住院医师规范化培训临床教学查房的实践与体会

在国家住院医师规范化培训持续深入推进的背景下,以医院加强住院医师规范化培训临床教学查房为基础,分析了住院医师规范化培训临床教学查房的内涵及特点,提出了组织临床教学查房的实施方案,并就如何实现住院医师规范化培训临床与教学有机融合提出了意见建议。     

中医住院医师规范化培训的实践与思考

中医住院医师规范化培训是中医人才队伍建设与储备的重要环节,本文通过分析总结中医住院医师规范化培训的现状及问题,结合我院在实际过程中的经验与做法,对持续提升中医住院医师规范化培训的质量提出思考。

     

综合医院住院医师规范化培训管理实践与探索

国家对住院医师规范化培训项目越来越重视,芜湖市第二人民医院紧随政策导向,贯彻实施住院医师规范化培训。通过以芜湖市第二人民医院住院医师规范化培训管理实践为例,介绍住院医师规范化培训背景、现状及管理实践,为持续改进培训管理工作提供参考。     

建立住院医师规范化培训管理体系的探索

住院医师规范化培训是医学生向医生转变的必修科目,也是住院医师向高层次医师迈进的必由之路,对于提高住院医师临 床技能及完善医疗水平极为重要。目前,我国住院医师规范化培训存在很多弊端,相关管理体系缺乏统一、完善的评价标准。因 此,建立一个完善的住院医师规范化培训管理体系是我们应该重视的问题。本文结合医院临床教学实习所积累的经验,并学习借 鉴发达国家及地区对住院医师规范化培训管理制度的优点与长处,探索建立住院医师规范化培训管理体系的新方法,旨在促进 住院医师规范化培训工作的持续发展。     

肝胆外科住院医师规范化培训教学探讨

住院医师培训是医学教育中重要环节之一,是提高临床医疗水平的关键。因此,如何探索科学、合理的住院医师培养方案,已成为临床医学教育探索的重要课题。本文对肝胆外科住院医师规范化培训的实践进行了总结分析,希望对提高肝胆外科住院医师规范化培训效果起到一定的促进作用。     

我院住院医师规范化培训模式实践创新探索

临床住院医师规范化培训是我国加快年轻医师成长成才的极为重要又不可缺少的阶段,是我国提高医疗卫生服务质量的重要保障。哈尔滨医科大学附属第一医院自1993年实施住院医师规范化培训工作,建立了以住院医师为中心,以培训职业胜任力为核心的全方位内容、多渠道方法、全过程评价的管理模式：推进管理创新,完善体系建设;学习先进理念,创新带教模式;完善质量评估,实施全程质控;加强基地建设,改善住培条件;促进协同交流,提升示范作用。     

住院医师规范化培训管理现状调查与分析

目的 调查分析医院开展住院医师规范化培训现状。方法 选取2011—2013年进入医院住院医师规范化培训基地的住院医师,采用现场发放调查问卷方法进行无记名调查分析。将调查内容分为报名招录、轮转培训、各类考核、组织管理和其他板块。结果 96.7%认为医院招录过程合理或基本合理,92.6%认为培训计划制定具有一定的合理性,90.1%住院医师能够按照规定完成培训内容,各类考核内容基本能够反映住院医师的培训水平。在众多培训期间存在困难中,依次为收入偏低、个人婚恋生育计划难以实施以及工作和学习压力过大。结论 住院医师基本认同目前医院的培训管理制度和方法,逐步提高住院医师薪酬待遇,有效疏导培训压力和加强师资队伍建设是提高住院医师培训积极性和培训质量的保证。     

口腔颌面外科住院医师规范化培训中临床能力培养初探

住院医师规范化培训是培养具有独立执业能力和高超临床技能的专业医学人才的重要环节。通过对3年来口腔颌面外科住院医师规范化培训教学工作经验的总结,根据现代医学素质教育理念,结合口腔颌面外科的学科特点,探讨更加适合口腔住院医师规范化受训人员的教学方法,以促进受训住院医师临床实践综合能力的提高。我们在规范化培训中按纲施训,从转变临床思维模式、强调学习自主性、加强临床基本技能训练、注重人文思想的渗透等多方面入手,针对临床实践中的薄弱环节进行培训,为培养高素质医学人才奠定了基础,取得了教与培的满意效果。     

