以问题为中心的学习方法在高职社区问诊技能教学中的应用

目的:探讨以问题为中心的教学方法(problem-based learning,PBL)在高职社区问诊教学中的效果,寻求更有效的现代医学教育方法。方法:在高职社区问诊技能学习中开展以问题为中心的教学方法(PBL),分析问诊中存在的问题,以提高知识应用与沟通能力。结果:通过对62名高职医学生进行问诊技能和见习报告评分显示,成绩优良比率为89%,满意度调查显示83.87%的高职医学生对PBL教学方法满意。PBL教学可以让高职医学生灵活的利用自已的时间,进行比较主动的学习,可以更好的发现高职医学生在问诊见习中存在的问题,有利于提高高职医学生的问诊技能及医患沟通能力,但实施中所需时间较长,占用课时多。结论:PBL教学对高职医学生的主动学习能力、问诊技能及医患沟通能力的提高有利,医学生对PBL教学方法满意度高。在医学教育中可以将PBL教学和传统教学方法结合起来,以在有效的时间里达到更好的教学效果。     

多媒体技术在人体解剖学教学实践中的作用

目的：探讨多媒体技术应用于在医学高等院校人体解剖学专业课程中的意义,以及该教学策略对生物医学教学实践的作用。方法：选取我院校本部学生80人,随机分为实验组和对照组,每组40人。实验组采取多媒体教学法,对照组则采用传统教学法。比较两组学生的期末考试成绩,并在假期对两组学生进行问卷调查,分析调查结果。结果：①期末测试结果：实验组学生的期末考试平均分为88.3,对照组学生的期末考试平均分为68．9,实验组明显优于对照组,差异具有统计学意义（P〈0．05）;②问卷调查结果：实验组92．28％的学生认为教学能够提高学习主动性,而对照组为69．36％;实验组88．61％的学生认为教学有助于提升对课程内容的理解,而对照组为66．19％;实验组93．45％的学生认为教学促进师生互动,而对照组为67．64％;实验组72．75％的学生认为教学可增强团队合作精神,而对照组为46．73％。实验组的调查结果明显优于对照组,差异具有统计学意义（P〈0．05）。结论：将多媒体技术引入人体解剖学课程的教学实践中,能够更好的帮助学生掌握人体解剖学的理论体系,提升教学质量,提高学生的专业知识水平。     

建构主义教学模式在医学微生物学教学实践中的应用

传统的教学模式是以"教师为中心",建构主义教学模式强调"以学生为主体"。医学微生物学教学存在课时少、内容繁杂、知识点琐碎、逻辑性较差等特点,采用传统教学模式往往不能达到较好的教学效果。通过将建构主义理论引入医学微生物学教学实践中,我们设计了适合医学微生物学的建构主义教学模式,充分调动学生的主动性、积极性和创造性。该模式的应用,进一步提高了医学微生物学的教学质量,增加了学生综合素质的培养。     

GP registrars as teachers: a survey of their level of involvement and training

The role of general practice in medical education is increasing both at the undergraduate and postgraduate level. There is a paucity of evidence as to the level of involvement of GP registrars and their training to teach. Two hundred and forty one GP trainees in the Peninsula Deanery were surveyed as to their current level of involvement in teaching and their training to provide it. Seventy eight completed surveys were returned and these revealed that 62% were regularly involved in teaching but only 41% had ever received any training in this area. There was a strong feeling that teaching was an important skill for GPs with 92% of trainees wanting further training in this area. There is clearly a need for further research in this area both to identity whether this sample is representative of the situation nationally and to determine how best to equip trainees in their roles as educators now and in the future.     

Career Preferences of First-year Students at Canadian Medical Schools, 1966-67 to 1968-69

The principal findings of this study of the career preferences of first-year Canadian medical students were:Over 70% of the first-year students expressed a preference for specialty practice, with only 20% oriented towards practice as a family practitioner.There were considerable differences between the medical schools in the proportion of medical students preferring general practice, ranging from less than 10% at McGill to nearly 33% at Queen''s.Nearly one-third of the students stated that they preferred primarily salaried practice. These students were largely those who preferred specialty practice or a career in an area such as public health or research.Nearly 70% of the students looked for a career with part-time teaching, while 8% preferred a full-time teaching career.Only 1% preferred a full-time research career although 90% expected to have at least some research involvement.Students from smaller communities were more likely to express a preference for general practice than those from large urban areas.Men and women had similar practice preferences in terms of general practice and clinical specialty, but significantly more women than men preferred a career in salaried practice. Significantly fewer women expressed a preference for major involvement in either teaching or research.     

Student audit of clinical teaching: a three year study.

An audit of teaching to junior clinical students in the University of Birmingham organised by students identified several surgical and medical firms on which they received little clinical teaching. Consultants spent an average of four and a half hours a week teaching junior students on the wards, arrived about 10 minutes late for that teaching, but missed less than 10% of teaching sessions. Junior students missed less than 10% of consultant teaching sessions and found them useful, though not always stimulating. Audit organised by students is an acceptable method of monitoring the informal teaching received by clinical students.     

