浅析国内外医学生临床实习教学差异——以南京医科大学第一附属医院营养教研为例

Differences between Domestic and Foreign Clinical Medical Internship—Based on Clinical Nutrition Practice of First Affiliated Hospital of Nanjing Medical University

摘要: 目的：本研究旨在调查分析现行临床实践教学方法优劣势，以期对后期系统性完善具有专科特色的国际化营养实习带教模式具有指导意义。方法：向我教研室2017~2018年所收全部国内外实习生征询《临床营养实习调查问卷》并分析结果，浅析国内外临床营养学生的实践教学差异。结果：在实习目的满意度方面，国内外学生均评价较高(X₁± S₁ = 9.46 ± 1.12, X₂± S₂ = 8.50 ± 1.38, P = 0.266)，国内学生的就业需求更为显著。在实习时长方面，国外留学人员的满意度显著低于国内，工作内容安排受限、在促进个性化发展”(X₁ ±S₁ = 9.62 ± 0.51, X₂± S₂ = 8.83 ± 1.83, P < 0.01)和“实习资源满意度”(X₁ ± S₁ = 9.62 ± 0.65, X₂± S₂ = 8.33 ± 1.51, P < 0.01)方面的满意度均不及国内学生。可见国外留学人员对专业方向主动探索的积极性更强、对寻求个人发展的想法更多、对实习内容的要求更为丰富。结论：为全面提升医学营养人才的理论及实践能力，高质量实习带教模式亟需改革发展。可适当参考国外优秀教育经验，在遵循医学教育和人才成长规律的基础上，加快构建具有我国专科特色的营养人才培养体系。

Abstract: Objective: This research was designed to analyze the relative advantages and disadvantages of clinical practice in operation. It is hoped that this result will be useful to guide the improvement of international practice teaching mode with nutrition characteristics systematically. Method: Participants: Both domestic and international students our department has adopted from 2017-2018 were included in this research. The participants were asked to finish an anonymous questionnaire named “Satisfaction of Clinical Nutrition Internship”. The analysis was based on its results to illustrate the differences between domestic and foreign clinical medical internship. Results: Both of them were highly satisfied with their practical purposes (X₁± S₁ = 9.46 ± 1.12, X₂± S₂ = 8.50 ± 1.38, P = 0.266), while domestic participants were more curious about their future career. Foreign students showed lower satisfaction with their interns’ duration. The satisfaction degree of promoting personalized development (X₁ ± S₁ = 9.62 ± 0.51, X₂± S₂ = 8.83 ± 1.83, P < 0.01) and internship resources (X₁ ± S₁ = 9.62 ± 0.65, X₂± S₂ = 8.33 ± 1.51, P < 0.01) is lower than that of domestic students. It follows that foreign interns showed stronger exploration on professional direction and cared more about individualized development and had more requirements on internship content. Conclusion: Clinical practice of medical nutrition education should be quality controlled and standardized, so that the quality of theoretical and practical ability could be promoted comprehensively. The advanced teaching experience abroad should be integrated to construct a medical recruitment training system with subject feature and Chinese characteristics on the basis of following the law of medical education and talent growth.