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1.
Floyd C. Pennington 《The Western journal of medicine》1978,128(6):558-562
A review of program development literature in adult education and continuing medical education (CME) indicates the pervasive influence of a single approach to designing instructional activities. An examination of the assumptions of this model indicates several weaknesses. An alternative model is proposed that recognizes the importance and impact of the planners'' interaction with representatives of the learner group, institutional colleagues and persons in outside agencies. Results of previous research, experience in planning, observations of the planning processes of others and discussions with expert continuing medical educators show that planning is a dynamic process of suggesting and selecting from many alternatives those instructional activities with the greatest potential for effecting the desired changes in learners. Through a series of deliberations, needs are specified, instructional activities are designed, goals and objectives are stated, and evaluation techniques are selected. CME planners direct the process and constantly focus on the immediate impact on the learners and ultimately on the learners'' practice behavior. 相似文献
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《The Western journal of medicine》1967,107(2):201-206
Following are the recommendations drawn up by workshops held as a part of the Planning and Goals Conference in Continuing Medical Education, sponsored by the California Medical Association and directed by its Committee on Continuing Medical Education, San Diego, March 11-12, 1967. The conference was supported in part by Contract No. PH 108-67-158, Bureau of Health Manpower, Public Health Service, Department of Health, Education and Welfare.The general subject was divided among four workshops and the reports of two of them—No. 1, (a) and (b) and No. 2—are printed in this issue. The reports of the other two workshops will be published in succeeding issues. 相似文献
4.
Paul J. Sanazaro 《The Western journal of medicine》1976,125(3):241-252
Medical audit and continuing medical education (CME) are now the mainstays of quality assurance in hospitals. Audits should address problems that have serious consequences for patients if proper treatment is not given. The single most important step is the selection of essential or scientific criteria that relate process to outcomes. CME does less than commonly believed to improve care. Today, quality assurance increasingly means a near-guarantee to every patient of appropriate treatment and fewest possible complications. Maintenance of the public trust rests on a firm commitment of the medical staff and board to this principle, implemented through an organized program of quality assurance. Under these conditions, medical audit and CME can effectively improve care by improving physician performance. 相似文献
5.
Smith RG 《The Western journal of medicine》1974,120(3):249-253
Confronted with the inability to offer access to trained mental health personnel to their remote rural community, a private medical group practice in California recruited and integrated psychiatric social workers in their clinic. The rapid acceptance of these newer mental health professionals by community members of all economic levels and by group physicians confirms the success of this program, now in its fourth year, and rising community interest in mental health services.The group practice prototype affords a unique opportunity for innovation in community health care delivery in outlying areas with their traditional difficulties in attracting health care professionals. 相似文献
6.
Lea C. Steeves 《CMAJ》1963,88(14):732-735
The experience of one Faculty of Medicine in developing programs of continuing medical education in community hospitals is presented. After mention of the importance of regular reading of the medical literature, and the problems created by its growing volume, the necessity of supplementary programs in community hospitals is pointed out. The different patterns of community hospital meetings that evolved to meet various circumstances in the Atlantic Provinces are detailed. A “course” consisting of six weekly evening meetings, followed by morning case presentations and discussions, has proved the most successful form of continuing medical education in community hospitals. Better than half the doctors in the community attend, and active participation is the rule. The importance of advance planning, the techniques of advance planning, and the expense of operating the program are listed. A projection is made that 46 such courses would be required to cover the four Atlantic Provinces adequately, with a staff equivalent to eight full-time teachers and a budget in excess of $200,000. The fact that this is only 7.5% of Canada''s medical population indicates the magnitude of the unmet needs of continuing medical education in this country. 相似文献
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H.R. Michels 《Netherlands heart journal》2001,9(7):288-290,291
