Comparison of parents' expectations and importance ratings for specific aspects of childbirth.

We examined parents'' expectations of many aspects of the birth experience and compared them with the importance they attached to these aspects. Expectation was defined as a respondent''s rating that a given practice would be reality, and importance was defined as a respondent''s rating of the personal importance of a practice were all options possible. Subjects in the last 6 to 8 weeks of pregnancy were asked by their obstetricians to complete a questionnaire; 231 mothers and 227 fathers responded, for a response rate of 95%. In each of six subcategories parents'' importance ratings significantly exceeded their expectation ratings. Certain items were rated as relatively less important postnatally than prenatally and by multigravid women than by primigravid women. Parents'' perceptions of available options reflect consistent discrepancy with what they wish were possible. However, increased efforts to inform parents of existing options and to provide the rationale for specific practices may reduce the discrepancy between importance and expectations. This would in turn heighten the likelihood of a psychologically positive birth experience for parents.     

Animals in science education—ethics and alternatives

Increasingly, moral objections are being voiced to the use or killing of animals for educational purposes, and students' opinions are reflecting this. An animal rights philosophy often underlies these objections, but many people are unaware of the logic of the animal rights position, which is often dismissed as sentimentalism or anthropomorphism. While it is now possible to take A-level biology without undertaking dissection, there are many potential undergraduate students who would like to do courses in biology, medicine, pharmacology, physiology, and nursing, but are dissuaded by the animal use involved. Such students are frequently not offered non-animal options and risk being marked down in course work and exams, even though considerable advances have been made in the development of alternative teaching aids. This article summarizes the animal rights argument, and reviews some of the alternative approaches and their teaching effectiveness.     

Preregistration house officers in general practice.

OBJECTIVES--To obtain from house officers who had rotated through general practice in their pre-registration year their views about their experience; and, separately, to compare the overall hours and type of work performed by hospital based and general practice based house officers. DESIGN--Postal questionnaire; and self recording of working hours and duties during four consecutive weeks. SETTING--Inner London teaching hospital and nearby general practice. PARTICIPANTS--28 preregistration house officers in general practice, 1981-91; and 12 preregistration house officers, four each in medicine, surgery, and general practice. RESULTS--26 out of 28 questionnaires were returned (response rate 93%). Twelve respondents were following or thinking of following a career in general practice. Twenty five respondents were satisfied with the clinical and educational aspects of the general practice rotation and would recommend the rotation, and 25 thought four months was about the right length of time in general practice. With regard to hours and type of work performed, hospital based house officers worked on average 55.5 hours a week (excluding on call), with an average of 12.5 hours (22.5%) spent in clinical activities; general practice based house officers worked about 41 hours a week, of which 24 hours (58%) were in clinical activities. House officers in hospital received less than one hour''s specific teaching a week; those in general practice received nearly three hours'' a week. CONCLUSIONS--A preregistration rotation in general practice is a popular alternative to the hospital based rotation. Although this is a limited study, other medical schools should consider introducing general practice options for preregistration house officers.     

“趣味教学法”在微生物学课堂中的应用及探讨

微生物学属于生命科学的重要分支,是生物、食品科学、临床医学等大学专业一门重要的基础课。该课程综合性强、知识涉及面广,所以如何有效调动学生的学习兴趣将直接影响课堂效果。为达到良好的教学效果,教师可在微生物学教学过程中综合运用多种方式提高学生学习兴趣与学习质量。因此,我们采用“趣味教学法”进行教学设计,并针对连续3个不同年级的相同专业班级做出教学改革,通过学生期末闭卷成绩、过程考核（签到率、课堂参与度、注意力集中程度等）成绩与学生反馈评语对教学成果进行验证。结果表明,采用“趣味教学法”进行教学改革的班级学生期末闭卷成绩中不及格率低于未改革的班级,“良好”与“优秀”学生比例均高于未改革的班级,过程考核成绩远高于未改革的班级,说明“趣味教学法”教学改革有效调动了学生的学习兴趣。我们认为,在大学微生物学课堂上,教师可在教学设计中适当引入趣味教学内容并适时展开,有助于改善教学气氛,调动学生学习积极性与主动性,提高教学质量。     

Bioethics for clinicians: 2. Disclosure.

