Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a control group, respectively. The former group was taught according to a new, integrated mode, while the latter received traditional methods. Students' scores on practical tests in physical examination, internal punctures, and case analysis; theory-based exams on diagnostics and internal medicine; and questionnaire surveys were compared and analyzed. In addition, system-oriented curricula were explored and implemented.Results: A novel mode that closely and effectively integrates theory and practice in the observation group had been established although there were no statistically significant difference (P&gt;0.05) between Grade 2010 and Grade 2009 in clinical basic skills training scores. However, there were statistically significant differences (P&lt;0.05) in scores on practical tests of physical examination and internal punctures among the diagnostic, internal medicine and internship periods in the class of 2010 but no statistically significant difference (P&gt;0.05) in case analysis scores. Therefore, system-oriented curricula were initially designed and explored in excellent students from Grade 2010 to reinforce clinical thinking.Conclusion: The novel program integrating simulation scenarios and clinical situations for training students in diagnostics and internal medicine skills can improve medical students’ clinical comprehensive abilities and achieve effects that are similar to those of the traditional method. This program is more popular with students and ensures patient safety as well. In addition, different characteristics of clinical skills training have been compared for the further exporation of system-oriented curricula.

Investigation on the satisfaction degree of the combination training mode for the professional master's degree of clinical medicine

Objective To discuss the views and significance of the parallel training mode, and provide a reference for the smooth development of the graduate students' standardized training work. Methods The self-designed questionnaire included rotation/training, clinical skills, scientific research, supporting conditions, and the rationality and prospect of the integrated training mode. We chose the graduate students of professional type classes of Grade 2014 and 2015 in a university affiliated hospital of Kunming, in a secret-based manner, and questionnaires were distributed and collected by stratified sampling and random sampling according to the proportion of 50% of the total number of them. Excel database was used for data processing and analysis. Results A total of 200 questionnaires were distributed and 167 were recovered with an effective recovery rate of 83.5%. The research items involved in the investigation of the students that were more satisfied with the project were as follows: methods of integrated training mode being more reasonable (85.0%, n=142), improving clinical comprehensive ability (83.2%, n=139), accelerating the development of high-level clinical talents (67.7%, n=113), conducive to unify the clinical practice standards (55.1%, n=92), conducive to employment (48.5%, n=81), saving medical resources (44.3%, n=78). Meanwhile, the survey found that graduate students were not satisfied with the following items: research time (88.0%, n=147), arrangements for plans of rotate conversion (65.8%, n=110), monthly income (89.8%, n=150). Conclusion The integrated training mode can accelerate the development of high-level clinical talents, save medical resources, further improve the medical education system and better improve the clinical comprehensive ability of medical students. However, it still needs to be further improved in terms of the arrangements for plans of rotate conversion of clinical departments, cultivation of scientific research ability, and salary, etc. Key words: Standardized training for residency; Clinical medicine; Professional degree; Post-graduate education

Appliance of two teaching modes to the clinical comprehensive ability training management of new nurses in emergency department

Objective To discuss about the impact of two teaching modes on clinical comprehensive ability new nurses in emergency department. Methods The preliminary competence evaluations were conducted to the newly allocated graduates and teachers.62 new nurses were divided into experimental group and control group randomly according to entry time, and the traditional teaching mode of one-to-one master and apprentice relationship was used for control group.One senior teacher that had teaching qualification was responsible for teaching a new nurse.After comprehensive evaluation was conducted to experimental, the nursing posts of responsibility nurse, treatment nurse, main-class nurse, equipment nurse, individual diagnosis nurse and emergency nurse were set.After a new nurse was taught by 6 start-level nurses, the post performance and first-aid comprehensive ability of new nurse were compared. Results The post performance and first-aid comprehensive ability of new nurses in experimental group were significantly higher than traditional group.The difference had statistical significance(P<0.05). Conclusion Several-for-one teaching mode can improve the clinical comprehensive ability of new nurses in emergency department. Key words: New nurse; Emergency department; Teaching mode; Training

