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1、 临床课程整合后的按系统进行集体备课方略初探郭庆峰，郭劲松，薄 红，崔 莹，张东华*，杨立斌 (哈尔滨医科大学第一临床医学院，黑龙江 哈尔滨 150001)摘要按系统进行集体备课是指在临床课程整合后，在教研室集体备课之前，由学院组织同一系统的不同教研室的授课教师针对教学各环节和临床课程整合实施中遇到的实际问题进行沟通和研讨的过程。实践证明，这种方法有利于教学、有利于学生学习、有利于教学质量的提高。关键词临床课程整合；系统；集体备课哈尔滨医科大学在2005年开始实施基础课程整合以后，成立了临床课程整合教学改革研究组，经过分析、对比、学习和研讨，制定了临床课程整合方案，确立了呼吸、消化、循环、血液
2、、泌尿生殖、神经等十大系统课程1，并于2008年开始在2005级、2007级、2008级临床医学七年制和2006级、2007级、2008级、2009级临床医学本科中实施，已取得了一些成效，但也存在一些问题，如不同教研室之间交叉内容较多，出现讲课内容重复，知识结构分散，个别教师临床相关学科的知识不能讲透彻，难以达到理想的教学效果等问题，单独以教研室组织的集体备课不能从根本上解决，以及教学各环节存在的一些问题，为了有利于教学、有利于学生学习、有利于教学质量的提高2，学院于2011年初开始组织不同教研室的教师，按系统进行集体备课（简称系统集体备课）。一、系统集体备课的组织管理系统集体备课是在学院的统
3、一安排下,由教务部组织同一系统的不同教研室的授课教师在教研室集体备课前进行。二、系统集体备课的方法学院教学管理人员经调研，将教学督导、教研室管理人员、教师、学生的意见与建议进行汇总和分析，总结出授课教师在教学各环节和临床课程整合实施中遇到的实际问题，包括教学大纲的认知、教案书写、多媒体课件制作、课堂理论教学和课间见习教学方法、PBL教学、学生考核、不同学科交叉内容等方面。针对问题，由学院教学管理人员提出建议，然后大家集中讨论，进行提问答疑。在学院系统集体备课后,系统所涉及的各教研室按照教学计划定期组织教师进行教研室集体备课，熟悉教学大纲，掌握教学基本要求和内容，并通过钻研大纲和教材，掌握教学目
4、的和重点3。三、系统集体备课的实施1.备教学大纲明确教学目的、讲课内容的重点、难点，特别是课程整合的部分，如呼吸系统疾病的肺炎、肺结核，包括成人和儿童，二者之间有相同的方面，也有各自的专科特点，授课教师一定要将教学大纲吃透。2.备教案重点强调几个方面：教案要项目完整齐全，有学期授课计划；教学内容要详略得当、有重点难点标记、有新进展内容；教学方法设计要注重师生互动和启发式教学；教学手段设计要恰当，并体现现代化；要有教学时间分配设计；字迹要工整正确，层次清晰、有双语词汇。3.备多媒体课件强调几点注意事项，一是颜色对比度，建议蓝底白字或白底黑字，不要颜色多样化，在电脑上看比较清晰明了，但在教室投影幕
5、上的效果不是很理想，后面的学生可能看不清楚；二是做到图片清晰效佳，有的教师准备很多图片，如X线、CT等，建议准备典型图片，同一类型的典型片不宜过多，在同一张PPT上放置1-2张图片，放置过多，学生观看效果不好；三是文字精炼清晰，文字不宜过多，要简要、精炼，突出知识主干线即可；四是如果教师掌握计算机水平好，可以增加动态模式图、视频录像短片等。4.备课堂理论教学方法原来倡导“以病例为引导”的教学方法进行理论授课，基本得以实现，就是在上课开始先讲一个或几个病例，来导出我们所要讲的问题或课程，或者是在课程进行中或结束后讲一个或几个病例，来检验学生对讲授知识的理解程度；现在我们强调“以病例为基础”的教学
6、方法，就是一次理论授课（90分钟）中，通过讲解3-5个病例，来引出整堂理论授课内容，这些病例可以相关联或不相关联，简单易懂，第一个病例侧重于疾病的病因、发病机制等，第二个病例侧重于疾病的临床表现等，第三个病例侧重于疾病的诊断及鉴别诊断等，第四个病例侧重于疾病的治疗等，第五个病例侧重于疾病的预后等，病例设置的数量和所关联的知识点，可以根据讲课内容自行设定，总之，通过讲解病例，引导出所要讲授知识要点。注重师生互动和启发式教学。 5.备课间见习教学方法临床见习是学生经过临床理论知识学习后，在教师指导下，深入病房，接触实际，认识症状、体征，获得感性认识的教学环节，是培养学生理论联系实际、临床操作技能和
7、临床问题解决能力的重要教学过程。指导教师应为学生积极创造临床见习机会，提倡“以病人为基础的临床见习教学”，同时可以灵活运用理论讲授、示教、实践、模拟教具、电教等各类教学方法，临床见习每次时间为4学时（200分钟），建议基本模式如下：见习前讲解；学生分组进病房询问病史和查体；学生回示教室书写并报告病历摘要；请学生提出必要的辅助检查，并说明每项检查的目的，由指导教师提供相应检查项目的结果；学生归纳病人的临床特点、诊断依据和治疗方法等；指导教师讲评并总结当天见习内容。通过这样的方法，针对每一名学生，只看一名病人，但同时可以了解多个病人的情况。6.备PBL教学强调教师在PBL教学授课中作用，一是课堂引
8、导作用，保证讨论内容与教学目标一致；二是教师评判作用，同一堂课不同授课教师之间要充分沟通，保证课堂评价及循证报告评分的公正、公平；三是教师总结作用，PBL教学内容不做课堂理论授课，学生只是授课前对相关章节进行预习，在头脑中没有形成系统的理论框架，PBL授课结束后，要对相关理论知识进行“穿线”，明确重点、难点、考点。7.备考核，完善试题库建设成绩考核可分为课堂考核、见习考核及试卷考核。系统授课教师要明确考核方法和考核手段，明确考核知识要点，根据教学大纲、讲授内容及学时，参与试题库建设，淘汰与教学目标不一致的试题，添加与教学要求相符合的试题。题型包括选择题、名词解释、问答题、病例分析题等，分数视试
9、题情况及教学管理部门的要求自拟。 8.系统授课教师交流与研讨教师交流与研讨是集体备课中的重要环节。不同学科的授课教师之间可相互沟通，弥补不足，完善讲课内容；探讨授课方法；针对不同课程之间的交叉点，明确讲课范围；也可根据讲课内容提出自己的观点等。例如在呼吸系统疾病中，肺炎、肺结核的讲授，儿科、呼吸内科、胸外科的教师就要充分沟通，阐述学科特点，充实讲课内容；在循环系统疾病中，原安排心脏神经症、心血管疾病的溶栓和抗栓治疗的单独讲授，经讨论将其融合入到冠心病等疾病的讲授内容，避免重复讲授；心脏疾病原讲授2学时，教师认为讲课内容比较多，课时少，根据学科要求增至4学时。四、系统集体备课的体会1.通过系统集
10、体备课，针对原有临床课程整合的系统教学内容，进行删减或添加，使其更加趋于合理，进一步完善了临床课程整合体系。2.解决了临床课程整合实际运行中出现的不同学科讲课内容重复问题，提高了临床课程整合的精炼度。3.解决了专科细化，不同教研室的教师能够通过沟通，了解对方学科对同种疾病的认知，特别是疾病的治疗和新进展。提高了教师特别是年轻教师的实际教学能力、专业知识水平。4.加强了授课教师在教学各环节的重视程度，在对教学大纲的认知、规范教案书写、多媒体课件制作、教学效果等方面得到进一步提高。5.更新教育理念，推行新的教学方法。“以病例为基础的理论教学”和“以病人为基础的临床见习教学”配合临床课程整合的系统授