浅析急诊科住院医师规范化培训问题及对策

正2014年11月,国家卫生计生委、教育部、国家中医药管理局联合召开"医教协同深化临床医学人才培养改革工作推动会",会议明确提出要在5年内(也就是到2020年)我国全面实行住院医师规范化培训(规培)工作。随着医疗体制的改革,规范培训在我国的全面推行具有重要的现实意义,但制度在实施中出现的问题以及因此遭遇的各种吐槽和批评也在所难免[1]。作者在急诊科住院医师的培训中虽取得较好的成绩,但也发现存在一些问题,现就存在问题及其对策     

住院医师规范化培训中的问题及国际经验启示

目的 梳理我国住院医师规范化培训存在的问题,借鉴国际经验,提出相关政策建议。方法 对现阶段我国住院医师规范化培训存在问题和典型国家住院医师培训开展文献调研和专家咨询。结果 我国 住院医师规范化培训存在管理制度不完善,培训过程和内容不合理,考核制度不健全,动员机制不顺畅等问题。结论 根据 国际经验,提出厘清各部门分工,充分发挥行业组织的桥梁和纽带作用;加强顶层设计和政策配套,保障培训制度的落实;拓宽培养内容,加强学员考核,提高培养质量等政策建议。     

儿科临床路径管理引导住院医师规范化培训的探讨

?????? 目的 研究应用儿科临床路径管理的方法对住院医师规范化培训管理的价值。方法 采用对照研究的方法,用SPSS10.0软件计算χ²,确定统计学意义。结果 新方法的应用儿科理论成绩明显提高,住院医师定专业成功率提高,住院医师被患者投诉明显减少。结论 儿科临床路径管理应用于住院医师规范化培训管理,管理流程化,充分调动了培训医师的积极性和创新性,提高了学习效率和效果。     

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。     

Evaluation of a standardized physical training program for basic combat training

A control group (CG, n = 1,138) that implemented a traditional Basic Combat Training (BCT) physical training (PT) program was compared to an evaluation group (EG, n = 829) that implemented a PT program newly designed for BCT. The Army Physical Fitness Test (APFT) was taken at various points in the PT program, and injuries were obtained from a medical surveillance system. After 9 weeks of training, the proportion failing the APFT was lower in the EG than in the CG (1.7 vs. 3.3%, p = 0.03). After adjustment for initial fitness levels, age, and body mass index, the relative risk of an injury in the CG was 1.6 (95% confidence interval [CI] =1.2-2.0) and 1.5 (95% CI = 1.2-1.8) times higher than in the EG for men and women, respectively. The newly designed PT program resulted in higher fitness test pass rates and lower injury rates compared to a traditional BCT physical training program.     

Determination of standardized ileal crude protein and amino acid digestibilities in protein supplements for piglets