The European Board for Accreditation in Cardiology (EBAC) is a joint initiative of the European Society of Cardiology (ESC) and the Cardiology Section of the Union of European Medical Specialists or Union Européenne des Médecins Spécialistes (UEMS). EBAC operates independently from these parent organisations. The ESC is the highest cardiovascular scientific authority in Europe and the most important provider of Continuing Medical Education (CME) in cardiology. The UEMS officially represents the European medical specialists at the European Union (EU). The UEMS consists of different mono-specialist sections, among which the Cardiology Section. The recognition of the importance of CME and the need for quality standards and quality control led the UEMS to establish the European Accreditation Council for CME (EACCME) in January 2000. CME activities that seek European accreditation have to comply with the regulations of this council. As a consequence of the establishment of EACCME, the mono-specialist sections of the UEMS together with the different European scientific societies started to create accreditation boards with the aim to assess international CME activities in accordance with the regulations of UEMS and EACCME. EBAC was founded in 2000. EBAC accreditation is complimentary to national CME accreditation. The Netherlands Society of Cardiology (Nederlandse Vereniging voor Cardiologie, NVVC) and its Institute for CME, the Netherlands Institute for Continuing Cardiovascular Education (Cardio-Vasculair Onderwijs Instituut, CVOI) formally recognise EBAC accreditation and Attendance Certificates. 相似文献
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Phil R. Manning 《The Western journal of medicine》1978,128(3):260-265
Mandatory continuing education for physicians and other health professionals raises numerous problems. Issues that were considered academic when continuing education was voluntary now take on major practical and political significance. There is the risk that future legislation will mandate activities and methodologies which have not been proven. Research and development in continuing education must be accelerated so that decisions can be based on proper data. Centers of research and development should be established to encourage research and provide a sound foundation for the future of continuing education. 相似文献
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Peter M. Chapman 《人类与生态风险评估》2008,14(1):5-40
Ecological risk assessment (ERA) of metals, metalloids, and inorganic metal substances (collectively referred to as metals) no longer focuses solely on persistence and bioaccumulation, but rather on solubility, toxicity, natural occurrence (concentrations above/added to background), essentiality (deficiency as well as excess), speciation, and bioavailability. Tolerance (both acclimation and adaptation) and possible resultant energetic costs are being considered, and realism is being increased in laboratory toxicity tests by the use of organisms pre-acclimated to natural levels of metals. The present status of ERAs for inorganic metals is summarized in terms of four key questions: (1) Do metals accumulate in biota above background levels? (2) Are these metals metabolically active? (3) If so, are they likely to result in adverse effects to individuals either alone or in combination with other stressors? (4) If so, are they likely to result in adverse impacts to populations? The most pragmatically useful future research will be that focused on the interactive risks of both complex chemical mixtures (metals and non-metals) and non-chemical stressors (both biotic and abiotic). Ideally this should occur in the context of continued metal loadings to terrestrial and aquatic ecosystems assessed holistically, including trophic food web relationships, metal transfer, and genetic diversity. Relationships between environmental concentrations and internal, metabolically active doses are the key to understanding and predicting environmental risks without excessive reliance on safety factors. 相似文献
11.
Lawrence Juda 《Ocean Development & International Law》2013,44(1):34-54
The European Union has been engaged in an effort to develop a marine strategy to protect the marine environment and a more encompassing integrated maritime policy that would provide a comprehensive system for the management of the uses of the marine areas of Europe. An earlier article by the author described the beginnings of this policy development; this article examines the subsequent 2008 Directive of the European Parliament and the Council, which establishes a framework for community action in the field of marine environmental policy. The Marine Strategy Framework Directive provides a plan of action with designated responsibilities and obligations and a schedule that is to be adhered to by member states and the European Commission. It represents a significant step in the European endeavor to advance ocean use management and sets the stage for future development of European marine policy. 相似文献
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Lea C. Steeves 《CMAJ》1965,92(14):758-761
Continuing medical education is an essential feature of the practice of modern medicine since it furnishes the means to maintain the doctor''s ability to provide quality patient care.To ensure that continuing medical education is provided efficiently and in the best quality, and utilized fully, it is necessary that: (1) the medical faculty inculcate in the student the concept of lifelong learning; (2) the practitioner adopt less time-consuming patterns of practice, to free more of his time for learning; (3) community hospital-based clinical teaching be provided universally; and (4) research be conducted to determine the best of current teaching methods and develop better ones. Conflicting efforts to meet these needs by practitioners (whose primary responsibility it is) and by organized medicine, specialty societies, voluntary health agencies and others have led to inefficient use of medical faculty teachers. The key parties in continuing medical education—practitioner and teacher—can learn best in medical school-administered programs, which need be supported by all other interested organizations. 相似文献
