基层医疗机构人才队伍建设的探讨

??????? 在医改中硬件是基础,软件是根本,基层医疗机构人才队伍建设问题至关重要,本文就如何吸引毕业生下沉到基层、如何提升基层现存医疗队伍的技术水平提出建议,并为如何实现2020年培养30万名全科医生的总体目标,提出利用社会融资方法培养农村全科医生的构想。     

新农科背景下农业类研究生专业实践基地多元共治治理体系探索

新农科建设提出培养具有创新实践能力的现代农业复合型人才,而专业实践基地是农业类研究生创新实践能力培养的重要载体,构建专业实践基地治理体系对提高农业类研究生培养质量意义重大。针对农业类研究生专业实践基地治理的现实困境,结合三螺旋理论构建了政府参与的多元共治新型基地治理体系,并比较分析了科技小院和广东开放基地两种多元共治基地治理体系,提出政府参与农业类研究生专业实践基地治理的必要性以及多元共治基地治理体系完善与发展的建议。     

丘北县核桃产业发展现状及对策研究

核桃木本油料林是我国粮油安全战略的特色经济林,国家积极鼓励、扶持发展核桃木本油料基地建设,本文分析了丘北县核桃产业发展的现状和优势,并提出了加快丘北县核桃产业发展的对策和建议。     

高职生物制药生产性实训基地建设模式探索与实践

针对高职生物制药技术校内生产性实训基地的建设具有制药行业的特殊性及其法律法规的特殊限制,探讨了高职生物制药生产性实训基地建设的工学结合的人才培养模式和教学改革。提出了高职生物制药技术校内生产性实训基地的建设理念、思路及相应的举措。实践证明,建设以学校主导模式的基地建设和运行模式,有利于培养学生的动手能力和实践创新能力,有利于落实工学结合、以职业能力培养为主线的技能型人才培养。     

中国科学院生命科学与生物技术创新三期规划

中国科学院党组在创新工程三期中,根据我国经济社会发展的需求,提出了科技发展的“1＋10”基地建设的战略布局。中国科学院生命科学与生物技术局负责“人口健康与医药创新基地”、“先进工业生物技术创新基地”、“现代农业科技创新基地”的建设。通过基地的建设和实施,将有助于组织争取国家各项科技任务,大力推进重大技术平台的建设,进一步提高中科院在生命科学与生物技术领域的科技创新能力。     

生物学实验教学示范中心创新建设与实践

对传统生物学实验教学体制进行了改革,建立了校级生物学实验教学示范中心。提出以增加设计性和创新性实验的比例,强化开放实验室和实习实践基地的建设,着力构建三层次、四模块、开放式的创新型实践教学体系,有效地提高实践教学水平,促进了学生实践能力和创新能力的培养。     

以基地平台为抓手,促进生物技术创新与转化

生物技术领域技术创新与成果转化类基地平台是开展生物技术关键技术研究,推动应用示范、成果转化及产业化的重要载体。通过对近年来我国生物技术领域技术创新与成果转化类基地平台发展现状进行梳理分析,探讨基地平台在促进生物技术创新与转化中的作用,总结优势和不足,为其今后的发展建设提供参考和借鉴。     

研发动态

中国科学院生命科学与生物技术创新三期规划中国科学院党组在创新工程三期中,根据我国经济社会发展的需求,提出了科技发展的“1+10”基地建设的战略布局。中国科学院生命科学与生物技术局负责“人口健康与医药创新基地”、“先进工业生物技术创新基地”、“现代农业科技创新基地”的建设。通过基地的建设和实施,将有助于组织争取国家各项科技任务,大力推进重大技术平台的建设,进一步提高中科院在生命科学与生物技术领域的科技创新能力。人口健康与医药科技创新基地瞄准重大疾病、人口控制、营养健康和脑与认知科学领域的国家重大需求,注重原…     

