Exploration on the teaching plan of medical laboratory clinical microbiology practice

Abstract: Clinical microbiology testing is a subject combining laboratory science and clinical medicine. The clinical practice stage is a key stage for deepening theoretical knowledge and improving professional practice ability. Teaching teachers have constantly updated teaching concepts and design a practical teaching process, which is the core of practice teaching. This paper expounds the implementation process of the clinical microbiology teaching program from the aspects of laboratory safety training, professional knowledge training and assessment, scientific research innovation, etc., so as to achieve the purpose of improving the professional practice ability and comprehensive thinking ability of interns.

Key words: clinical microbiology test; practice teaching; communication ability; scientific research innovation

Clinical microbiology testing is a discipline that combines laboratory science and clinical medicine, mainly providing laboratory basis for the diagnosis of infectious diseases and the rational use of antimicrobial drugs. Some achievements have been made in bacterial resistance monitoring research. However, today, with the introduction of various antibacterial drugs, the morbidity and fatality rate of infectious diseases are still high, and the bacterial resistance rate is increasing year by year. Reducing the bacterial resistance rate has become a hot spot of global anti-infective treatment. [1-2], which also puts forward higher requirements for the professional ability of microbiological inspection workers. Clinical practice is an extension of school education. Improving the teaching methods of clinical microbiology practice and continuously standardizing the practice teaching system is a powerful guarantee for improving the professional ability of graduates. In recent years, through continuous theoretical exploration and practice, the inspection department of the hospital has achieved the established talent training goals. The key points of practice teaching are summarized as follows.

1 Paying attention to laboratory safety training is the basis for the successful completion of the internship

The clinical microbiology laboratory is a specific place for the detection and analysis of various pathogens, and it is a place where pathogens are relatively concentrated. Therefore, doing a good job in biosafety protection is the basis for the smooth development of microbiological inspection work. First, use pre-job training to conduct biosafety training for interns, mainly through multimedia teaching to teach relevant laws and regulations on laboratory biosafety management, relevant policies of Chongqing, the application of the "List of Pathogenic Microorganisms Infected Between Humans", bacteria (virus) species and the storage, transport and management of specimens and other laws and regulations, combined with laboratory biosafety incidents that have occurred in recent years. The awareness of the concept of sterility”; secondly, the general situation of the laboratory and the daily work flow were introduced, and the interns were trained on how to use fire extinguishers, fire hydrants and other fire-fighting appliances, and they were familiar with the fire safety emergency response plan and the emergency escape routes of the department; finally, By simulating the laboratory emergencies that may occur in daily work, the importance of personal protection and fire safety is explained in depth, so that everyone can master the emergency response process of accidents. After completing the training, each intern must pass the examination before entering the microbiology laboratory.

