关于临床医学专业学位硕士研究生教学与培养的几点思考

随着医学科学技术的发展和社会需求的扩大,医学界对高层次人才的需求持续增长。为推进我国医疗卫生系统的可持续发展,医学院校适应时势变化,积极调整和优化研究生教学类型结构,大力发展专业学位研究生教育。专业学位研究生教育以培养临床思维和提高临床技能为重点,同时注重基本科研素质的培养。随着专业学位研究生招生人数的增加,如何保证研究生的"质"和"量"的同步提升成为高校和教育者研究热点。本文通过借鉴临床医学科学学位硕士研究生的教学与培养模式,结合临床医学专业学位硕士研究生的特点及培养要求,对以往教学经验与教训做一总结,着力于探索一条适合临床医学专业学位硕士研究生的教学与培养模式,为建立标准化的临床医学专业学位硕士研究生的教学与培养模式提供参考。     

中医专业学位硕士研究生培养与住院医师规范化培训“双轨合一”存在的问题及对策研究

目的探讨改进和完善现阶段中医学专业学位硕士研究生培养与住院医师规范化培训"双轨合一"培养模式下存在问题的措施。方法分析中医专业学位硕士研究生培养与住院医师规范化培训"双轨合一"存在的问题,并探讨其对策。结果 "双轨合一"培养模式下存在一定的问题,如研究生待遇偏低、管理模式混乱、导师地位的边缘化及临床带教医师教学水平参差不齐等。结论针对"双轨合一"存在的问题进一步完善和改进,才能真正提高中医临床医师临床诊疗水平。     

临床专业学位研究生培养与住院/专科医师培训的比较研究

通过对临床专业学位研究生培养与住院/专科医师培训模式的比较研究,尝试对两者进行同一化管理,将利于量化临床型研究生临床能力培养情况,提高招生吸引力,利于挑选优秀临床型研究生,与住院医师规范化培训对象招录工作相衔接。     

基于认知学徒制的CBL教学模式在护理专业学位研究生临床实践能力培养的应用

目的探讨基于认知学徒制的CBL教学模式在护理专业学位研究生的临床实践能力培养中的应用效果。方法选取广西医科大学全日制护理硕士专业学位研究生作为研究对象,采用基于认知学徒制的CBL教学模式开展为期2周的临床实践课程教学,并评价其效果。结果培训前,学生的理论考核成绩为(80.64±1.91)分,培训后为(85.82±1.67)分,培训前后的理论考核成绩比较差异具有统计学意义(P<0.001);培训前,学生的技能操作考核成绩为(89.27±1.56)分,培训后为(93.64±1.80)分,培训前后的技能操作考核成绩比较差异有统计学意义(P<0.001)。结论基于认知学徒制的CBL教学模式有助于护理专业学位研究生临床实践能力的提升。     

我院两类人员并轨培养模式的实践

临床医学专业学位硕士研究生的临床能力培养与住院医师规范化培训在培养目标、培养内容、考核标准等方面具有一致性。对二者进行并轨培养,在二者的工作时间与工作量、培养形式和考核要求等方面做出同一性规定,起到了互相促进的作用。更高层次的并轨亟须在师资能力建设、临床实践时间保证以及国家层面的政策衔接等方面进一步明确并加强。     

病理学专业学位研究生临床与科研能力培养模式初探

病理学是研究疾病的发病、病变机理及在疾病发展过程中各组织器官形态特征与功能变化的一门学科,被称作是联系基础与临床的桥梁和纽带。据统计我国现阶段临床病理医生的需求量很大,而高水平临床病理诊断医师尤为欠缺。近年来,病理学专业学位研究生的培养应运而生,旨在为国家培养高质量的病理学人才。然而由于我国传统的病理学研究生的培养仍存在种种弊端,毕业的研究生难以获得临床与科研二者综合能力的提升,因而限制了其自身在病理学事业方面的发展。本文依据我科室专业学位研究生的培养经验,探讨病理学专业学位研究生的培养模式以及如何培养高层次病理学人才,促进其科学研究与外科病理诊断的有机结合,为推动我国病理学事业的蓬勃发展打好坚实基础。     