提高《生物工程设备》课程教学质量的探索与实践

《生物工程设备》是生物工程专业本科生的学科专业课程。针对《生物工程设备》课程的教学现状,本着调整课程教学体系、优化教学内容、革新教学方法和手段、重视实践教学基地建设和师资队伍建设、注重培养学生创新能力等形式和原则, 对课程进行了教学改革和实践。     

提高《生物工程设备》课程教学质量的探索与实践

《生物工程设备》是生物工程专业本科生的学科专业课程。针对《生物工程设备》课程的教学现状,本着调整课程教学体系、优化教学内容、革新教学方法和手段、重视实践教学基地建设和师资队伍建设、注重培养学生创新能力等形式和原则,对课程进行了教学改革和实践。     

Research in general practice. Sources of advice.

Regional advisers, faculty secretaries of the Royal College of General Practitioners, heads of academic departments of general practice and primary care, and heads of RCGP research units were invited to complete a semistructured questionnaire to determine the nature and availability of current sources of advice for general practitioners participating in research activities and the demands placed on the available sources in the United Kingdom. The principal source for research advice was university departments of general practice, yet these have insufficient resources to cope with requests and few have spare capacity to stimulate research. Regional advisers and faculty secretaries do not seem to be kindling a spirit of inquiry and they seem somewhat complacent about both the lack of requests for research advice from general practitioners and the difficulties of academic departments. Proper development of research capability in general practice and primary care is unlikely to occur without more resources to create training posts in academic departments and a greater spirit of inquiry in vocational training programmes, which should lead to both review (audit) and research.     

Roles,risks, and responsibilities in maternity care: trainees' beliefs and the effects of practice obstetric training.

OBJECTIVES--To document the content of practice obstetric vocational training, the beliefs of general practitioner trainees about the roles of midwives and general practitioners in maternity care, and the risks of providing such care; and to ascertain if undergoing such training affects their beliefs. DESIGN--Confidential postal questionnaire survey. SUBJECTS--Random one in four sample of all general practitioner trainees in the United Kingdom on vocational training schemes or in training practices in autumn 1990. MAIN OUTCOME MEASURES--Beliefs scored on seven point Likert scales and characteristics of trainer and training practice. RESULTS--Of 1019 trainees sent questionnaires, 765 (75.1% response rate) replied; 638 (83.3%) had done some part of their practice year. Of their trainers, 224 (35.1%) provided full obstetric care. 749 (99%) and 364 (48%) trainees believed that midwives and general practitioners respectively have an important role in normal labour; 681 (91.7%) trainees believed that general practice intrapartum care is a high risk "specialty." Those trainees whose trainers provide full obstetric care were significantly more likely to believe that both midwives and general practitioners have an important role in abnormal labour and to see the provision of intrapartum care as an incentive to join a practice. CONCLUSION--In this series most general practitioner trainees believed that both midwives and general practitioners have important roles in maternity care. Exposure of trainees to the provision of full obstetric care while in their training practice resulted in a more positive attitude towards the provision of such care by general practitioners.     

Approval of trainers and training practices in the Oxford region: assessment.

This is the second paper of three on criteria for approval of trainers of general practitioners drawn up for the Oxford region. This paper describes assessment of trainers and training practices by a team of general practitioners who visit for one day.     

全科医师急救技能调查分析

目的:了解全科医师对急救技能掌握情况和对培训的态度。方法:对在我院参加培训28名社区全科医师急救技能进行调查,对心肺复苏中的胸外心脏按压频率、电除颤功率等问题进行理论和技能考核,并对4项技术(止血、包扎、固定和转运)进行技能考核。根据职称分为初级和中级2组,比较2组成绩差异;发放调查问卷,了解对急救技能培训的需求情况。结果:社区全科医师急救技能掌握普遍较差,心肺复苏技能平均合格率为14.2%,4项技术合格率为17.8%;初级与中级职称组成绩无差别(P>0.05);89.2%的社区全科医师认为急救技能非常重要,92.8%希望定期得到急救技能培训。结论:社区全科医师急救技能普遍掌握较差,应定期进行对他们急救技能培训。     