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Donald H. Williams 《CMAJ》1967,96(14):1040-1044
Five basic forms of continuing educational endeavour by physicians are listed in rank order. These components constitute an indivisible unit bound together by self-learning. The scholarly habit of planned daily reading and study in a home library-sanctuary as an integral part of a physician''s workday heads the list. Day-to-day informal and formal colleague-association in patient care in the community and teaching hospital, in group practice and by consultation is the present major form of continuing educational endeavour. Emphasized is the sabbatical return every three to five years for three months at least to the teaching hospital to reinforce scholarly motivation and attitudes and to acquire new skills and knowledge. Attendance at scientific sessions of learned professional societies and short courses should be accompanied by presession and post-session guided reading to be undertaken in the physician''s home library-sanctuary. 相似文献
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Neil C. Andrews 《The Western journal of medicine》1980,132(4):368-378
A survey was carried out on the tuition charged for continuing medical education (CME) programs offered by a variety of providers. These included schools of medicine throughout the United States, national organizations and societies, state-wide organizations and societies located in California, and a small group of hospitals in or near Sacramento, California.The fees charged for continuing medical education (expressed in this article as the amount in dollars that a physician must pay for one hour of approved Category I credit) may vary from nothing to more than $20 an hour. The average charge per hour for CME courses sponsored by medical colleges in the United States ranged from none to $11.19 during 1976 and 1977. Recent data indicate that most schools have increased tuition for CME courses because of inflation. Many schools of medicine provide CME through grand rounds, conferences and special lectures at no cost to participants. Similarly, in a small sample of hospitals in California, CME was found to be available at a minimal charge to physicians.Some CME programs are more costly because fees may include the expenses of honored visiting faculty, and costs of food or social activities. There may be further expense if travel is required, although these additional costs may be offset by the benefits of study in a relaxed atmosphere away from practice and office pressures. 相似文献
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《Endocrine practice》2019,25(5):423-426
Objectives: To our knowledge, no prior research has explored the prevalence of wearing continuous glucose monitors (CGMs) and/or insulin pumps among in-training fellows and their perception of doing so as part of their education. Our objectives therefore were to estimate the frequency with which wearing a CGM and/or insulin pump is used as a learning opportunity and explore the main motivators and perception on its value.Methods: A multiple-choice survey that addressed each fellow's level of training, type of fellowship training program, and use of CGM and/or insulin pump was sent to all Accreditation Council for Graduate Medical Education endocrinology, diabetes, and metabolism program coordinators or program directors. We asked them to forward this survey to their graduating fellows. Their perception on the value of wearing these devices was addressed.Results: Fifty-one graduating fellows responded to the survey; 78.43% and 62.5% of them wore a CGM and insulin pump, respectively. A total of 89.48% and 90% of those who wore a CGM and insulin pump, respectively, thought it was above-average value for their education, and the most common reasons were to learn the technical aspects and understand what patients with diabetes go through.Conclusion: Wearing a CGM and/or insulin pump is perceived by endocrinology graduating fellows as valuable to their education, specifically, to learn the technical aspects, understand the patient's experience, and develop empathy.Abbreviations: ACGME = Accreditation Council for Graduate Medical Education; CGM = continuous glucose monitor 相似文献
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Thorvald Sætersdal Svein Ødegården Svein Rotevatn Hogne Engedal 《Cell and tissue research》1980,209(3):345-351
Summary The ultrastructure of atrial specific granules of the human auricle has been studied in myoblasts of 8–12 week embryos, in myoblasts cultured for 15 days, and in cells of the hypertrophied juvenile and adult atrium. The granules of young myoblasts and those of cultured cells are fairly evenly distributed throughout the sarcoplasm. Myocytes of the hypertrophied juvenile auricle show structural characteristics indicative of granule formation. Structural evidence of exocytosis has not been observed in either of the tissues studied. In the cultured and the hypertrophied tissue the granules are structurally well preserved even in areas with extensive intracellular lysis.This work was supported by grants from The Norwegian Council on Cardiovascular Disease and from The Norwegian Research Council for Science and the Humanities 相似文献
17.