基于网络的医学微生物学混合式教学的效果评价

根据医学微生物学的教学要求和特点,对临床医学专业采用混合式教学,即将总课时的80%用于传统课堂教学,20%用于网络课堂教学,通过对比分析考核成绩和问卷调查,评价该教学模式对医学微生物学教学效果的影响.结果显示混合式教学模式优于单一的传统课堂教学模式,并能显著提高医学微生物学的教学效果,对突破传统课堂教学的局限性和帮助学生自主学习具有重要意义.     

医学生实习中外科基本操作常犯错误及对策分析

目的：探讨医学生临床实习中在基本操作上常犯的错误,并对此提出建议和纠正措施,旨在进一步提高临床带教水平及临床教学质量。方法i总结我院临床医学专业实习生进行常见的外科临床基本操作考核成绩的情况,对错误类型等进行统计并提出合理的解决措施。结果：共考察学生90名,其中外科换药方法欠佳者22人（24．4％）,消毒铺巾存在问题24人（26．6％）,缝合存在问题32人（35．5％）,打结存在问题38（42．2％）人,拆线存在问题19（21．1％）人。结论：加强医学生外科实习期间的无菌观念培养及强化手术基本操作是临床教学的重要环节。     

不同层次医学生实验室生物安全课程的教学实践与体会

根据对不同层次和专业医学生实验室生物安全教学的实践和体会,从教学指导思想、课程设置、考核评估等方面进行了总结,并分析了教学过程发现的问题,以期通过教学活动培养学生良好的实验室生物安全意识和素质。     

军校预防医学专业本科学员临床课程教学现状及建议

随着医学模式的转变,预防医学已经成为现代医疗体系的重要组成部分,在提高公共卫生健康水平方面发挥着越来越重要的作用。为了更好地开展预防医学工作,预防医学专业学员不仅要掌握牢固的预防医学专业知识,更要具备丰富的临床医学知识。针对预防医学专业本科学员的临床课程教学,我校经过多年的探索与改革,已经积累了丰富经验,教学质量较高;但现阶段仍然存在着一些问题。本文分析我校预防医学专业本科学员临床课程的教学现状及存在的主要问题,并提出建议;从而为进一步提高预防医学专业本科学员的临床课程教学质量提供依据。     

Do physicians assess lifestyle health risks during general medical examinations? A survey of general practitioners and obstetrician-gynecologists in Quebec

BACKGROUND: In Canada several guidelines have been published for the screening of lifestyle health risks during general medical examinations. The authors sought to examine the extent to which such screening practices have been integrated into medical practice, to measure physicians'' perceived level of difficulty in assessing these risks and to document physicians'' evaluation of their formal medical training in lifestyle risk assessment. METHODS: An anonymous mail survey was conducted in 1995 in Quebec with a stratified random sample of 1086 general practitioners (GPs) and with all 241 obstetrician-gynecologists (Ob-Gyns). The authors evaluated the proportion of physicians who reported routine assessment (with 90% or more of their patients) of substance use, family violence and sexual history during general medical examinations of adult and adolescent patients; the proportion of those who find inquiring about these issues difficult; and the proportion of those who evaluated their medical training in lifestyle risk assessment as adequate or excellent. RESULTS: The overall response rate was 72.6%. Among adult patients, 82.2% of the GPs reported routinely assessing tobacco use, 67.2% alcohol consumption, 34.2% illicit drug use and 3.2% family violence; the corresponding proportions for assessment among adolescent patients were 77.1%, 61.8%, 52.9% and 5.6%. Comparatively fewer Ob-Gyns reported routinely assessing these issues (56.1%, 28.6%, 20.4% and 1.3% respectively among adults and 62.7%, 35.2%, 26.8% and 2.8% respectively among adolescents). In the area of sexual history, condom use was routinely assessed by more Ob-Gyns than GPs (47.0% v. 28.2%); however, the proportion of Ob-Gyns and GPs was equally low for assessing number of partners (24.8% and 23.1%), sexual orientation (18.8% and 16.9%) and STD risk (26.2% and 21.2%). The vast majority of GPs and Ob-Gyns reported finding it difficult to assess family violence (86.5% and 93.0%) and sexual abuse (92.7% and 92.4% respectively). Over 80% of the physicians felt that they had had adequate or excellent medical training in assessing risk behaviours for heart disease and STD risk. The proportion who felt this way about their training in screening for illicit drug use, family violence and sexual abuse ranged between 12.7% and 31.6%. INTERPRETATION: Although morbidity and mortality associated with smoking, alcohol consumption, illicit drug use, unsafe sexual practices, family violence and sexual abuse have been well documented, routine screening for these risk factors during general medical examinations has yet to be integrated into medical practice.     