OSCE在全科医师转岗培训临床能力考核中的应用研究

通过客观结构化临床考试应用于全科医师转岗培训临床能力考核,体现出全科医师各站平均成绩跟总分有较大差距,且临床基本技能成绩相对较高,临床技术操作为最薄弱的环节。对全科医师关于客观结构化临床考试考核方案的问卷调查和现场调研表明,全科医师大多非常支持客观结构化临床考试考核方法,但是感觉考核的内容多时间长,身心压力大。通过以上结果,进一步改进应用于全科医师的客观结构化临床考试考核方案,并针对培养过程中的不足之处,进一步改进全科医师培训临床实践教学。     

Study of diagnostic accord between general practitioners and an ophthalmologist.

OBJECTIVES--To identify diagnostic accord and disagreement between general practitioners and an ophthalmologist and thereby determine how undergraduate and non-specialist postgraduate ophthalmic training could be improved. DESIGN--Comparison of diagnosis of presenting conditions by general practitioners and one ophthalmologist in patients consulting general practitioners for ophthalmic problems during March 1989 to February 1990. SETTING--12 general practices in west Nottingham. PATIENTS--1474 patients presenting to the study general practitioners with new ophthalmic conditions or new episodes of recurrent conditions. MAIN OUTCOME MEASURES--Diagnoses of general practitioners and ophthalmologist. RESULTS--1121 (76%) of patients with eye problems agreed to see the ophthalmologist and most were seen within three days. Sufficient data for comparison were available on 1103 patients. Diagnostic agreement was found in 638 cases (58%), but potentially serious misdiagnosis was found in only 15 cases; management in three of these cases would have ensured later identification. Most commonly confused conditions were infective and allergic conjunctivitis, blepharitis, and dry eyes. General practitioners assessed visual acuity in only 114 cases yet eight of the 15 patients seriously misdiagnosed had reduced acuity, an important diagnostic sign. CONCLUSIONS--Most ophthalmic disease seen in general practice does not require specialised equipment for diagnosis. Most cases of misdiagnosis have no serious consequences for the patient. Undergraduate and postgraduate training in ophthalmology should ensure that common conditions can be easily differentiated and more serious conditions identified and referred.     

Why are clinical problems difficult? General practitioners' opinions concerning 24 clinical problems.

This study was conducted to describe the difficulties perceived by general practitioners concerning 24 common clinical problems and to compare their perceptions with those of faculty members in family medicine. A random sample of 467 general practitioners and all 182 faculty members in family medicine in Quebec were sent one of four open-ended questionnaires, each of which dealt with six clinical problems; 214 general practitioners and 114 faculty members participated. A total of 5111 difficulties were reported; the number reported by each subject varied from 0 to 13 (mean 2.6 [standard deviation 2.09]) per problem. The problems that generated the most difficulties were depression, confusion in the elderly, chronic back pain, loss of autonomy in the elderly and sexually transmitted disease. The most frequent difficulties were with the patient''s noncompliance with treatment, clinical diagnosis, failure of a specific treatment, inadequate health care resources and the physician''s own emotional reactions. The difficulties for each problem were the same in the two groups 70% of the time. Physician''s perceptions of their difficulties can be useful in the planning of initial training and continuing medical education.     

What will a primary care led NHS mean for GP workload? The problem of the lack of an evidence base.

Ongoing negotiations on the general practitioner contract raise the question of remunerating general practitioners for increased workload resulting from the shift from secondary to primary care. A review of the literature shows that there is little evidence on whether a shift of services from secondary to primary care is responsible for general practitioners'' increased workload, and scope for making generalisations is limited. The implication is that general practitioners have little more than anecdotal evidence to support their claims of greatly increased workloads, and there is insufficient evidence to make informed decisions about remunerating general practitioners for the extra work resulting from the changes. Lack of evidence does not, however, mean that there is no problem with workload. It will be increasingly important to identify mechanisms for ensuring that resources follow workload.