In the context of patient consent, "disclosure" refers to the provision of relevant information by the clinician and its comprehension by the patient. Both elements are necessary for valid consent. Disclosure should inform the patient adequately about the treatment and its expected effects, relevant alternative options and their benefits and risks, and the consequences of declining or delaying treatment. The clinician''s goal is to disclose information that a reasonable person in the patient''s position would need in order to make an informed decision. Therefore, clinicians may need to consider how the proposed treatment (and other options) might affect the patient''s employment, finances, family life and other personal concerns. Clinicians may also need to be sensitive to cultural and religious beliefs that can affect disclosure.     

改进微生物学教学模式提高学生创新能力

对微生物学课程进行教学模式的改革与探索。通过丰富和更新教学内容,改进课堂教学方法和手段,改革实验教学模式和成绩考核方式,以提升学生的兴趣和自主学习能力。近几年的教学实践证明,该教学模式的改革显著提高了学生的科研实践能力和创新思维能力。     

STEAM教育理念下“线上+线下”混合教学模式初探：以微生物学实验为例

随着信息化手段的不断丰富,新型教育理念结合线上学习平台的新信息化教学模式成为高校课堂的改革新趋势。本次教学改革利用科学(Science)、技术(Technology)、工程(Engineering)、艺术(Art)和数学(Mathematics)多学科融合的超学科教育理念(简称STEAM教育)对教师教学过程进行了整体设计,同时借助“线上+线下”教学平台对学生学习过程进行了全面优化。将原本分散的验证型、操作型实验重新整合串联成以多角度“项目式”任务为主线、以Blackboard线上平台为辅线的自主研究型实验项目。新型教学模式以学生为主体,给学生提供更多自我展示和讨论互动的平台。从学生的课堂表现、知识测验、课后反馈、实验操作及实验报告4个方面对新型模式下的教学效果进行了分析和评价。结果表明,此模式不仅提高了学生在微生物学实验中的学习质量,增强了其学习主观能动性,而且有利于培养和提升学生的问题探究及实践创新能力。这一新型教学模式对其他生物学科实验课程的教学具有一定的借鉴意义。     

基于“岗课赛证”四元融通的“食品微生物检验技术”教学改革与实践

“岗课赛证”四元融通是以课程为中心,将岗位、竞赛和职业证书有机融合于课程的一种教学改革模式。本课程团队以“岗课赛证”融合育人为抓手,通过以岗定课、以赛促课、以证融课的方式,全面实施高等职业院校“食品微生物检验技术”课程教学改革。基于企业岗位能力需求和典型工作任务,开展模块化、项目式教学;以技能竞赛和创新创业大赛为载体,赛教融合,激发学生成长的内生动力,提升学生职业综合素质;基于“1+X”证书制度,课程标准与技能证书标准对接,优化教学资源。通过近三年的教学实践,证实基于“岗课赛证”的“食品微生物检验技术”教学改革能够有效提高学生职业竞争力,满足企业和社会对岗位人才的需求,为职业教育食品专业相关课程改革提供参考。     

Advance directives: the views of health care professionals.

OBJECTIVES: This study examined the views and experiences of 20 physicians and 20 nurses at a major Canadian teaching hospital regarding the use of advance directives in clinical care. DESIGN: The participants were purposively drawn from four clinical specialties: family and community medicine, oncology, intensive care and geriatrics. Detailed interviews were conducted in person. Content analysis was used to code the data, which were further analysed with both quantitative and qualitative techniques. MAIN RESULTS: Thirty-nine of the 40 participants favoured the use of advance directives in clinical care; physicians had somewhat less positive attitudes than nurses toward such directives. Advance directives were thought by participants to be helpful in resolving disagreements between patients and their families about treatment options; in making patients more comfortable, both physically and psychologically, during the process of dying; and in opening up communication and trust among patients, their families and health care professionals. Concerns about the use of advance directives focused on the lack of clarity in some patients'' instructions, the absence of legal status for directives, the possible interference with a practitioner''s clinical judgement, the adequacy and appropriateness of patients'' information about their circumstances, and the type of intervention (passive or active) requested by patients. CONCLUSIONS: New regulations and legislation are making the use of advance directives more widespread. Health care professionals should participate in the development and implementation of these directives. Continuing professional education is essential in this regard.     