Dodson GG 《Biochemical Society transactions》2011,39(5):1313-1322
Scientific contact lies at the heart of research and that between China and the U.K. is an important example of how it can come about. In 1911, when the Biochemical Society began, U.K. science was developing fast with profound discoveries in physics (the Rutherford atomic model) and biochemistry (the discovery of vitamins). In China, however, there was great social and political instability and a revolution. Since then, the turbulence of two world wars and a variety of deep global political tensions meant that the contacts between China and U.K. did not reflect the prodigious growth of biochemistry. There was, however, one particular and remarkable contact, that made by Joseph Needham, an outstanding biochemist. He visited China between 1943 and 1946, contacting many Chinese universities that were severely dislocated by war. Showing remarkable diplomatic abilities, Needham managed to arrange delivery of research and teaching equipment. His activities helped the universities to carry out their functions under near-impossible conditions and reminded them that they had friends abroad. Most remarkably, Joseph Needham developed an extraordinary grasp of Chinese culture, science and history and he opened the West to the extent and importance of Chinese science. Formal scientific and intellectual contacts between the scientific academic bodies in China and U.K., notably the Chinese Academy of Science and the Royal Society, resumed after British recognition of the Chinese Communist government in 1950. The delegations included outstanding scientists in biochemistry and related disciplines. Research activities, such as that concerning influenza, were soon established, whereas institutions, such as the Royal Society and the Wellcome Trust, acted a little later to support research. The outcomes have been long-term collaborations in such areas as insulin structure and function. There are now numerous joint activities in biochemistry and biomedicine supported by the MRC (Medical Research Council), BBSRC (Biotechnology and Biological Sciences Research Council), NERC (Natural Environment Research Council), EPSRC (Engineering and Physical Sciences Research Council) and UKRC (UK Research Councils). The present contacts and the associated research are very considerable and growing. It is clear that biochemistry in both countries has much to offer each other, and there is every reason to believe that these contacts will continue to expand in the future. 相似文献
18.
David R Bassett 《Journal of applied physiology》2002,93(5):1567-1582
Beginning in 1910, A. V. Hill performed careful experiments on the time course of heat production in isolated frog muscle. His research paralleled that of the German biochemist Otto Meyerhof, who measured the changes in muscle glycogen and lactate during contractions and recovery. For their work in discovering the distinction between aerobic and anaerobic metabolism, Hill and Meyerhof were jointly awarded the 1922 Nobel Prize for Physiology or Medicine. Because of Hill's interest in athletics, he sought to apply the concepts discovered in isolated frog muscle to the exercising human. Hill and his colleagues made measurements of O(2) consumption on themselves and other subjects running around an 85-m grass track. In the process of this work, they defined the terms "maximum O(2) intake," "O(2) requirement," and "steady state of exercise." Other contributions of Hill include his discoveries of heat production in nerve, the series elastic component, and the force-velocity equation in muscle. Around the time of World War II, Hill was a leading figure in the Academic Assistance Council, which helped Jewish scientists fleeing Nazi Germany to relocate in the West. He served as a member of the British Parliament from 1940 to 1945 and as a scientific advisor to India. Hill's vision and enthusiasm attracted many scientists to the field of exercise physiology, and he pointed the way toward many of the physiological adaptations that occur with physical training. 相似文献
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This article is a slightly revised version of the Presidential Address delivered at the annual business meeting of the Council on Anthropology and Education, Washington, D.C., December 1, 2007. ["little communities," ethnography as picaresque, parrhesia] 相似文献
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Dr. Frank R. Lillie, embryologist extraordinary, was uniquelyinvaluable in innumerable ways to zoologists, directly duringhis lifetime and indirectly thereafter. He excelled academicallyin teaching, research and administration at the University ofChicago. His research was masterfully planned, highly productive,exciting, and stimulating to many others and invariably openedup new and fundamental research areas for further explorationby others. He is most widely known for his vital leadershipin development of the Marine Biological Laboratory during criticalyears of its survival and expansion. He was unanimously electedpresident of the National Academy of Sciences and chairman ofthe National Research Council, the first person to hold thesetwo key positions simultaneously, and in addition was activein establishment of the Union of Biological Sciences responsiblefor publication of Biological Abstracts, establishment and administrationof the National Research Council Fellowships in the biologicalsciences and in motivation of research in problems of sex, especiallythose concerned with the roles of sex hormones in sexual differentiation.The Woods Hole Oceanographic Institution was established largelythrough his skill and labor and he served as president of itscorporation from 1930 to 1939. His uniqueness resided in hiscapacity to function in a highly effective manner and oftensimultaneously in many key positions of responsibility and stillfunction effectively as a highly personable and respected humanbeing. 相似文献