In the current medical environment, Chinese medical students have fewer and fewer opportunities for practice at the internship stage, which leads to a serious lack of clinical skills to meet the demands of the real world of work. In this study, we used a practical training scenario simulation teaching method oriented to strengthen clinical skills, and systematically compared the teaching effectiveness with that of traditional internship teaching models. This study included 40 5-year clinical medicine interns who practiced in the Department of Neurology at our hospital. They were randomly divided into a control group and an observation group, with 20 participants in each group. The control group adopted the bedside teaching, and the observation group adopted the practical training scenario simulation teaching method. Students in both groups were assessed using Mini-CEX scores on comprehensive qualities related to clinical skills, including physical examination of the nervous system, humanistic care, communication skills, organizational skills, etc And then, their learning outcomes are assessed in the form of after-department examination. After the internship, all the scores of teaching effect of students in the observation group were significantly higher than those of the control group, especially in terms of doctor-patient communication, physical examination of the nervous system, localization and nature determination, organizational skills, and overall performance (P < 0.05). The results of students' exit exams, students' and teachers' teaching satisfaction of the observation group were significantly better than those of the control group (P < 0.05). This method has an obvious promotion effect on the improvement of medical students' clinical skills. The method significantly improves the performance of medical students during the internship stage, and results in higher teaching satisfaction for teachers and students.

Keywords: Clinical skills; Mini-CEX; internship stage; neurology department; practical training scenario simulation teaching method.

在当前的医疗环境中，中国医学生的实习机会越来越少，导致他们在临床技能方面严重缺乏，无法满足实际工作需求。本研究采用了一种以强化临床技能培训为导向的实践场景模拟教学方法，并系统地将其教学效果与传统实习教学模式进行了比较。这项研究包括了40名在我院神经内科实习的五年制临床医学实习生，他们被随机分成对照组和观察组，每组20人。对照组采用床边教学方式，而观察组则采用了实践场景模拟教学方法。两组学生均通过Mini-CEX评分系统评估其与临床技能相关的综合能力，包括神经系统体检、人文关怀、沟通技巧、组织能力等，并在实习结束后以科室考试的形式对其学习成果进行评价。实习结束后，观察组学生的所有教学效果得分明显高于对照组，尤其是在医患沟通、神经系统体检、定位和性质判断、组织能力和总体表现方面（P<0.05）。观察组学生出科考试成绩、师生的教学满意度均显著优于对照组（P<0.05）。该方法对提高医学生的临床技能有明显的促进作用，并且在实习阶段显著提高了医学生的绩效，使得教师和学生都获得了更高的教学满意度。

关键词：临床技能；Mini-CEX；实习阶段；神经内科；实践场景模拟教学法。