计算机模拟病例在临床医学八年制儿科学见习教学中的实践与探索

张瑞; 宋丹羽; 徐文瑞; 桑田; 廖莹; 齐建光

doi:10.3760/cma.j.cn116021-20260108-02278

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计算机模拟病例在临床医学八年制儿科学见习教学中的实践与探索

临床教学 | 更新时间：2026-07-27

- 计算机模拟病例在临床医学八年制儿科学见习教学中的实践与探索
- Practice and exploration of computer-based case simulations in pediatric clerkship teaching for eight-year clinical medicine program students
- 中华医学教育探索杂志 2026年25卷第7期页码：842-848
- 作者机构：
  
  北京大学第一医院儿童医学中心，北京 102627
- 作者简介：
  
  齐建光，Email：qjg2006@126.com
- 基金信息：
  
  2024年北京大学人工智能助推课程建设项目(2024AI08);2025年北京大学本科教学改革立项;2025年度北京大学医学部教育教学改革与研究课题示范智慧课程建设重点专项(2025SFZD05);2026年北京大学“教学新思路3.0”(2026XSL31)
- DOI：10.3760/cma.j.cn116021-20260108-02278
  中图分类号： R-0;R-4
- 收稿：2026-01-08，
  
  网络首发：2026-07-27，
  
  纸质出版：2026-07-20
- 稿件说明：
移动端阅览
张瑞, 宋丹羽, 徐文瑞, 等. 计算机模拟病例在临床医学八年制儿科学见习教学中的实践与探索[J]. 中华医学教育探索杂志, 2026, 25(7): 842-848.

Zhang Rui, Song Danyu, Xu Wenrui, et al. Practice and exploration of computer-based case simulations in pediatric clerkship teaching for eight-year clinical medicine program students[J]. Chinese Journal of Medical Education Research, 2026, 25(7): 842-848.
张瑞, 宋丹羽, 徐文瑞, 等. 计算机模拟病例在临床医学八年制儿科学见习教学中的实践与探索[J]. 中华医学教育探索杂志, 2026, 25(7): 842-848. DOI： 10.3760/cma.j.cn116021-20260108-02278.

Zhang Rui, Song Danyu, Xu Wenrui, et al. Practice and exploration of computer-based case simulations in pediatric clerkship teaching for eight-year clinical medicine program students[J]. Chinese Journal of Medical Education Research, 2026, 25(7): 842-848. DOI： 10.3760/cma.j.cn116021-20260108-02278.

摘要

目的

探讨计算机模拟病例（computer-based case simulations，CCS）在临床医学八年制儿科学见习教学中的应用效果，评估其对临床能力培养的价值与局限性。

方法

选取2024年10月至12月在北京大学第一医院儿科见习的52名八年制医学生，按学号顺序将其分为试验组（25名）和对照组（27名）。试验组采用传统教学联合CCS的方式开展教学，对照组仅采用传统教学。通过课程考核、问卷调查和质性访谈进行定量与定性评价，采用SPSS 29.0软件，并运用卡方检验、Wilcoxon秩和检验进行统计分析。

结果

试验组与对照组学生理论考核成绩[90.25（85.18，94.15）分 vs. 88.00（86.00，89.70）分

]

与病例分析成绩[13.7（13.2，14.2）分 vs. 13.8（13.0，14.1）分

]

差异均无统计学意义（

=-1.77，

=-0.12，均

0.05）。问卷调查显示，95.24%（20/21）的学生认为CCS有助于培养临床思维；在辅助检查选择环节，52.38%（11/21）的学生更倾向于CCS，而在问诊（16/21，76.19%）和体格检查（13/21，61.91%）环节则更倾向于传统教学。访谈结果显示，CCS形式新颖，能模拟真实接诊场景，提升临床思维，是对典型病例的标准化补充；但其存在问诊重点不突出、操作模式压缩思考空间等设计局限，且无法完全替代真实临床体验，对教师的能力要求更高。

结论

CCS作为儿科学见习教学的有效辅助工具，在培养临床思维和激发学习兴趣方面具有明确价值，但在人际互动和实操技能训练方面存在一定局限性，且未能显著提升学生的考核成绩。CCS仍需与传统临床实践相结合，持续优化以实现优势互补。

Abstract

Objective

To explore the application effects of computer-based case simulations (CCS) in pediatric clerkship teaching for eight-year clinical medicine program students and to evaluate its value and limitations in cultivating clinical competencies.

Methods

A total of 52 eight-year program medical students undergoing pediatric clerkship at Peking University First Hospital

China from October to December 2024 were selected and divided into an experimental group (

=25) and a control group (

=27) according to their student ID number sequence. The experimental group received traditional teaching combined with CCS

while the control group received t

raditional teaching only. Quantitative and qualitative evaluations were conducted through course assessments

questionnaire surveys

and qualitative interviews. Statistical analysis was performed using SPSS 29.0 software

including the chi-square test and Wilcoxon rank-sum test.