PBL+LBL教学模式在留学生医学微生物学教学中的实践

由于留学生的特殊性导致他们对传统教学模式的不适应,医学微生物学的课程特点使留学生学习掌握相关知识较困难,有必要探索好的教学方法,提高教学质量。我国传统的LBL教学模式和国际上流行的PBL教学模式各有优缺点,我们融合PBL和LBL的优点,互补其缺点,对留学生医学微生物学课程采取PBL+LBL教学模式,既发挥PBL教学法打破学科界限,容易调动学生学习积极性,注重培养学生自主学习和团结协作能力的特点,又结合LBL教学法传授知识系统、完整,培养学生基础理论扎实等优势。教学实践证明,PBL+LBL教学法运用于留学生医学微生物学教学,能激发留学生学习兴趣,在增强留学生对医学微生物学基础理论和基本技能掌握的同时,培养留学生知识整合的能力及创新思维的医学综合能力,提高教学质量。     

The teacher, the physician and the person: how faculty's teaching performance influences their role modelling

Objective

Previous studies identified different typologies of role models (as teacher/supervisor, physician and person) and explored which of faculty''s characteristics could distinguish good role models. The aim of this study was to explore how and to which extent clinical faculty''s teaching performance influences residents'' evaluations of faculty''s different role modelling statuses, especially across different specialties.

Methods

In a prospective multicenter multispecialty study of faculty''s teaching performance, we used web-based questionnaires to gather empirical data from residents. The main outcome measures were the different typologies of role modelling. The predictors were faculty''s overall teaching performance and faculty''s teaching performance on specific domains of teaching. The data were analyzed using multilevel regression equations.

Results

In total 219 (69% response rate) residents filled out 2111 questionnaires about 423 (96% response rate) faculty. Faculty''s overall teaching performance influenced all role model typologies (OR: from 8.0 to 166.2). For the specific domains of teaching, overall, all three role model typologies were strongly associated with “professional attitude towards residents” (OR: 3.28 for teacher/supervisor, 2.72 for physician and 7.20 for the person role). Further, the teacher/supervisor role was strongly associated with “feedback” and “learning climate” (OR: 3.23 and 2.70). However, the associations of the specific domains of teaching with faculty''s role modelling varied widely across specialties.

Conclusion

This study suggests that faculty can substantially enhance their role modelling by improving their teaching performance. The amount of influence that the specific domains of teaching have on role modelling differs across specialties.     

网络云交互技术辅助外科实践教学的创新应用探索

目的:探索传统教学模式结合网络云交互技术在外科实践教学中的应用效果。方法:于我校2011级五年制临床医学专业本科生中选取76人,随机平均分为两组,分别采取单纯传统大课教学模式、传统教学结合网络云交互技术教学模式;课程结束后进行闭卷理论考试和实践操作考试,综合两项成绩进行评定。同时向两组学员发放调查问卷,以此评价使用网络云交互技术辅助教学的效果。结果:采取传统教学结合网络云交互技术教学模式组的成绩优于采取单纯传统教学模式组,两组成绩差异具有统计学意义(P0.05)。结论:在传统教学模式的基础上添加网络云交互技术更能激发学生的学习兴趣,大大提高了学习效率,更有利于本科生外科实践的教学以及教学资源的整合及教学档案的建立。     

浅析基于PBL教学模式下的临床医学教学应用

目的:PBL是"基于问题式学习"的教学法,本文以PBL教学法内涵为理论基础,剖析了在临床医学教学过程中实施PBL教学法的必要性。PBL教学法可以顺应时代发展的要求提高学生的综合能力提升教师的教学水平增进和改善师生关系,并总结归纳出PBL教学法的一般模式和实施过程中常见的主要问题,主观上传统的教育观念根深蒂固,客观上存在师资力量不足、现有教学体系不科学的问题。提出了解决问题的策略:转变教学理念,不断完善教学环境;提高教师队伍素质建设,发挥教师导向作用;逐步建立科学的教育体系。PBL教学法有助于全面培养学习者的学习能力,提高学习者的综合素质,全面推行切合自身实际的PBL教学模式,逐步建立具有中国特色的临床医学教学模式,培养高素质临床医学人才,与现代社会对人才培养的要求基本一致,值得推广和应用。     

“发酵工程原理与技术”混合式教学研究与实践：以“抗生素发酵生产工艺与工程实践”内容为例

“发酵工程原理与技术”是理工科高校生物专业的核心课程之一,具有较强的应用性和实践性。然而目前以线下教学为主的传统教学方式不利于学生对知识的理解和掌握。同时,该课程实验教学环节存在发酵设备更新不及时、缺乏大型工艺设备、易受场地限制等问题,严重影响实践教学效果。线上线下相结合的混合式教学模式是丰富教学资源和提升教学质量的重要手段。我们以“抗生素发酵生产工艺与工程实践”内容为例,基于虚拟仿真平台设计并构建虚拟仿真实验项目,同时结合课堂教学和实验室教学等线下教学方式,形成线上线下高度融合的混合式教学新模式。混合式教学强化了课堂教学与在线教学、虚拟实验与实体实验的有机结合,促进了学生扎实掌握理论知识和实验技能,培养了学生的创新精神和实践能力,提高了学生的综合素质。     

