Lüers Georg H, Dünne Anja-Alexandra, Werner Jochen A, Putz Reinhard
Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg, Robert Koch Str. 8, 35037 Marburg, Germany.
Ann Anat. 2007;189(3):251-9. doi: 10.1016/j.aanat.2006.11.005.
A sound knowledge of the scientific basis of medicine is a prerequisite for successful learning and understanding of clinical issues. Teachers of clinical medicine, however, often complain that their students' knowledge on the scientific basis of medicine is too low. In the clinical curricula of most medical schools in Germany, students rely on self-directed learning efforts to optimize their knowledge of basic issues for the study of clinical medicine. Using anatomy and otorhinolaryngology (ENT) as an example, we have compared the effects of a structured seminar for recall of anatomical knowledge and its elaboration under clinical perspective with self-directed learning efforts of the same contents. Effects on clinical performance and students confidence were compared in a randomized trial. We found that the clinical performance of students was significantly higher (6.9%) in the seminar group compared with the control group. Furthermore, the students' self-estimation of clinical competence was increased in the seminar group and they were more content with their clinical course in ENT. Based on the design of the study we believe that the improvement of clinical performance was a longterm effect due to deeper understanding of the clinical problems among participants of the seminar. Irrespective of their experimental study group, most students asked for more integration of seminars on the scientific basis of medicine into the clinical curriculum. With the significant increase in clinical performance shown in this study and the limited effort needed for implementation, these seminars could be an efficient way to improve the quality of teaching in clinical medicine.
扎实掌握医学科学基础是成功学习和理解临床问题的前提。然而，临床医学教师经常抱怨学生在医学科学基础方面的知识水平太低。在德国大多数医学院的临床课程中，学生依靠自主学习来优化他们在临床医学学习中对基础问题的了解。以解剖学和耳鼻喉科学（ENT）为例，我们比较了一个结构化研讨会在从临床角度回顾解剖学知识及其详细阐述方面的效果与相同内容的自主学习效果。在一项随机试验中比较了对临床实践表现和学生信心的影响。我们发现，与对照组相比，研讨会组学生的临床实践表现显著更高（6.9%）。此外，研讨会组学生对临床能力的自我评估有所提高，并且他们对自己在耳鼻喉科的临床课程更满意。基于该研究的设计，我们认为临床实践表现的提高是由于研讨会参与者对临床问题有更深入的理解而产生的长期效果。无论他们属于哪个实验研究组，大多数学生都要求将更多关于医学科学基础的研讨会纳入临床课程。鉴于本研究中显示的临床实践表现显著提高以及实施所需的努力有限，这些研讨会可能是提高临床医学教学质量的有效途径。