微生物学类研究生创新技能培养体系的探索——以南京农业大学为例

探讨南京农业大学"微生物学研究方法与技术"专项培训体系的构建,重点阐述建设内容、建设方式及教学成效。该培训体系分为5个功能模块,每个模块由专题讲座和实验技能培训两部分内容组成。通过该培训体系的训练,研究生能熟练掌握大型仪器设备的应用、操作、维护等相关知识,培养了良好的实验技能、严谨的实验作风、认真的科学态度,具备了基本的科学研究能力和科学研究品质,是提高研究生创新能力和实践能力的有效途径。     

我院两类人员333制并轨培养效果评价

??目的 了解住院医师和专业学位研究生333制并轨培养的效果。方法 对实施333制管理模式前后的住院医师与专业学位研究生进行年度考核,比较考核成绩。结果 实施333制管理模式前,专业学位研究生考核成绩与住院医师有统计学差异,经过一年的并轨培养,专业学位研究生考核成绩显著提高,与同年住院医师考核结果无统计学差异。结论 专业学位研究生在住院医师规范化培训基地与住院医师进行并轨培养,能够提高专业学位研究生的临床能力。     

分子实验技能课程教学模式初探

目的:探索适合临床研究生的分子实验技能课教学模式,提高研究生科研思维能力和实验技能。方法:根据临床研究生的特点,以学生为主体,注重学生科研思维的培养,运用多样化的教学手段,对研究生临床分子实验技能课程的教学方法进行探索。结果:通过实验技能课的学习与培训,临床研究生科研思维能力得到很大的提升,对医学实验研究兴趣增加,取得了很好的教学效果。结论:多元化教学模式比较适合临床研究生实验技能课的教学。     

“双轨合一”模式下中医专业学位研究生在重症医学科临床教学中存在的问题及对策

目的在"双轨合一"模式下,探讨中医专业学位研究生在ICU临床教学问题及解决方法。方法基于本院重症医学科中医专业学位研究生临床教学现况,结合文献调查法了解目前临床教学问题和探讨对策。结果中医专业学位研究生在重症医学科临床教学中仍存在诸多不足。结论本文总结了现阶段重症医学科里中医专业学位研究生临床教学中教、学、管存在的主要问题,并探讨相应的对策,为提升中医专业学位研究生在ICU的临床教学质量提供参考。     

专科层次临床医学专业课程建设效果调查分析

目的:了解临床医学专业课程建设情况,总结专科层次临床医学专业教育教学的主要成绩,查找专业建设存在的问题,为专科层次临床医学专业教育教学改革提出改进意见。方法:对我校2013届(应届生)306名、2011届和2012届(往届生)333名专科层次临床医学专业毕业生进行问卷调查,主要调查内容包括:课程内容、课程资源和课程评价。结果:专科层次临床医学专业毕业生认为本专业核心课程知识和技能模块设计合理,且应届毕业生认可度高于往届毕业生;对专业类纸质图书、纸质期刊等课程资源满意度高,认为专业类精品课程、教学视频等课程资源需要进一步改善;毕业生对专业知识考评认可度较高,应届生认可度优于往届生。结论:专科层次临床医学专业课程建设效果较好,特别是课程内容安排和课程评价合理,但在专业技能训练和课程资源建设方面需重点加强。     

五年制临床医学专业防原医学课程标准的制定与探索

防原医学是为五年制临床医学专业开设的一门必修的军事医学课程,理解和掌握防原医学知识,是成为具有全面技能的军事医学人才的基础。为了通过本门课程的学习,更好地培养高素质的新型军事医学人才,本文结合第四军医大学五年制临床医学专业学员的培养目标和实际情况,对课程标准的内容制定和实施进行思考,探索课程标准下的防原医学教学模式与方法,旨在进一步提升教学效果,造就新时期军事变革条件下的优秀人民军医。     

Competencies required for the practice of geriatric medicine as a consultant physician.