Results

There were no statistically significant differences between the two groups in theoretical assessment scores [90.25 (85.18

94.15) vs. 88.00 (86.00

89.70)

]

or case analysis scores [13.7 (13.2

14.2) vs. 13.8 (13.0

14.1)

]

(

=-1.77

=-0.12

0.05). The questionnaire survey showed that 95.24% (20/21) of the students believed CCS was helpful for cultivating clinical thinking ability. In terms of teaching session preferences

52.38% (11/21) of students preferred CCS for auxiliary examination selection

whereas the majority preferred traditional teaching for history taking (16/21

76.19%) and physical examination (13/21

61.91%). Interview results indicated that CCS was perceived as innovative

capable of simulating real clinical scenarios and enhancing clinical thinking ability

serving as a standardized supplement to typical cases. However

limitations were identified

including a lack of focus in history taking sessions

an operation mode that may constrain thinking space

and an inability to fully replace real clinical experience

which imposes higher demands on teachers' proficiency in using the tool.

Conclusions

As an effective auxiliary tool in pediatric clerkship teaching

CCS demonstrates clear value in fostering clinical thinking ability and stimulating learning interest. However

it exhibits limitations in interpersonal interaction and practical skill training and did not significantly improve students' assessment performance. CCS should be integrated with traditional clinical practice and continually optimized to achieve complementary advantages.

关键词

Keywords

references

Dillon GF , Clyman SG , Clauser BE , et al . The introduction of computer-based case simulations into the United States medical licensing examination [J ] . Acad Med , 2002 , 77 ( 10 Suppl ): S94 - S96 . DOI: 10.1097/00001888-200210001-00029 http://dx.doi.org/10.1097/00001888-200210001-00029 .

赵春芝，娄方勇，娄艺涵，等 . 计算机模拟及临床真实病例结合PBL教学法在全科住院医师规范化培训中的应用 [J ] . 卫生职业教育， 2024 ， 42 （ 19 ）： 135 - 139 . DOI: 10.20037/j.issn.1671-1246.2024.19.36 http://dx.doi.org/10.20037/j.issn.1671-1246.2024.19.36 .

陈适，罗云云，白皙，等 . 计算机临床思维训练在罕见病临床思维教学上的应用价值 [J ] . 基础医学与临床， 2021 ， 41 （ 6 ）： 914 - 917 . DOI: 10.16352/j.issn.1001-6325.2021.06.026 http://dx.doi.org/10.16352/j.issn.1001-6325.2021.06.026 .

徐文瑞，齐建光，廖莹，等 . 教师在儿科学本科教学中采取翻转课堂模式的意愿及其影响因素研究 [J ] . 中华医学教育探索杂志， 2025 ， 24 （ 4 ）： 460 - 465 . DOI: 10.3760/cma.j.cn116021-20250105-02021 http://dx.doi.org/10.3760/cma.j.cn116021-20250105-02021 .

Yazdani S , Hosseinzadeh M , Hosseini F . Models of clinical reasoning with a focus on general practice: a critical review [J ] . J Adv Med Educ Prof , 2017 , 5 ( 4 ): 177 - 184 .

张家玮，祁祯楠，齐建光，等 . 混合式教学在全科医师的儿科临床思维培训中的应用 [J ] . 中华医学教育杂志， 2023 ， 43 （ 6 ）： 414 - 417 . DOI: 10.3760/cma.j.cn115259-20220802-00970 http://dx.doi.org/10.3760/cma.j.cn115259-20220802-00970 .

陈适，白皙，潘慧 . 临床思维教学的常用教学方法 [J ] . 中国毕业后医学教育， 2020 ， 4 （ 2 ）： 108 - 111 . DOI: 3969/j.issn.2096-4293.2020.02.002 http://dx.doi.org/3969/j.issn.2096-4293.2020.02.002 .

倪芳英，管学妹，沈根海，等 . 医学生内科临床思维培养改革实践与思考 [J ] . 中华医学教育探索杂志， 2020 ， 19 （ 4 ）： 444 - 448 . DOI: 10.3760/cma.j.cn116021-20190603-00102 http://dx.doi.org/10.3760/cma.j.cn116021-20190603-00102 .

Lee CY , Jenq CC , Chandratilake M , et al . A scoping review of clinical reasoning research with Asian healthcare professionals [J ] . Adv Health Sci Educ Theory Pract , 2021 , 26 ( 5 ): 1555 - 1579 . DOI: 10.1007/s10459-021-10060-z http://dx.doi.org/10.1007/s10459-021-10060-z .

兰学立，向阳 . 住院医师规范化培训中的临床思维培养 [J ] . 中华医学教育杂志， 2025 ， 45 （ 5 ）： 338 - 343 . DOI: 10.3760/cma.j.cn115259-20241114-01180 http://dx.doi.org/10.3760/cma.j.cn115259-20241114-01180 .

Simpkin AL , Vyas JM , Armstrong KA . Diagnostic reasoning: an endangered competency in internal medicine training [J ] . Ann Intern Med , 2017 , 167 ( 7 ): 507 - 508 . DOI: 10.7326/M17-0163 http://dx.doi.org/10.7326/M17-0163 .

曾勇，王国民，蔡映云，等 . “临床思维” 的理解与培养 [J ] . 复旦教育论坛， 2005 ， 3 （ 1 ）： 90 - 93 . DOI: 10.3969/j.issn.1672-0059.2005.01.023 http://dx.doi.org/10.3969/j.issn.1672-0059.2005.01.023 .

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