问诊是病史采集的主要手段,教学时不应局限于内科住院患者,需要对学生进行多情境的问诊训练.门诊问诊训练时,需要设计好问诊场景及时间限制,主要为重点病史采集,同时训练病历书写;急诊问诊训练时,可介绍些常用问诊准则,如SAMPLE准则;还可针对老年人群、儿童、外科患者、海洛因依赖患者等不同人群介绍问诊的侧重点.通过理论教学和见习相结合,理论授课中穿插小组讨论和角色扮演,见习中设计多情景教学,加强标准化病人的应用,合理规划课堂学时、内容分配并及时反馈,以获得最优教学效果.%Inquiry is the main method of history taking. The training should not be limited to the medical inpatients inquiry. Different training scenes should be taken. The outpatient history inquiry needs a similar clinic room and set time limit, and focuses on key point history inquiry as well as document writing. Some principles in emergency inquiry are introduced, such as SAMPLE principle. The key points of inquiry of different patients including elderly patients, child patients, traumatic patients and drug addiction patients are also introduced. Through the combination of theory and practice mode, the group discussion and role-play, different scenes design and standardized patients application, reasonable design of teaching hours and content distribution, as well as feedback in time, optimal teaching effect can be finally achieved.
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