Geriatric medicine in Canada is now being viewed not merely as an academic specialty but, rather, more broadly as a service specialty providing consulting support to other physicians. Any redesigning of training programs will have to be done with this fact in mind. We drew up a list of competencies required for consultant practice in the field and presented them to other practitioners of geriatric medicine and members of the Canadian Society of Geriatric Medicine for feedback. We believe that the resulting list of competencies can be used as a starting point for redesigning training programs in geriatric medicine.     

Sex and gender medicine in physician clinical training: results of a large,single-center survey

Background

“Sex and Gender Medicine” is a novel medical discipline that takes into account the effects of sex and gender on the health of women and men. The Institute of Medicine in the USA declared in its 2001 and 2010 statements that being a woman or a man significantly impacts the course of diseases, and therefore, this fact must be considered in diagnosis and therapy. We evaluated the representation of Sex and Gender Medicine in clinical training at Cedars-Sinai Medical Center, a large, tertiary, non-profit, academic medical training center in the Western United States.

Methods

Post-graduate physician trainees (residents and fellows) in all medical and surgical departments (medicine, surgery, OB-GYN, pediatrics, anesthesiology, pathology, urology, electrophysiology, pulmonary critical care, cardiology, women’s heart, medical genetics, radiology, neurosurgery, and radiation oncology) were surveyed online; 80 (55 and 45 % female and male residents, respectively) out of 890 physicians (9 % response rate) responded to questions regarding sex and gender-based medicine.

Results

Seventy percent of post-graduate physician trainees indicated that gender medicine concepts are never or only sometimes discussed/presented in their training program. Slightly greater than 70 % of the trainees indicated that gender concepts are never or only sometimes incorporated into didactic lectures or clinical teaching. However, more than 65 % felt that gender medicine concepts are important, and 60 % agreed that gender medicine curriculum should be implemented and taught in their clinical program.

Conclusions

Current physician trainees endorse both a current lack of and need for Sex and Gender Medicine clinical training.

     

Imagerie hybride,TEP-TDM et TEMP-TDM. En quoi peut-elle influencer la formation et la pratique en médecine nucléaire en France ?

To define the policy of our specialty with a consensus opinion, a questionnaire entitled “hybrid imaging” was sent to practicing nuclear medicine specialist physicians in France to obtain their opinion on the impact of this recent method in training and in the practice of nuclear medicine and on the relations between nuclear medicine specialists and other medical imaging specialists. This questionnaire, written by the office of the French Society of Nuclear Medicine (FSNM) and molecular imaging , was divided into four parts: Profile and experience in hybrid imaging, Relations with radiologists, Practice of CT scans with hybrid equipment, and the Future of the specialty and of training in nuclear medicine. The response rate was 60%, i.e. 374 completed questionnaires. Overall, the responses were uniform, whatever the respondent's experience, type and place of practice. Regular participation in hybrid imaging practice was the reply provided by the majority of respondents. In terms of relations with radiologists, such contacts existed in over 85% of cases and are considered as being of high quality in over 90% of cases. The vast majority of practitioners believe that hybrid imaging will become the standard. Opinions on the diagnostic use of CT scans are divided, as well as their interpretation by a radiologist, a nuclear medicine specialist or by both. In the opinion of the vast majority, hybrid equipment systems should be managed by nuclear medicine specialists. With regard to the future, nuclear medicine should remain an independent specialty with enhanced training in morphological imaging and a residency training program whose length should be increased to 5 years.     