11、课，使学生在提高学习效益的同时，形成科学的临床思维方式和良好的学习习惯4，提高了学生培养质量和综合分析能力。此方法通过实践，颇受学生欢迎。6.强化了PBL授课教师在PBL教学过程的作用，使学生能够充分参与到讨论中，提高自身的交流能力、思辨能力和团队精神，建立循证医学的理念。7.授课教师参与试题库建设，使试题与教师所讲内容相呼应，避免了教考分离所带来的弊端，能够真实反映出学生的学习水平。8.有效地发挥群体的优势互补, 相互渗透、相互帮助、取长补短的作用, 并能充分调动每位教师的积极性和主动性, 集思广益,弥补各位教师备课过程中的不足，不断提高临床教学水平5。 参考文献1张东华，郭劲松，曹德品，等
12、.临床课程整合的探索与实践J.中华医院管理杂志，2010，26（10）:793-794.2黄启林.集体备课有利于教师专业素质的整体提高J.卫生职业教育，2004，10（8）:33-34.3牙彩林.集体备课的体会J.卫生职业教育，2004，22（22）:75-76.4张东华，郭劲松，曹德品，等.临床课程整合的探索与实践J.中华医院管理杂志，2010，26（10）:793-794.5李建美,卢竞前,潘丽萍，等.集体备课在心内科教学中应用探讨J.医学信息,2007,20(8):1347-1348.Systems-based collective preparation for class of in
13、tegrated coursesGUO Qing-feng,GUO Jin-song,BO Hong,CUI Ying,ZHANG Dong-hua,YANG Li-bin(First Clinical College, Harbin Medical University, Harbin 150001, Heilongjiang, China)Abstract: Systems-based collective preparation for class of integrated courses happen before the collective preparation of clas
14、s in a teaching department. The college organizes the teachers who instruct the same system from different departments to communicate and discuss about the teaching process and the problems encountered after the integrated courses are implemented. It has been proved that it benefits teaching and lea
15、rning, and is instrumental for the improvement of teaching quality.Key Words: integration of clinical courses; systems; collective preparation of classes作者简介郭庆峰，男，讲师，医学学士，主要从事临床教学管理工作。通讯作者张东华Editors note: Judson Jones is a meteorologist, journalist and photographer. He has freelanced with CNN for fo
16、ur years, covering severe weather from tornadoes to typhoons. Follow him on Twitter: jnjonesjr (CNN) - I will always wonder what it was like to huddle around a shortwave radio and through the crackling static from space hear the faint beeps of the worlds first satellite - Sputnik. I also missed watc
17、hing Neil Armstrong step foot on the moon and the first space shuttle take off for the stars. Those events were way before my time.As a kid, I was fascinated with what goes on in the sky, and when NASA pulled the plug on the shuttle program I was heartbroken. Yet the privatized space race has renewe
18、d my childhood dreams to reach for the stars.As a meteorologist, Ive still seen many important weather and space events, but right now, if you were sitting next to me, youd hear my foot tapping rapidly under my desk. Im anxious for the next one: a space capsule hanging from a crane in the New Mexico
19、 desert.Its like the set for a George Lucas movie floating to the edge of space.You and I will have the chance to watch a man take a leap into an unimaginable free fall from the edge of space - live.The (lack of) air up there Watch man jump from 96,000 feet Tuesday, I sat at work glued to the live s
20、tream of the Red Bull Stratos Mission. I watched the balloons positioned at different altitudes in the sky to test the winds, knowing that if they would just line up in a vertical straight line we would be go for launch.I feel this mission was created for me because I am also a journalist and a phot
21、ographer, but above all I live for taking a leap of faith - the feeling of pushing the envelope into uncharted territory.The guy who is going to do this, Felix Baumgartner, must have that same feeling, at a level I will never reach. However, it did not stop me from feeling his pain when a gust of sw
