医学基础课程教学改革的实践与探讨

本文以潍坊医学院为例,探讨了在医学基础课程中开展三明治法教学改革的实践活动,从三明治教学的实施方案、内容选择、实施策略、考核评价及总结等方面展开了讨论。实践表明,三明治教学法在培养学生的自主学习能力,锻炼学生发现、解决问题的能力、表达能力、交际能力等方面有其独特的优势。三明治教学法有利于提高医学院校医学基础课程的教学质量,有利于医学生综合素质的全面提高。     

整合-混合式临床应用型解剖学教学模式的探索与展望

人体解剖学作为一门医学生的专业基础课,课程设置和教学方法在不断改进。本文总结了国外医学院校人体解剖学最前沿的教学模式,结合我校解剖学教学改革现状,提出整合-混合式临床应用型解剖学教学模式,旨在简化学习难度,提高教学效果,努力培养应用型和创新型医学人才。     

高等医学院校生物学科主干课程整合与教学体系重构初探

课程整合及相应的教学体系重构是当前高等医学教育改革的核心与热点。医学教育中,生物学学科主干课程的整合很有必要,但目前尚无成熟的模式。作者尝试将《生物化学》、《分子生物学》、《细胞生物学》和《医学遗传学》四门生物学主干课程进行整合,对原有教学内容进行优化、精简和融合,形成了一门新的整合课程。在课程教学中,"以学生为中心",采用基于案例和问题的小组讨论式教学;采取形成性评价与总结性评价相结合的方法进行课程考核和成绩评定;跨科室组建教学团队,实行多学科联组教学。这些尝试为高等医学院校生物学相关课程的整合提供了有益的借鉴和经验。     

荧光显微成像在医学细胞生物学实验教学中的应用探索

医学细胞生物学是医学院校本科生的重要基础学科之一,其实验课程教学工作的改革与创新具有重要意义。本文深入分析了医学细胞生物学实验课程现状,认为课程普遍存在目的不明确、内容不新颖、缺乏整体性、临床联系少等问题。荧光显微成像技术是细胞生物学研究中的关键技术,利用这一技术设计具有整体性的科研实验对于培养医学生操作能力和科研素养具有重要意义。顺铂(cisplatin)为当前肿瘤联合化疗中最常用的药物之一,由于其抗癌机制涉及细胞增殖、细胞凋亡、细胞骨架等一系列细胞生物学知识,且与临床联系紧密,非常适合用于综合性实验设计。实验方案拟使用BrdU染色、Hoechst33258染色及鬼笔环肽染色法,分别检测人肺癌细胞系A549顺铂处理后细胞增殖、细胞凋亡及细胞骨架重排情况。实验完成后,鼓励学生通过查阅文献得出综合的实验结论。希望能够通过科研与教学相融合的方式,更好的激发医学生的学习热情,提高医学生的科研素质,培养全方位的医学人才。     

基础医学阶段“B＆C”模式人才培养体系的建立与实践

文章分析了目前基础医学教学存在的诸多问题,建立了一种医学院校基础医学阶段“B＆C”模式的创新型人才培养体系。以强化医学生医德素养和临床实践能力培养为核心任务,积极开展理论与实验教学改革,加强学生的临床技能训练,重组课程体系,革新教学方法,优化和丰富网络等基础医学教学资源,按照早临床、多临床、反复临床的教学设计目标要求,稳步推进医学基础课程的交叉整合及与临床实践的连接,培养人文道德素质过硬、医学知识整体优化、实践创新能力强、临床技能规范的创新型医学人才。     

实验教学中的创新能力培养

高等医学院校的医学生,是否应当接受科研训练,在我国医学教育界历来存在争论。不赞成的理由大致有二：一是认为医学生毕业后主要从事临床工作,实验研究工作并非必需,科研训练因此可以从简甚至从略;二是鉴于欧美许多医学院校近年来精简了大量基础医学实验课程,认为这是教育先进国家的经验,我们可以照搬。     