如何上好“绪论”第一课：以“普通植物病理学”课程为例

“绪论”是高校所有课程的第一课,上好“绪论”第一课可第一时间在学生心中播下对该门学科的使命感、进取心和责任心的“种子”。作者通过多年的教学研究与实践,认为“绪论”教学的首要目的是激发学生的好奇心和求知欲,点燃学生的进取心和紧迫感,进而喜欢和会学这门课程。为达到上述教学目的,我们构建了“绪论”第一课授课内容、方法与目的三者相吻合的教学模式：首先,采用生动有趣和灵活多样的手段导入情景和实物,并设问;随后通过循循善诱和启迪独立思考,师生共同探究和感悟该学科属性、形成发展历史、目前研究现状及未来发展前景,以及教与学的目的、任务和方法等,从而让学生树立上进心和责任心,增强学好该课程的决心和信心。本文以普通植物病理学课程为例,展示了采用“绪论”第一课的教学模式开展的教学过程。多年的教学实践证明,“绪论”第一课教学模式导入的“绪论”内容规范、系统、全面、与教学目标相契合。并且,其内涵丰富、可操作性强、实施效果好,对提高教学质量十分奏效,适合推广应用。     

基于在线课程的混合式教学在微生物学课程中的探索和实践

在线课程的建设与应用已成为现阶段高校教学信息化变革的重要举措,有效应用在线课程资源、开展混合式教学的设计与实践是建设一流本科课程的重点。依托微生物学在线精品课程(浙江省绍兴市),在科学教育2016-2018级尝试了基于在线课程的混合式教学,3轮教学实践表明:基于在线课程的混合式教学能提升学生学习兴趣和参与度,促使学生深度学习,促进学生综合能力和素质的提高;微生物学课程在学院和学校层面已经形成品牌,受到学生的普遍欢迎和好评。     

“微世界，大情怀”：浅谈微生物学课程思政教学设计与改革

充分发挥课堂教学主渠道在高校思想政治工作中的作用,运用教学创新方法、创新方式,助力课程思政工作创新。我们在微生物学课程教学中,通过改革教学模式,采用大班授课小班辅导,注重过程考核,将理论教学与实验教学、创新实践紧密结合,以及挖掘典型教育案例、代表性人物励志故事、我国科技创新的事例等,将课程知识点与思政元素相结合。实践表明,改革后的课程教学培养了学生的自主学习能力,夯实了学生的专业基础,有效提升了教学效果和学生的科学素养,提高了学生的应用能力和综合素质,有助于增强学生的自信心和服务社会的责任感,增强学生的爱国主义情怀,能够实现知识传授、能力培养与价值引领的有机统一。     

Major merger gives London Canada's second-largest teaching hospital.

Two of London''s three major teaching hospitals joined forces recently to form Canada''s second-largest teaching hospital. The merger is considered a harbinger as teaching hospitals strive to maintain current teaching, research and clinical activities in the face of decreasing government spending.     

景观设计思维的培养途径与教学探讨——从设计思维的特性谈起

作为一门以落地性为特征的应用型学科,对学生规划设计思维与能力的培养一直是风景园林专业教学的重要目标,如何通过教学有效地培养学生规划设计思维与能力也成为了风景园林专业教育关注的重要议题。本文从设计思维的特性出发,针对设计教学课程提出了一套控制方式和流程,并以同济大学本科三年级上学期的公园设计课程为例,对景观设计思维的培养途径和方法展开了教学尝试。     

军校五年制学员营养学PBL教学模式的构建及效果评价

目的:探讨PBL教学模式在营养学教学中的作用及不足,并评价其教学效果。方法:采用随机抽样的方法,选取第四军医大学2012级五年制营养学专业学员(114名)实施PBL教学,2011级五年制临床专业学员(159名)实施传统教学;从四个方面(考试成绩、教学满意度、学员解决未知问题的方式、学习兴趣及积极性)综合评价PBL教学效果。结果:与传统教学组相比较,PBL教学组的考试成绩、教学满意度、学员解决未知问题的方式以及学习兴趣均显著升高。结论:PBL教学模式不仅提高了学员的考试成绩,还提高了学员的学习能力与素质,有必要进一步优化并大力推广。