22、irling wind kicked up and twisted the partially filled balloon that would take him to the upper end of our atmosphere. As soon as the 40-acre balloon, with skin no thicker than a dry cleaning bag, scraped the ground I knew it was over.How claustrophobia almost grounded supersonic skydiverWith each t
23、wist, you could see the wrinkles of disappointment on the face of the current record holder and capcom (capsule communications), Col. Joe Kittinger. He hung his head low in mission control as he told Baumgartner the disappointing news: Mission aborted.The supersonic descent could happen as early as
24、Sunday.The weather plays an important role in this mission. Starting at the ground, conditions have to be very calm - winds less than 2 mph, with no precipitation or humidity and limited cloud cover. The balloon, with capsule attached, will move through the lower level of the atmosphere (the troposp
25、here) where our day-to-day weather lives. It will climb higher than the tip of Mount Everest (5.5 miles/8.85 kilometers), drifting even higher than the cruising altitude of commercial airliners (5.6 miles/9.17 kilometers) and into the stratosphere. As he crosses the boundary layer (called the tropop
26、ause), he can expect a lot of turbulence.The balloon will slowly drift to the edge of space at 120,000 feet (22.7 miles/36.53 kilometers). Here, Fearless Felix will unclip. He will roll back the door.Then, I would assume, he will slowly step out onto something resembling an Olympic diving platform.B
27、elow, the Earth becomes the concrete bottom of a swimming pool that he wants to land on, but not too hard. Still, hell be traveling fast, so despite the distance, it will not be like diving into the deep end of a pool. It will be like he is diving into the shallow end.Skydiver preps for the big jump
28、When he jumps, he is expected to reach the speed of sound - 690 mph (1,110 kph) - in less than 40 seconds. Like hitting the top of the water, he will begin to slow as he approaches the more dense air closer to Earth. But this will not be enough to stop him completely.If he goes too fast or spins out
29、 of control, he has a stabilization parachute that can be deployed to slow him down. His team hopes its not needed. Instead, he plans to deploy his 270-square-foot (25-square-meter) main chute at an altitude of around 5,000 feet (1,524 meters).In order to deploy this chute successfully, he will have
30、 to slow to 172 mph (277 kph). He will have a reserve parachute that will open automatically if he loses consciousness at mach speeds.Even if everything goes as planned, it wont. Baumgartner still will free fall at a speed that would cause you and me to pass out, and no parachute is guaranteed to wo
31、rk higher than 25,000 feet (7,620 meters).It might not be the moon, but Kittinger free fell from 102,800 feet in 1960 - at the dawn of an infamous space race that captured the hearts of many. Baumgartner will attempt to break that record, a feat that boggles the mind. This is one of those monumental moments I will always remember, because there is no way Id miss this.
