我院医学影像科（放射科）住院医师规范化培训模式的构建及经验初探

住院医师培训是国、内外公认的医师成长必由之路。2010年上海市实施新形势下的住院医师规范化培训,医学影像科作为独立的学科进行住院医师规范化培训,如何在新的体制下构建医学影像科住院医师规范化培训模式面临新的挑战。本文针对医学影像科的特点,从我院医学影像科住院基地的概况、生源构成及培训的初步经验进行了探讨。     

规范医学影像诊断报告书写,提高医学生及住院医师临床技能

医学影像诊断报告是正确行使医疗行为和保证医疗质量的依据,书写高质量的医学影像学诊断报告是医学生及住院医师必须掌握的一项基本功和基本技能。本文将结合我院长期的医学生及住院医师临床教学经验和实际,以神经系统影像报告为例,从医学影像诊断报告的重要性、医学生及住院医师医学影像诊断报告技能教学的现状、规范化医学影像报告书写技能的培养、评估、反馈和评价进行探讨,以期在医学生和住院医师的培养中提高其临床技能,供广大同道在医学教育与实践中借鉴和改进。     

Mini—CEX在住院医师培养中的应用现状

住院医师培养制度现已逐步在中国各城市开始实施,住院医师培养最主要的目标是培养临床能力合格的医师。对住院医师临床能力的评估,最好的方式应该是在临床的实践工作中的给予评估。Mini—CEX（Mini-Clinical Evaluation Exercise）是在传统的CEX基础上,发展出的一套用来评估住院医师临床技能并具有教学功能的测评工具,包括观察和评价住院医师的知识、技能、态度和主治医师的适时反馈。Mini-CEX为一种迷你型的多次重点式评估,在门诊、急诊或住院等临床例行工作中均可以开展,具备相当可靠的信效度和极好的便利性。Mini—CEX具有一个参与双方的信息及时反馈。应用Mini．CEX能增强评估的科学性,并能促进学习和培训。Mini-CEX作为目前医学教育体系中应用最广泛的一种评估手段之一,受到了国内外医学教育工作者的关注,并开始逐渐引入我国。Mini-CEX将在中国住院医师培养制度中发挥非常重要的作用。     

Mini-CEX 在住院医师培养中的应用现状

住院医师培养制度现已逐步在中国各城市开始实施,住院医师培养最主要的目标是培养临床能力合格的医师。对住院医师临床能力的评估,最好的方式应该是在临床的实践工作中的给予评估。Mini-CEX(Mini-Clinical Evaluation Exercise)是在传统的CEX基础上,发展出的一套用来评估住院医师临床技能并具有教学功能的测评工具,包括观察和评价住院医师的知识、技能、态度和主治医师的适时反馈。Mini-CEX为一种迷你型的多次重点式评估,在门诊、急诊或住院等临床例行工作中均可以开展,具备相当可靠的信效度和极好的便利性。Mini-CEX具有一个参与双方的信息及时反馈。应用Mini-CEX能增强评估的科学性,并能促进学习和培训。Mini-CEX作为目前医学教育体系中应用最广泛的一种评估手段之一,受到了国内外医学教育工作者的关注,并开始逐渐引入我国。Mini-CEX将在中国住院医师培养制度中发挥非常重要的作用。     

大学生科研训练计划存在的问题及对策建议

大学生科研训练计划(SRTP)是针对在校本科生开展的科学研究训练项目,是在本科教育阶段实施实践教学改革的一项措施.在国外,美国的麻省理工学院鼓励和支持达到一定条件的本科生,参与教师的科学研究项目并且实施运行,这种将科研与教学相结合的培养过程,为学生的创新和开拓能力的施展提供了广阔的舞台.在国内,众多大学借鉴麻省理工学院,从1996年开始创建并实施SRTP.但是,目前,许多高校开展大学生科研训练计划的过程中存在较多问题,本文在计划开展大学生科研训练计划的实践中总结了学生对科研的认识、教师的指导及管理制度等存在的问题,提出了改革人才培养模式、提升教师人才培养能力等对策建议.     

上海放射学住院医师规范化培训考核效果回顾性分析

目的 回顾性分析上海市放射学住院医师规范化培训技能考核的形式和内容,探讨影响规范化培训技能考核成绩的相关因素。方法 对2001—2009年,共计260名医学影像学住院医师参加规范化培训技能考核的理论题成绩以及技术操作成绩,运用描述性分析、秩和检验等方法对数据进行研究。结果 （1）放射学住院医师规范化培训CT基础理论题考核成绩的影响因素包括年龄（P=0.000）和毕业专业（P=0.012）;（2）MRI理论题考核成绩的影响因素为毕业院校类别（P=0.001）;（3）介入放射学理论题考核成绩的影响因素为服务医疗机构（P=0.042）;（4）CT操作技术考核成绩的影响因素为毕业院校类别（P=0.014）和服务医疗机构（P=0.015）,差异具有统计学意义。结论 住院医师规范化培训是医师成长的重要阶段。住院医师的学习经历和其所在医院工作情况直接影响其临床技能培训与考核的效果。     

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。     

Establishment of a General Medicine Residency Training Program in Rural West Africa

Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana’s rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the “brain drain” of young physicians out of West Africa.     

Program review. Challenges and opportunities for training the next generation of biophysicists: perspectives of the directors of the Molecular Biophysics Training Program at Northwestern University

Molecular biophysics is a broad, diverse, and dynamic field that has presented a variety of unique challenges and opportunities for training future generations of investigators. Having been or currently being intimately associated with the Molecular Biophysics Training Program at Northwestern, we present our perspectives on various issues that we have encountered over the years. We propose no cookie-cutter solutions, as there is no consensus on what constitutes the "ideal" program. However, there is uniformity in opinion on some key issues that might be useful to those interested in establishing a biophysics training program.     

Diploma Training for Technologists in Tissue Banking

There is a great demand for a formal training programme for tissue bank technologists not only for the Asia Pacific Region but also for technologists in other regions including Latin America and Africa. To meet this need, National University Hospital (NUH) Tissue Bank was established as the International Atomic Energy Agency (IAEA)/National University of Singapore (NUS) Regional Training Centre for training tissue bank operators in the Asia Pacific Region (Regional co-operative Agreement, RCA) in November 1997. The training centre conducts a one-year distance learning Diploma in Tissue Banking offered by the NUS. The syllabus for the Diploma Course included the multi-media IAEA curriculum on tissue banking. The first Diploma Course has been successfully completed in October 1998. Twelve students convocated, 4 with Distinction, 5 with Credit and 3 with Pass. Sixteen candidates from the Asia Pacific Region registered for the Second Diploma Course in April 1999. This second batch will be due to sit for their Diploma Examination in April 2000. With the increasing popularity of this Diploma Course, the third batch of students which will be registered in April 2000, will include technologists not only from Asia Pacific Region but also from other regions including Africa.     

医院多学科专业技术人员订单培养模式的构建

2006年,教育部《关于全面提高高等职业教育教学质量的若干意见》（教高［2006］16 号文）明确提出要“改革人才培养模式,积极推行订单培养”。这份纲领性文件出台后,全国各级各类职业院校都在用不同的形式对这种教学模式进行探索。总结了北京大学人民医院在教育部高教司的支持下,探索医院多学科卫生专业技术人员订单培养模式的经验与存在的问题,为医院卫生专业技术人才培养提供了新思路。