目的: 评价临床技能标准视频（以下简称“视频”）对提高我校医学生临床技能操作能力的作用,探讨临床教师在临床技能教学中的指导作用,寻找更有效的临床技能教学方法。方法: 将选修临床基本操作课程的60名大学三年级医学生随机分为有教师指导的视频教学组和传统教学组;另选择自愿到实训中心自学训练的40名各年级医学生,均采用无教师指导的自学视频方式,并根据其年级分为自学视频组高年级组和低年级组。比较有教师指导的标准视频教学和传统教学的差异,以及远期教学效果,比较有教师指导的视频教学组和自学视频组考核成绩,了解教师的指导作用。对相应的学生和教师进行问卷调查,了解学教双方对标准视频教学的满意度等。结果: 视频教学组学生的考核成绩明显高于传统教学组（P<0.05）,平均分值相差8.4分;8周后再次考核,视频教学组和传统教学组学生的考核成绩均较8周前明显降低,但传统教学组成绩下降的分值较视频教学组下降的更多（P<0.05）。自学视频组学生中,低年级组的考核成绩明显低于高年级组（P<0.05）,与高年级组间的平均分值相差8.8分。有教师辅导的视频教学组学生的考核成绩均明显高于自学视频低年级组及自学视频高年级组（P均<0.05）,组间平均分值分别相差18.9分和10.1分。调查问卷结果显示,100%学生对课程兴趣浓厚,95.02%的学生认为视频教学对学习有帮助。10名教师均认为通过统一标准的视频教学,可减少评价的误差性和差异性。结论: 视频教学组的教学效果优于传统教学组。低年级医学生通过视频自学临床技能操作的效果低于高年级组医学生,且低年级医学生初始学习的过程中更需要教师指导。

Objective: To evaluate the efficacy of using standardized clinical skills instruction video in teaching of clinical skills and investigate the role of clinical instructor in teaching clinical skills for finding a more effective method to improve the teaching of clinical skills. Methods: Sixty third-year grade medical students taking the elective course of clini-cal skills and other 40 students from junior grades volunteered for taking self-taught instruction video training course of clinical skills were enrolled. The 60 third-year grade students were divided into clinical skill instruction video teaching group and conventional teaching group. The 40 junior grade students were categorized into freshman and sophomore grade groups and all received self-taught instruction video training course of clinical skills. Resultsof teaching were evaluated and compared between these groups, and a questionnaire survey was conducted in both the students and tutors. Results: The average score in instruction video teaching group was significantly higher than that of conventional teaching group (P<0.05) with a difference of 8.4 counts (a full of 100 counts). Eight weeks later the scores of the two groups were significantly decreased, and the decrease was more significant in conventional teaching group (P<0.05). In groups of self-taught instruction video training, the average score of freshman grade group was lower than that of sophomore grade group (P<0.05), with a difference of 8.8 counts. The scores in freshman and sophomore grade self-taught instruction video training groups had lower scores than those in clinical skill instruction video teaching group, which got help from instructor (P<0.05); the differences were 18.9 and 10.1 counts, respectively. The results of questionnaire showed that all students had a strong interest for the clinical skill course, and 95.02% of the students believed that the clinical skill instruction video was helpful for the learning of clinical skills. All teachers agree that standardized clinical skill instruction video can reduce the error and difference in teaching evaluation. Conclusions: The teaching results of clinical skill instruction video teaching group are superior to that of conventional teaching group. The efficacy of self-taught clinical skill instruction video training in freshman grade students is lower than that in sophomore grade students and the help from instructor is more needed.