The objective of the study was to determine standardized ileal digestibilities (SID) of crude protein (CP) and amino acids (AA) in six ingredients commonly used in weanling pigs diets. The ingredients consisted of extruded soybeans (SBe), high-protein soybean meal (SBMhp), soy protein concentrate (SPC), hydrolyzed wheat gluten (WGh), conventional fish meal 1 (FM1) and extracted fish meal 2 (FM2e). Each assay feed ingredient was added to a purified cornstarch-based basal diet supplemented with casein and crystalline AA, and SID of CP and AA of assay ingredients were estimated using the difference method. A total of 12 3-week-old barrows were surgically fitted with T-cannulas at the distal ileum. The piglets were allocated to four simultaneous 3 × 3 Latin-square designs with three animals and three periods each, resulting in six observations per assay diet. After 3 to 5 days recovery from surgery, each assay diet was fed at a level of 30 g/kg body weight. Each experimental period consisted of 5 days for adaptation to the assay diets and 2 days for ileal digesta collection. The SID of CP, Lys, Met, Thr and Trp were 73%, 78%, 76%, 66% and 71% in SBe; 80%, 84%, 87%, 75% and 81% in SBMhp; 86%, 89%, 89%, 78% and 83% in SPC; 87%, 60%, 88%, 76% and 79% in WGh; 87%, 92%, 94%, 86% and 86% in FM1; and 79%, 86%, 89%, 80% and 74% in FM2e, respectively. The greatest SID of indispensable AA were observed for FM1 and SPC (SID 85% for most indispensable AA), followed by WGh, FM2e and SBMhp (SID 80% for most indispensable AA) and the smallest SID were obtained for SBe (SID < 80% for most indispensable AA). The SID of CP and indispensable AA in both types of fish meal, SBMhp and WGh were similar to SPC (P = 0.063 to 0.855), except for Arg (P = 0.010) and Lys (P = 0.001) in WGh, and Phe (P = 0.044) and Trp (P = 0.037) in FM2e. The SID of CP and indispensable AA were smaller in SBe compared with SPC (P < 0.001 to P = 0.017), except for Lys (P = 0.136). The SID of CP and indispensable AA were consistently smaller in FM2e compared with FM1 with significant differences for CP (P = 0.035), Phe (P = 0.028) and Trp (P = 0.008). Digestibility values measured in the present study can be used to formulate diets for piglets based on standardized ileal digestible contents of CP and AA.     

Teacher training for medical faculty and residents.

Since 1984 the University of British Columbia''s School of Medicine has offered teaching improvement project systems (TIPS) workshops on effective teaching techniques; two workshops a year are given for medical faculty members and two a year for residents. The faculty members who conduct the workshops have received training on how to present them. The most powerful learning experience offered by TIPS is the opportunity for participants to present 10-minute teaching segments that are videotaped and later viewed privately by the participants. Eight workshops have been attended by 166 faculty members, and two others have been attended by 42 residents. This project demonstrates faculty development for both the participants and the people who teach the workshops.     

基于同化数据的标准化土壤湿度指数监测农业干旱的适宜性研究

农业干旱是导致作物减产的主要灾害之一,及时、准确地监测农业干旱状况有助于制定区域减灾策略,降低灾害损失。标准化土壤湿度指数(SSMI)是基于历史土壤湿度时间序列构建的一种农业干旱指数,目前分析该指数监测农业干旱的适宜性研究十分缺乏。本文以黄淮海平原为研究区,利用数据同化的根区土壤湿度数据构建SSMI,并通过与标准化降水蒸散指数(SPEI)、农业干旱灾害记录数据的对比以及与冬小麦产量的关系分析,综合评价SSMI监测农业干旱的适宜性。结果表明,SSMI与SPEI具有良好的一致性,二者之间具有极显著相关关系(P0.001);利用SSMI识别的农业干旱与农气站点干旱灾害记录是基本一致的,SSMI能够有效反映干旱发生、发展直至减轻的演变过程;冬小麦生长季SSMI与减产率显著相关,利用SSMI识别的农业干旱发生区域与基于统计数据计算的减产区域基本相符,SSMI能够对农业干旱引起的冬小麦减产起到一定的指示作用。综上所述,基于同化数据构建的SSMI能够反映黄淮海平原的农业干旱状况,利用SSMI监测区域农业干旱状况是适宜的。研究可为基于土壤湿度的农业干旱监测业务化运行提供依据,为黄淮海平原的抗旱减灾提供科学参考。     

硕士研究生住院医师规范化培训的实践与成效分析

目的 实施硕士研究生住院医师规范化的临床培训,提高住院医师的业务素质与临床技能。方法 探讨硕士研究生住院医师临床培训的运行机制与模式,利用统计描述法对培训成效进行分析。结果 2006—2008年度,203位硕士研究生住院医师的阶段培训考核合格率高于80%;品德素质、理论知识、技能操作、病历质量、临床教学与科研能力等指标均达到培训要求。 结论 明确硕士研究生住院医师规范化培训的目标,探讨适宜的培训运行机制与模式,对实现住院医师规范化培训有积极意义。