Zhang Wenhong called "Sherlock Holmes-level professor", and listened to this professor say that diagnostics are two or three things

Medical diagnostics is like a detective, stripping away the cocoon, exploring the way in the fog, peak circuit turning, some doctors have been obsessed with this "detective road" all their lives. For example, Lin Guowei, a tenured professor at Huashan Hospital affiliated to Fudan University. In January this year, when Mr. Lao had been practicing medicine for 62 years, Professor Zhang Wenhong, director of the Department of Infectious Diseases of Huashan Hospital, talked about Lin Lao and called him a "Sherlock Holmes-level professor".

"Since I entered Huashan Hospital, Elder Lin is one of the several professors of internal medicine that I particularly admire, and my teacher, Professor Weng Xinhua, they are all Sherlock Holmes-level professors who are the most admired in our original medical school." Zhang Wenhong said that the most powerful thing about "Sherlock Holmes-level professors" is "detective", that is, the diagnosis of diseases, as students standing by their side, witnessing them from consultation to physical examination, is a kind of enjoyment.

According to Zhang Wenhong's recollection, at that time, the teaching films of the old doctors would also invite these teachers as models, "not because they are handsome, of course, they are also handsome, but what is more 'handsome' is the breadth and logic of their medical knowledge, reaching the top level, and guiding the post-learning to continue to move forward in this field, raising diagnostics to a new height and better serving patients." ”

Lin Guowei was the director of the Diagnostic Teaching and Research Department of Huashan Hospital, and what did Zhang Wenhong learn from Elder Lin? Look at Lin Guo's "I and the Teaching of Diagnostics" written by Lin Guo for the professor.

Fundamentals of Internal Medicine

I started teaching diagnostics in the 1960s, when I was a resident in my second year. At that time, the course of diagnostics was called Fundamentals of Internal Medicine, presumably a name learned from the Soviet Union. There was no separate teaching and research department for this course, but it was undertaken by the Internal Medicine Teaching and Research Department, and Director Zhu Baorong was responsible, and he needed an assistant at that time, and he asked me by name. Although teaching outside of work will have an impact on the training of resident doctors, because I am a party member, I must obey the arrangements of the teaching and research department, so I agreed to it. Since then, in my teaching career, I have formed an indissoluble relationship with diagnostics.

The teaching task of this course of fundamentals of internal medicine is very heavy, there are several classes, Director Zhu and I both took up the burden of the class, which is a certain difficulty for me. Because of my low seniority, I could only spend double the time preparing for classes, and sometimes I had to consult my supervisor, Professor Ding Xunjie. After one semester, the response of my classmates to my lectures was very good, which increased my confidence a lot.

Director Zhu also used a lot of brains to improve the teaching effect. At that time, the conditions were limited, there was no visual teaching aids, he took photos of the typical cases of medical performance, and then enlarged, made into teaching aids, hung in the classroom to increase students' understanding. Director Zhu's enthusiasm and professionalism for teaching deeply touched me, and at the same time, I learned a lot of things, laying a solid foundation for me to engage in diagnostic teaching in the future.

Pedagogical reform

In 1996, Huashan Hospital first established the Diagnostics Teaching and Research Department, and Comrade Zhang Yongxin, the party secretary at the time, came to me and hoped that I could serve as the director of the teaching and research department, and instructed me: "To solve the problems of the general decline in the medical history and physical examination quality of the clinical work of residents and graduate students in our hospital, and the basic skills are not solid, we must start from diagnostics." "I knew in my heart that this was a very difficult task, because there was no staffing, the teachers were drawn from various teaching and research departments, and there was no funding. But because I loved teaching diagnostics, I agreed.

Diagnostics is a very important course, the foundation of various clinical courses, the bridge course for medical students to contact the clinic, and the introductory stage for the basic skills training of clinicians. After the establishment of the Department of Diagnostics, I began to explore teaching reform, including teaching content and methods. Establish a system of pre-job training and collective lesson preparation for teachers, reform assessment methods, compile internship guidance, standardize 100 physical examination methods and sequences, strengthen the consultation summary of various symptoms, etc., and carry out all-round teaching reform. After two pilots of medical students, the curriculum has gradually matured and the quality of teaching has improved significantly. At that time, President Zhang Yuanfang personally held an on-site meeting to promote the experience of diagnostic teaching reform, which had a certain role in promoting the teaching work of the entire hospital.

Recording of the first instructional video

During my tenure as Deputy Director of the Department of Internal Medicine, I was in charge of the training of resident physicians. I once did a "survey" to understand the basics of diagnostics among residents, and the results were unsatisfactory and reflected a number of problems, especially in terms of mastering physical examination skills and the rate of sign discovery. Therefore, the teaching and research department decided to record a video of the formal procedures and methods of the physical examination.

The most difficult thing about self-made video is to choose the "protagonist" in the film, and everyone recommends me, but I refuse to agree to it, in fact, I am weak in my heart. Because I know that there is still a certain gap between the basic skills of physical examination of our generation of doctors and our teachers. Therefore, I recommended Professor Feng Yaoting, Who has worked in Zhongshan Hospital for many years and studied under Professor Lin Zhaoqi, and his basic skills are very solid.

Professor Feng took on this heavy responsibility, knowing that there was not a penny of funding at that time. Under my organization and director, after several months of hard work, I finally completed this self-created video that reflects the basic skills of our old medical school. After trying it out, the results are very satisfactory. This has not only become an important visual teaching material in the future teaching of diagnostics, but also an important teaching material for pre-job training and basic skills of resident training in teacher training.

Preparation of the auxiliary textbook "New Diagnostic Foundations"

The biggest step in the reform of diagnostic teaching is the reform of teaching methods.

According to the national textbook, it is based on the "system", the inspection method, normal and abnormal are explained in a system, and the complete physical examination method cannot be fully mastered until the end of the semester. Because diagnostics is a very practical course, we propose to teach in "phases". Explain the "common symptoms" in the consultation training stage, match each symptom with a "consultation summary", and ask students to repeatedly practice "asking" after class to achieve proficiency, and then go to the ward for internship and consultation. In the "Physical Examination" training stage, the physical examination method and sequence are explained, accompanied by repeated video viewing and peer-to-peer checks to achieve proficiency. After passing the assessment, go to the ward for physical examination. The third stage explains the signs of various diseases. Through repeated exercises, we will practice the basic skills one by one and lay a solid foundation for future clinical work.

In order to adapt to the new teaching methods, there is an urgent need for a teaching aids. It took our team more than a year to write the "Fundamentals of New Diagnostics", which was officially published by Fudan University Press. The book is characterized by the emphasis on the basic skills of clinical skills training, which is widely welcomed by medical students, because it can save a lot of learning time, more, faster, better, and more economical to grasp the requirements of the syllabus.

This article was written to commemorate the sixtieth anniversary of my practice as a medical teacher. I have taught medicine all my life, lectured on diagnostics, internal medicine and clinical epidemiology, and participated in many large-scale teaching reforms, which were the most successful. I love medical teaching, edited a total of ten textbooks, won seven teaching achievement awards, and has been awarded the National Outstanding Teacher (Baosteel Award) and the Outstanding Teacher of the School (Pukang Award) for many times.

Author: Lin Guowei

Editor: Tang Wenjia