Application of "whole-jobs" double tutorial system in clinical nursing teaching

Objective To analyze the effects of whole-jobs double tutorial system in clinical nursing teaching. Methods A total of 120 nursing students in the Second Affiliated Hospital of Wenzhou Medical University from 2013 to 2015 were randomly divided into the experimental group and control group with 60 cases respectively. Control group used the traditional jobs teacher teaching mode, while the experimental group adopted whole-jobs double tutorial system teaching mode. Clinical comprehensive ability and the nursing students' evaluation of the teaching mode were compared between two groups. Results After the practice, the score of the clinical comprehensive ability of the nursing students in the experimental group was (87.54±2.09) , while the score in the control group was (73.89±2.15) . There was statistically significant difference between two groups (t=1.781, P<0.05) . The satisfaction rates of nurses to the clinical whole-jobs were 96.7% in the experimental group and 90.0% in the control group, with statistically significant difference between two groups (χ2=6.287, P<0.05) . Conclusions The whole-jobs double tutorial system has significant teaching effects, with a high satisfaction of nursing students to the clinical teaching method, thus it can be promoted in clinical teaching of nursing students. Key words: Double tutorial; Nursing student; Teaching; Whole-jobs

Optimization of standardized training model and evaluation system for residents in the department of orthodontics

Standardized training of residents in the department of orthodontics is an important learning stage for stomatology students before carrying out clinical orthodontic diagnosis and treatment work. At present, there are some deficiencies in the standardized training system of the residents in the Department of Orthodontics, such as the single teaching mode, imperfect training items, and unclear evaluation criteria. The department of orthodontics of Stomatology Hospital of Southern Medical University carried on a preliminary study on the training pattern of resident doctors in the refinement of the training content, optimizing curriculum design, implementation of tutorial teaching mode, the combination of theoretical study and clinical training, regular training evaluation and quantitative assessment indicators. The results showed that the trainees' acceptance and satisfaction were higher, which was beneficial to the improvement of clinical comprehensive ability of orthodontics. Key words: Orthodontics; Resident; Standardized training

Application of" one to one" tutorial system in the talents cultivation of colleges cooperated with universities and psychiatry and teaching synergy

Objective To explore the application effect ofone to one tutorial in in the talents cultivation of colleges cooperated with universities and psychiatry and teaching synergy. Methods During September 2015 to July 2016, 102 nursing students of 2014 clinical nursing class were selected as the research object, and 52 students of class 1 were devided into the control group, and they received traditional teaching management method. 50 students of class 2 were taken as the experimental group, and they receivedone to one tutorial management method, their daily life and learning were managed as well as the practice of students. The theory and practice grades of two groups, and the effectiveness of existing student management pattern, were compared between two groups. Results After intervention, the scores of theory and practice of nursing students in the experimental was (79.5±7.4) and (85.6±6.7), and they were all higher than those in the control group (74.9±8.7), (80.2±8.0) (t=2.871, 3.688; P<0.05); The scores of theory in short answers questions, case analysis and multiple choice test of nursing students in the experimental group were all higher than those in the control group(t=2.002, 2.168, 2.239; P<0.05); the recognition degree of nursing students to management model, promotion of combining the clinical practice and theoretical knowledge together, improvement of comprehensive skill, and the communication with part-time teachers in the experimental group were all higher than those in the control group (χ2=4.816, 17.191, 37.975, 8.497; P<0.05); and nursing students in the experimental group were more eager in gainingone to one tutorial (χ2=7.834, P<0.05). Clinical part-time teachers showed their recognition in one-to-onetutorial system . Conclusions The training method ofone-to-one tutorial for clinical teaching classes is either beneficial to the improvement of students′ theory and practice level as well as clinical comprehensive ability, and it improves the business level and management ability of the tutorial teachers, which is worth popularizing and applying. Key words: Education, nursing; Psychiatry and teaching synergy; Colleges and universities cooperation; Higher vocational college; One to onetutorial

Research on integrated classroom teaching model oriented by cases in teaching of oral nursing care

Objective To investigate the application effect of integrated classroom teaching model oriented by cases in teaching of oral nursing care, and seek a new teaching model, to improve the clinical comprehensive ability of nursing students. Methods Totally 287 undergraduate nursing students of Wenzhou Medical University were selected as the research object, and were divided into the control group and the observation group randomly. The control group adopted the traditional teaching method, while the observation group adopted the integrated classroom teaching model oriented by cases. The autonomous learning ability, critical thinking ability and satisfaction of nursing students between two groups were compared by questionnaire. Results There were no differences between two groups in nursing students′ autonomous learning ability and critical thinking ability before teaching (P>0.05), but after teaching, the scores of autonomous learning ability and critical thinking ability of students in the observation group were significantly higher than those of students in the control group (P<0.05). The students′ satisfaction towards teaching in the observation group (91.97±11.37) was significantly higher than that of the control group (84.43±10.12) (P=0.006). The examination results of oral care clinical ability in the observation group (83.47±8.19) were significantly higher than that in the control group (71.86±6.23) (P=0.001). Conclusions The integrated classroom teaching model oriented by cases can increase nursing students′ autonomous learning ability, critical thinking ability and clinical practice ability, and improve the learning enthusiasm and comprehensive ability of nursing students. Key words: Teaching; Cases; Oral nursing

