Objective To explore the teaching ability of the neurology refresher doctors by case teaching method combined with flipped classroom teaching mode. Methods The refresher doctors who were studying in the infection group of Department of Neurology, Xuanwu Hospital Capital Medical University between March 2019 and September 2020 were selected. According to the time of admission, the enrolled refresher doctors were divided into control group (grade 2019) and observation group (grade 2020). The control group adopted the traditional teaching mode, and the observation group adopted the case teaching method combined with the flipped classroom teaching mode. A self-designed questionnaire was used to compare the teaching ability of the two groups of refresher doctors. Results A total of 44 refresher doctors were included. Among them, there were 24 refresher doctors in the control group and 20 refresher doctors in the observation group. The self-evaluation of the teaching ability of the two groups of refresher doctors and the evaluation of their teaching ability by the teachers showed that, except for the item “enthusiasm for teaching and willingness to spend enough time to participate in the evaluation of teaching work” of humanistic quality (P>0.05), the observation group was better than the control group in professional knowledge, teaching ability, teaching methods and humanistic quality (P<0.05). Conclusions Through the case teaching method combined with flipped classroom teaching mode, the teaching ability of refresher doctors can be cultivated, which is helpful for training more high-quality doctors for the country and promoting the sustainable and coordinated development of medical education. However, the awareness and enthusiasm of the refresher doctors to teaching work need to be improved.
【摘要】 目的 通過比較遺忘型輕度認知障礙（amnestic mild cognitive impairment，aMCI）和血管性認知障礙非癡呆型（vascular cognitive impairment-no dementia，VCI-ND）患者及正常老年人群在簡易智能精神狀態檢查量表（mini mental state examination，MMSE）、聽覺詞語學習測驗（auditory verbal learning test，AVLT）、畫鐘試驗（clock drawing test，CDT）及臨床癡呆評定量表（clinical dementia rating scales，CDR）中的表現，進一步分析aMCI和VCI-ND在認知損害方面的不同特點。 方法 選取首都醫科大學宣武醫院神經內科門診收治aMCI患者23例及VCI-ND患者27例（CDR＝0.5分），同時選取40名正常老年人（CDR=0分）作為對照組。每位受試者均進行MMSE、AVLT、CDT及CDR等神經心理學量表測查，分析以上3組被試各項神經心理學測查得分之間的差異。 結果 各組受試者的年齡、性別及受教育程度差異無統計學意義（Pgt;0.05），具有可比性。aMCI和VCI-ND組在MMSE、CDT、即刻記憶、延遲記憶及延遲再認檢測中的平均值均低于對照組，且差異均具有統計學意義（Plt;0.05）。aMCI和VCI-ND兩組除延遲再認檢測外，其余各項測查的平均分均無統計學意義（Pgt;0.05）。在延遲再認檢測中，aMCI組（6.65±4.00）較VCI-ND組（8.67±2.76）再認詞語數量少，兩組延遲再認的得分均低于對照組（12.83±1.77），差異有統計學意義（Plt;0.05）。 結論 aMCI和VCI-ND在記憶力、執行能力和信息處理能力方面較正常老年人均有所損害。由于aMCI和VCI-ND不同的病理改變，導致患者存在不同類型的記憶儲存和提取機制。【Abstract】 Objective To investigate the different patterns of cognitive impairment in patients with amnestic mild cognitive impairment (amci), vascular cognitive impairment-no dementia (VCI-ND) and normal elder people. Methods A total of 23 patients with aMCI and 27 patients with VCI-ND (CDR＝0.5) and another 40 healthy elder people (CDR=0) were selected. Each individual underwent the neuropsychological tests, including mini mental state examination (MMSE), auditory verbal learning test (AVLT), clock drawing test (CDT), clinical dementia rating scales (CDR) and hamilton rating scale for depression (HAMD). The differences between the three groups were analyzed. Results The differences in age, sexes, and the education background among the three groups were not significant (Pgt;0.05) which meant comparability. The mean scores of MMSE, CDT, instant memory and delayed awareness in aMCI and VIC-ND group were much lower than that in the control group (Plt;0.05). The differences in all the test items except for delayed awareness between aMCI group and VCI-ND groups were not significant (Pgt;0.05). However, in the recall recognition test, these three groups had significant differences: the score in patients with aMCI (6.65±4.00) was much lower than that in patients with VCI-ND (8.67±2.76; Plt;0.05), and the scores of the two groups were both lower than that in the normal aging group (12.83±1.77; Plt;0.05). Conclusion Compared with normal elder people, the cognition of aMCI and VCI-ND patients is impaired severely. The memory tests suggeste that compared with aMCI patients, VCI-ND patients may have different neuropathological changes leading to different mechanism of memory encoding and retrieval.