人文素质教育与医学免疫学专业教育的整合

当前,人们的健康观念和生活方式发生了改变,对医疗卫生服务的需要和期望也发生了变化。然而,医学教育长期以来过分注重医学生的专业知识教育而忽视了人文素质教育,这使得医学生缺乏爱伤观念,对待病人冷漠、和不负责任,功利心较重,缺少奉献精神,从而加剧了医患关系紧张。因此,把医学生人文教育渗透到医学生专业学习的各个过程,使人文素质教育与医学专业教育完美的整合,才能培养出同时具有精湛医术和人文智慧、德才兼备的医生。医学免疫学是生命科学的前沿学科,是联系基础医学和临床医学的桥梁学科之一,也是医学本科生的一门重要的主干课程,其理论和实验技术发展迅猛。本文从医学免疫学专业理论课、实验课、考核等不同环节探讨了人文素质教育和医学免疫学专业教育的整合,进一步地寻找医学免疫学教学中人文素质教育的有效途径,为医学生的人文素质的全面提高提供有益的支持。     

医学统计学PBL法对医学创新人才的培养

医学统计学是医学院校各专业、各层次学生的一门必修课程,它能培养医学生科研思维,揭示事物自然客观规律.通过结合医学临床与科研实际,从学生知识水平和教学内容实际出发,尝试采用PBL教学法,改革医学院校必修课程医学统计学的教学方式,提高医学统计学教学质量,探索医学创新人才培养的有效途径.     

高校附属医院医学生信息素质教育的探索与思考

信息素质已成为当代社会人们发展和生存的基本素质之一。对医学生这个特殊的群体来说,未来会面临极其严峻的挑战,是否具有良好的信息素质对医学生的发展至关重要。本文针对我国医学生信息意识薄弱,信息道德薄弱,信息能力差等信息素养不高的现状,详细阐述了信息素质教育的内涵,深入细致地分析了医学生的信息素质教育现状,总结出目前在医学生信息素质教育中的一些问题,并且提出了培养医学生信息素质教育的策略与途径。通过合理运用计算机和网络、充分发挥医学院校图书馆的作用,推动高校医学生信息素质教育的广泛深入开展,从而全面提升医学生的信息素质。医学生通过不断地适应当今信息化时代,提高了自身的职业素质和诊疗能力,保证了优质的医疗服务质量。     

定向免费医学生组织学与胚胎学教学改革初探

为了提高基层医疗水平,国家启动了免费医学生培养计划,组织学与胚胎学是免费医学生一门必修课程,本课程为后续相关医学课程的基础,此课程学习得好与坏直接影响相关医学课程的学习,甚至影响免费医学生的培养质量,因此加强免费医学生组织学与胚胎学教学改革十分必要。     

Evaluating Sex and Gender Competencies in the Medical Curriculum: A Case Study

BackgroundSex and gender differences exist in the manifestation and prevalence of many conditions and diseases. Yet many clinician training programs neglect to integrate this information across their curricula.ObjectiveThis study aimed to measure the sex and gender medical knowledge of medical students enrolled in a program without an explicit directive to integrate sex and gender differences across a block system of core subjects.MethodsA forced-choice instrument consisting of 35 multiple-choice and true or false questions was adapted from an evaluation tool used in the European Curriculum in Gender Medicine held at Charité Hospital, Berlin, in September 2010.ResultsFourth-year (response rate 93%) and second-year (response rate 70%) students enrolled in Mayo Medical School completed the instrument. More than 50% of students in both classes indicated that topics related to sex and gender were covered in gynecology, cardiology, and pediatrics, and <20% of students indicated inclusion of such topics in nephrology, neurology, and orthopedics. More than twice as many second-year students indicated that topics dealing with sex and gender were included in immunology course material compared with fourth-year students. A consensus of written comments indicated that concepts of sex and gender-based medicine need to be embedded into existing curriculum, with an emphasis on clinically relevant information.ConclusionsAlthough this study represents only one medical school in the United States, information regarding sex and gender aspects of medicine is not consistently included in this curriculum without an explicit directive. These results can provide guidance for curriculum improvement to train future physicians.     