航空航天医学专业本科临床教学质量监控评价指标体系研究

目的:探讨航空航天医学专业本科临床教学质量监控评价指标体系,为航空航天医学专业本科临床教学质量提供监控标准。方法:参照《军队院校教学评价方法》,通过资料收集、专家座谈、个案分析方法,重点对航空航天医学人才的知识结构进行剖析,从教育设计(A1),教学条件(A2),过程管理(A3),质量评价(A4)四个角度分析,采用德尔菲法(Delphi)最终确定指标体系各要素。结果:目标层为:航空航天医学专业本科临床教学质量监控评价指标体系。中间层为ABCD四个等级;备选层为:教育设计、教学条件、过程管理、质量评价。汇总意见,构建航空航天医学本科临床教学质量监控评价指标体系。航空航天医学专业本科临床教学质量监控评价指标体系的实证应用结果:某军医大学检查结果得25个A标准,得3个B标准,达到优秀标准。结论:航空航天医学专业本科临床教学质量监控评价指标体系可行、有效。     

美国实验动物医学发展简史——对中国实验动物医学发展的思考

美国实验动物医学的发展起始于上世纪50年代,目前可能代表着世界上该领域的最高水平.本文对其发展史作了简的地回顾,包括生物医学领域对实验动物兽医的需求,实验动物科学领域早期的兽医实践,实验动物医学会的诞生,实验动物医学领域的培训、教育和考核等的沿革,以及相关法律法规对实验动物医学发展的影响等.笔者依据自身的工作实践和中国国情对中国实验动物医学领域的发展进行了一些思考,期盼实验动物相关法律法规能更加完善、在兽医教育中适度增加实验动物医学相关内容、加强实验动物医学领军人才的培养、加强实验动物医学界多渠道的交流、增加相关领域科研投入和支持等.中国要站在西方发达国家的肩膀上,借鉴其成功的经验,发展有中国特色的实验动物医学事业.     

The Class of 1989 and physician supply in Canada

BACKGROUND: "The Class of 1989" is a study of 1722 people who were awarded an MD degree by a Canadian university in 1989. This paper reports on migration, specialty choices and patterns of post-MD training in order to assess the contribution of the graduating cohort to the physician workforce of Canada. METHODS: A longitudinal study was conducted over 7 years after graduation to trace the current location, the post-MD training history and the professional activity of the graduating cohort. Several medical professional and educational associations in Canada and the United States provided year-by-year information on field and location of post-MD training, certification achieved, whether in practice and location of practice through to spring 1996. Information from all sources was linked to a list of 1989 medical school graduates. RESULTS: From entry to medical school through to 7 years after graduation the cohort was diminished by about 16%. The main reason for loss was migration to other countries: 193 graduates (11.2%) were outside Canada in 1995-96. Internal migration was extensive also; for example, by 1995-96 relatively few of the graduates were located in Newfoundland or Saskatchewan. Of the 1516 graduates active in Canada in 1995-96, 878 (57.9%) were in general practice/family medicine, and only 638 (42.1%) were practising or training in a specialty. INTERPRETATION: The "yield" of the Class of 1989 for Canada''s physician workforce is insufficient to meet annual physician inflows from Canadian sources to serve population growth and to replace retiring or emigrating physicians. As output from Canada''s medical schools drops even further, the gap between requirements and supply will grow even wider.     

神经内科硕士研究生临床和科研能力的培养

临床医学硕士研究生阶段是培养临床和科研思维能力的重要阶段,从某种意义上说是人生和医疗生涯的关键时期。神经内科硕士研究生不仅应该具有一定的临床工作能力,还应具有一定的科研能力。临床工作能力培养包括临床基本功的培训,基本理论的加强和基本技能的培养,临床思维能力的培养及医患沟通能力的培养等多个方面。科研能力包括文献阅读能力、科研思维能力和论文写作能力等。这样,硕士研究生毕业后不仅能够诊治神经内科常见病和多发病,会思考临床工作中的问题,更重要的是能想办法探索和解决这些问题。这也是硕士研究生和本科生的本质区别。因此,研究生阶段是医学生涯一个重要的里程碑,临床和科研能力的培养对个人未来的发展具有十分重要的意义。