2. Deepen the participation of interns in clinical practice and improve the level of professional knowledge

Flexible application of the split-class method to deepen the interns' understanding of theoretical knowledge and improve their practical operation ability. The two-part class is a teaching method founded by Zhang Xuexin, a Ph.D. from Princeton University and a professor of psychology at Fudan University. The class time is divided into two parts, half of which is taught by teachers, and the other half is reserved for interns to discuss. A psychological internalization link is introduced between the discussions, so that the interns can participate in the discussion preparedly after absorbing the content of the lecture [3]. Although the clinical practice cannot fully achieve the same fixed class time as the school, it is still possible to strengthen the students' understanding and application of professional knowledge through small lectures and difficult case discussions. It is not necessary to stick to the form and location, and use limited time and resources to complete teaching tasks. [4]. The completion of the detection of clinical microorganisms to be tested involves multiple post links, including specimen collection, smear, inoculation, isolation and culture, drug susceptibility identification, etc. Each link strictly follows the corresponding operating procedures to ensure the accuracy of the results. During the teaching process, the instructor will teach the standardized procedures and related principles of the experimental operation. The intern will start practicing alone or in a team within the specified time, and then the instructor will design the practice operation topic according to the content of the lecture, and the intern will complete the practice. Specimen testing and report analysis. The results of the experiment are not judged by the teachers, but the evaluation team composed of all the personnel involved in the experiment operation evaluates the entire operation process, points out the shortcomings in the operation and proposes improvement measures. Finally, according to the conclusion of the evaluation team, the teacher emphasizes the key control points of each link in the experiment, and points out the common mistakes that the interns make in the experimental operation and the remedial measures after the mistakes. Constantly adjust the focus of practice teaching. The specific teaching process is shown in Figure 1. The microbiology internship period is generally 8 weeks, but for the study of some bacteria, it is very likely that the corresponding specimens cannot be obtained during the internship period, resulting in a lack of intuitive understanding of some rare bacteria and caustic bacteria. Almost every hospital's microbiology laboratory has accumulated a wide variety of bacteria after years of accumulation. Teachers can select the bacteria that need to be taught through the bacteria library catalog, and instruct the interns to build a teaching bacteria library by themselves. Before the interns enter the microbiology laboratory for internship every year, the teachers first select the strains that appear less frequently in this internship stage and mix them into various types of specimens according to the teaching requirements. Carry out cultivation identification, observe the changes of bacterial colony morphology during the cultivation process, determine the type of bacteria according to the characteristics of various biochemical reactions, analyze the drug resistance characteristics of bacteria, and guide the intern to review theoretical knowledge; Store it in the practice bacteria bank, and record the properties of these bacteria in detail, so as to facilitate the study of another batch of interns who enter the microbiology laboratory for practice. After continuous subculture of bacteria, their colony morphology and drug resistance level may change. According to the records of the previous batch of interns, it was found that the bacteria changed after subculture and discussed them, which could help the interns to deepen their understanding of theoretical knowledge. It also raises the teamwork awareness of the interns [5]. The ultimate purpose of clinical microbiology test is to provide etiological basis for clinical diagnosis and treatment of infectious diseases, so as to formulate scientific drug regimen, which requires microbiology laboratory to strengthen communication with clinical. Therefore, in the teaching process, great importance is attached to the cultivation of clinical communication skills. Taking a patient with urinary tract infection as an example, the laboratory department of our hospital reported that the clinical urine culture was >3 kinds of bacteria growth, and the bacterial amount was >105 CFU/mL. The instructors found that through such typical clinical case design, the interns' ability to solve practical clinical problems can be cultivated. First of all, the interns need to refer to the bacteriological examination procedure of urine samples, analyze the possible problems before and during the experiment, and then consult the clinical department about the time, method and drug use of the patients to retain the samples, and guide the clinical retention Take qualified specimens for inspection; combine the patient's clinical symptoms and relevant test results to determine whether the result report is appropriate; determine whether it has guiding significance for the diagnosis of clinical diseases, and recommend what further clinical examinations can be done. Through the study of similar typical cases, the interns not only mastered the key points of the cultivation and identification of various specimens, but also improved the interns' ability to comprehensively analyze problems.

3 Pay attention to assessment and cultivate interns' scientific thinking

Because of different educational experiences, the level of professional knowledge of interns varies greatly from year to year. Therefore, a single exam cannot fully understand the degree of interns' mastery of professional knowledge. Clinical microbiology testing is a discipline that emphasizes both theory and practice. Its professional characteristics include a large amount of theoretical knowledge and also involve a number of basic operational skills. When organizing interns to carry out department assessment, two aspects should be taken into account [6]. The assessment of theoretical knowledge should cover the new development of professional theory and professional knowledge, and use subjective test questions such as case analysis to assess the interns' mastery of key knowledge and ability to analyze and solve problems; for practical operation assessment, select standard strains commonly used in laboratories and representative strains isolated in the inter-laboratory quality assessment of the clinical laboratory as the assessment materials, and set up staged examinations according to the content of the curriculum [7]. The interns decide the time to take the exam according to their own learning situation. The interns who pass the exam will enter the next stage of practice. The teacher will adjust the teaching plan in time according to the intern's exam situation, and strengthen the training of weak links. Scientific research thinking refers to a scientific way of thinking in the process of scientific research, which is essentially a thinking mode of actively discovering and solving problems [8-9]. As a medical intern, not only must master solid medical knowledge, but more importantly, have the scientific thinking ability to discover and solve medical problems. 10-11]. In the process of teaching practice, the interns are taught cutting-edge knowledge and assigned literature reading assignments. The interns choose literature reading according to their favorite fields. The PPT literature sharing report is held every week, and it is required to draw an idea map according to the content of the literature, to explain what hypotheses the author has put forward, what kind of hierarchical relationship there is between these hypotheses; what kind of research content has been used to verify these hypotheses and the research adopted The program guides the interns to understand the entire process of scientific research by analyzing the writing ideas of the authors of the literature, and trains the interns' reasoning thinking. To sum up, the practical teaching of clinical microbiology testing under the new situation should adopt a variety of teaching methods, and gradually improve the teaching process in teaching practice. Use the teaching mode of leading to guiding to help interns consolidate professional theoretical knowledge, improve interns' professional practical skills and clinical communication skills; stimulate interns' learning initiative, curiosity and spirit of exploration, so as to cultivate a high level of clinical practice Microbiology testing talents, and promote the development of my country's medical microbiology career.

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Exploration on the teaching plan of medical laboratory clinical microbiology practice