以执业医师考试为导向的基础医学教学模式探索与实践

以社会需求为导向,加强基础医学课程教学模式探索,不断深化医学人才培养改革,已成为基础医学教育创新改革的目标需求。本文就近年来以执业医师考试为导向的基础医学课程教学模式探索与改革实践进行了分析和总结,着重从优化整合医学课程体系,实施基于病例和问题的PBL教学方法改革,加强辅导答疑重点培养学员综合素质与能力,加强师资队伍建设,加强针对性练习强度及合理设置考试方式,加强信息化教学手段等方面进行了讨论,以期为进一步深化基础医学教育改革和不断提高基础医学教学质量提供思路。     

Medical Students’ Attitudes toward Abortion Education: Malaysian Perspective

Background

Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools.

Methods and Results

A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity.

Conclusions

Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights.     

Linking cardiovascular theory to practice in an undergraduate medical curriculum

Case-based teaching (CBT) tutorials were introduced by the Physiology Department at Adelaide University to bridge the gap between theory and practice in the early years of undergraduate medical education. With the use of a clinical case-based environment, CBT aimed to achieve integration of structure-function relationships and an increase in students' capacity to apply a physiological understanding to clinical observations/symptoms and data. With peer-peer interactions in small groups, students could trial history taking and examination skills, interpret common investigations, and relate their findings to an understanding of structure and function. Here, the cardiovascular tutorials highlight the centrality of an understanding of structure and function in the evaluation of a case of syncope. An independent evaluation of the students' learning experience demonstrated that CBT tutorials were successful in their aims. The "hands-on" experience was highly rated, with students reporting that the CBT approach gave relevance to structure and function. Whatever the curriculum learning style, underpinning practice with an understanding of theory remains a desirable feature of medical education.     

临床医学专业五年制含影像模块的循环系统整合模式课程教学初步设想

循环系统疾病为常见病及多发病,是临床医学专业医学生必须掌握的主要内容,其涉及的内容多、重点及难点集中,特别是循环系统影像学更是传统的教学中学生一直反映的教学难点。随着医学整合模式教学的推广及普及,对新形势下临床医学专业五年制医学生循环系统内容进行课程探索具有必要性及可行性。本文初步探讨临床医学专业五年制含影像模块的循环系统整合模式课程教学设想,试图为临床医学教学探索提供新的视角。     

Towards an updated ESTRO-EFOMP core curriculum for education and training of medical physics experts in radiotherapy – A survey of current education and training practice in Europe

PurposeESTRO-EFOMP intend to update the core curriculum (CC) for education and training of medical physicists in radiotherapy in line with the European Commission (EC) guidelines on Medical Physics Experts (MPE), the CanMEDS methodology and recent developments in radiotherapy. As input, a survey of the current structure of radiotherapy MPE national training schemes (NTS) in Europe was carried out.MethodsA 35-question survey was sent to all European medical physics national societies (NS) with a focus on existence of an NTS, its format and duration, required entry-level education, and financial support for trainees.ResultsTwenty-six of 36 NS responded. Twenty had an NTS. Minimum required pre-training education varied from BSc in physics or related sciences (5/2) to MSc in medical physics, physics or related sciences (6/5/2) with 50–210 ECTS in fundamental physics and mathematics. The training period varied from 1 to 5 years (median 3 years with 50% dedicated to radiotherapy). The ratio of time spent on university lectures versus hospital training was most commonly 25%/75%. In 14 of 20 countries with an NTS, a research project was mandatory. Residents were paid in 17 of 20 countries. The recognition was mostly obtained by examination. Medical physics is recognised as a healthcare profession in 19 of 26 countries.ConclusionsThe NTS entrance level, duration and curriculum showed significant variations. This survey serves to inform the design of the updated CC to define a realistic minimum training level for safe and effective practice aiming at further harmonization in line with EC guidelines.     

《生命科学前沿》课程思政的教学改革与实践

“课程思政”融入研究生课程体系具有重要意义, “大思政”格局下的课程改革不断推进。《生命科学前沿》是湖南师范大学生物学科的研究生必修课程,致力于普及学科发展前沿。其思政元素较为丰富,是开展课程思政的优秀载体。在分析了目前课程思政教学现状和存在问题的基础上,通过树立思政理念,提升教师开展课程思政的能动性;开展课程思政教学设计,注重课程前沿性和思政元素的有机融合。采用嵌入式课程思政的教学路径,提高课程思政教学效果等具体举措进行改革实践,实现学科前沿知识普及和价值引领相结合。实践证明,将思政内容引入专业课,可以提高学生学习主动性,引导学生树立正确的价值观,实现专业课协同育人的效果。课程思政重在建设,课程内容设计是先决条件,教师是关键,课程管理是基本保障,对课程思政教学改革实践进行反思,以期为相关生物学专业课程思政教学提供参考。     