The "four in one" integrated training system establishment and effects assessment for the nurses of orthopaedic group in Operating Room

Objective To explore the establishment of four in integration training system in the nurses of orthopaedic group in Operating Room and assess its effects. Methods A total of 32 nurses in orthopedic group of Operating Room were trained according to the hierarchy management, target monitoring, training implementation, training effect evaluation of four in integration system. Through collecting the doctors′ satisfaction for nursing quality, the nurses′ evaluation for teaching training effects, clinical nurse′s ability assessment, the indicators of nursing risk event rate, the training effects were compared before and after the established system. Results After training, the surgeon′s satisfaction for training, different aspects of nurses′ assessment, nurses′ evaluation for training effects were all improved compared before the training (P<0.05). After training, the incidence of nursing risk events decreased (P<0.01). Conclusions The construction of four in integrated training system can promote clinical comprehensive practice ability of the orthopaedic group nurses, improve the surgeon′s satisfaction, and reduce the nursing security risks, which is advantageous to nurses′ growth in the orthopedic group, and is worth for universally popularization and application in clinical teaching in Operating Room. Key words: Operating Room nurse; Orthopaedic surgery; Four in one integrated training system; System establishment; Nursing safety; Training effect

The application of virtual patient in gynecology and obstetrics clinical teaching

Gynecology and obstetrics is a theoretical and practical subject. It is an important goal for the medical students to develop the clinical thinking ability and operating skills and apply them in the diagnosis and treatment of disease. To overcome the limited teaching resources, the rare clinical skills opportunities caused by doctor-patient relationship tension, virtual patient (VP) combined with clinical teaching was applied in clinical teaching, which can reproduce the real, and bring the students to the role of the clinician, enrich the content of the obstetrics and Gynecology clinical teaching. Along with the reform the teaching faculty with high quality was established, their clinical teaching experiences and innovative thinking were improved significantly. The results were evaluated by means of clinical comprehensive ability test. The present study aimed to establish virtual patients of OBGYN (virtual patient, VP) learning to promote learning of basic knowledge, clinic skills, and thinking ability. Key words: Clinical teaching; Gynecology and obstetrics; Virtual patient

Application of Microsim medical simulation training system in medical student's clinical thinking training

Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A: After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically significant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the problem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47±5.23) vs. group B (84.09±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treatment ability. It can be used as an effective complement to clinical practice teaching. Key words: Microsim medical simulation training system; Clinical practice; Clinical thinking

Effect analysis of clinical pathway teaching method in respiratory medicine

medicine. Methods Seventy clinical medical students of our department during 2007 to 2009 were randomly divided into two groups. The control group （35 students） was treated by traditional teaching ways, while the experimental group （35 students） was treated by clinical pathway teaching ways, with 5 to 6 students forming a small group. Teachers provided one copy of the CP version to each person in advance. Then progressive questions and discussions were conducted according to the diagnosis, dif- ferential diagnosis and treatment of CP. After its implementation for a certain time, students were co- mprehensively assessed by the practice examination and questionnaire and the statistical analysis was performed by using SPSS 17.0 version statistics software. Results The experimental group＇s total aver- age score was （90.00 ± 4.00） points, while the control group＇s total average score was （76.00 ± 7.20） points. There was significant difference between the two groups（P=0.001）. The effect of these two kinds of teaching was evaluated and compared in stimulating interest in learning（P=0.002）, improving the analytical ability （P=0.004）, improving self-study ability（P=0.001 ）, deepening the under-standing of the basic concepts（P=0.112）, improving the innovation ability （P=0.005）, improving the efficiency of learning （P=0.034）, improving clinical comprehensive ability （ P=0.016）, and improving the ability of language expression（P=0.000）, showing that teaching method of clinical pathway could significantly improve clinical teaching effect, and there was statistically significant difference between them. Conclusion Clinical pathway teaching has obvious advantages in cultivating students＇ diagnostic thinking and clin-ical ability to solve practical problems, and therefore it has better clinical teaching effect than the tra-ditional teaching method. Key words: Clinical pathway; Medical education; Respiratory medicine