Spinal and sacroiliac assessment and treatment techniques used by osteopathic physicians in the United States

Background

Without systematic exposure to biomedical research concepts or applications, osteopathic medical students may be generally under-prepared to efficiently consume and effectively apply research and evidence-based medicine information in patient care. The academic literature suggests that although medical residents are increasingly expected to conduct research in their post graduate training specialties, they generally have limited understanding of research concepts. With grant support from the National Center for Complementary and Alternative Medicine, and a grant from the Osteopathic Heritage Foundation, the University of North Texas Health Science Center (UNTHSC) is incorporating research education in the osteopathic medical school curriculum. The first phase of this research education project involved a baseline assessment of students' understanding of targeted research concepts. This paper reports the results of that assessment and discusses implications for research education during medical school.

Methods

Using a novel set of research competencies supported by the literature as needed for understanding research information, we created a questionnaire to measure students' confidence and understanding of selected research concepts. Three matriculating medical school classes completed the on-line questionnaire. Data were analyzed for differences between groups using analysis of variance and t-tests. Correlation coefficients were computed for the confidence and applied understanding measures. We performed a principle component factor analysis of the confidence items, and used multiple regression analyses to explore how confidence might be related to the applied understanding.

Results

Of 496 total incoming, first, and second year medical students, 354 (71.4%) completed the questionnaire. Incoming students expressed significantly more confidence than first or second year students (F = 7.198, df = 2, 351, P = 0.001) in their ability to understand the research concepts. Factor analyses of the confidence items yielded conceptually coherent groupings. Regression analysis confirmed a relationship between confidence and applied understanding referred to as knowledge. Confidence scores were important in explaining variability in knowledge scores of the respondents.

Conclusion

Medical students with limited understanding of research concepts may struggle to understand the medical literature. Assessing medical students' confidence to understand and objectively measured ability to interpret basic research concepts can be used to incorporate competency based research material into the existing curriculum.     

A Simple Curriculum Content Change Increased Medical Student Comfort with Transgender Medicine

ObjectiveA barrier to safe therapy for transgender patients is lack of access to care. Because transgender medicine is rarely taught in medical curricula, few physicians are comfortable with the treatment of transgender conditions. Our objective was to demonstrate that a simple content change in a medical school curriculum would increase students' willingness to care for transgender patients.MethodsCurriculum content was added to the endocrinology unit of the Boston University second-year pathophysiology course regarding rigidity of gender identity, treatment regimens, and monitoring requirements. All medical students received an online, anonymous questionnaire 1 month prior to and 1 month after receiving the transgender teaching. The questionnaire asked about predicted comfort using hormones to treat transgender individuals. Shifts in the views of the second-year students were compared with views of students not exposed to the curriculum change.ResultsPrior to the unit, 38% of students self-reported anticipated discomfort with caring for transgender patients. In addition, 5% of students reported that the treatment was not a part of conventional medicine. Students in the second-year class were no different than other students. Subsequent to the teaching unit, the second-year students reported a 67% drop in discomfort with providing transgender care (P<.001), and no second-year students reported the opinion that treatment was not a part of conventional medicine.ConclusionA simple change in the content of the second-year medical school curriculum significantly increased students' self-reported willingness to care for transgender patients.(Endocr Pract. 2013;19:633-637)     

全球化背景下医学伦理学教学改革的探索

医学伦理学理论和实践根植于一定时期的社会经济、文化和教育,并随之发生改变和发展。随着全球经济一体化的进展完善,不同国家的文化和教育已在全球范围内互联互通并进而影响异乡本土医学文化。从目前我国医学伦理学教育和实践看,医学伦理学教学及评价体系已不能满足日新月异的全球化医学发展进程。本文从传统医学文化和医学伦理学的理论渊源入手,针对我国医学伦理学教学实践中存在的德性培育重视不足、临床决策能力培养缺失、标准化评价体系缺失等主要问题,探析教学改革的路径,以促进医学伦理学教学理论和实践的发展。