双师带教模式在胸外科研究生临床见习教学中的应用效果

目的:探讨双师带教模式在胸外科研究生临床见习教学中的应用效果。方法:选择新疆医科大学附属肿瘤医院2011级~2015级胸外科轮转硕士研究生56人为研究对象,依据随机数字表法将学生分为观察组和对照组,各28人,分别采用双师带教和普通带教进行临床教学,实习8周后统一安排出科考试和满意度评价。结果:两组出科成绩比较,理论考试成绩差异没有统计学意义(P0.05),临床操作得分观察组高于对照组,差异具有统计学意义(P0.05);学生对课程的满意度评价,观察组为85.71%,显著高于对照组的60.71%,差异有统计学意义(P0.05)。结论:在胸外科临床实践教学中运用双师带教制,能充分发挥不同医师的特长,引导学生学习热情,提升临床实习效果,值得在临床实践中推广。     

Mobilizing physicians to conduct clinical intervention in tobacco use through a medical-association program: 5 years' experience in British Columbia.

During the last 5 years, a program run by the medical association in British Columbia has recruited 23% of the province''s general practitioners (GPs) to take an active, systematic approach to clinical intervention in tobacco use. Another 9% of GPs (considered "semi-active") regularly use the program''s educational materials for patients, and another 25% have been trained in intervention or have been given intervention materials or both. If the cessation rate (rate of patients who quit smoking who would not otherwise have done so) was 4% among physicians actively involved in intervention and 2% among physicians considered semi-active, in 1995 an estimated 4700 smokers quit and were followed by their GPs as a result of the program. Another 135,000 smokers received brief counselling from their GPs and were also followed. This article reviews the strategies and methods used in this program to mobilize physicians.     

Teaching medical students how to break bad news

PROGRAM OBJECTIVE: To teach medical students to break bad news to patients and their families empathically and competently. SETTING: Seven teaching hospitals affiliated with the University of Toronto since 1987. PARTICIPANTS: All medical students in their third preclinical year. PROGRAM: The course presents a 6-point protocol to guide students in breaking bad news and comprises 2 half-day (3-hour) teaching sessions. Each session incorporates a video presentation, a discussion period and small-group teaching, consisting of exercises followed by 4 different role-playing scenarios conducted with the use of standardized patients. The course was evaluated through 2 questionnaires, 1 administered before and 1 after the course, which measured changes in the students'' attitude and strategy. Questionnaires were administered during 5 of the years since the course was started. A total of 914 precourse and 503 postcourse questionnaires were completed, of which 359 matched pairs of precourse and postcourse questionnaires were analysed to study any changes due to the course. OUTCOMES: Precourse questionnaires showed that 68% of the students had thought about the task of breaking bad news often or very often. Of the 56% of students who had seen clinicians performing this task, 75% felt that they had seen good examples. The proportion of the students who had a plan for how to conduct such an interview rose from 49% before the course to 92% after it, and the proportion who felt they might be reasonably competent in breaking bad news rose from 23% before the course to 74% after it. CONCLUSIONS: The subject of breaking bad news is important to medical students, and it is practicable to design a course to teach the basic techniques involved. Most students perceive such a course as enjoyable and useful and find that it increases their sense of competence and their ability to formulate a strategy for such situations.     

PBL结合与情景教学在呼吸科医学生实习中的应用价值

目的:研究"以问题为基础"的学习模式(PBL)结合与情景教学在呼吸科医学生实习中的应用价值。方法:将PBL结合与情景教学应用于呼吸科医学生实习中,以此来进行带教实习。结果:PBL结合与情景教学能较好的促进学生的学习能力,使学生由被动学习角色转变为主动学习角色;学生对PBL结合与情景教学具有较高的学习兴趣,能提高学习效率,增加对基础知识掌握的灵活度。结论:PBL结合与情景教学在呼吸科医学生实习中具有较好的应用价值,能充分利用临床资源,培养学生学习能力和临床思维。     

以病例为基础的互动教学法提高口腔见习教学质量的探索

目的：为提高口腔科学教学质量,探索”以病例为基础的互动教学法”在口腔见习课教学中的效果。方法：五年制医学本科2007级125名学生为对照组口腔临床见习课教学中采用传统教学法,2008级120名学生为实验组采用以病例为基础的互动教学法,对这2组学生考试成绩进行分析,用P检验进行统计分析,同时进行问卷调查,比较两种教学方法的教学效果和学生的评价。结果：实验组学生的考核成绩优于对照组,差异有显著性;问卷调查表明实验组学生总体满意度较高,学习自我感觉较轻松,学生反应课程内容充实,对疾病的诊断、鉴别诊断、治疗设计、并发症等的认识更系统,且参与实践机会多,提高了学习的积极性。结论：”以病例为基础的互动教学法”能加强理论知识和临床病例的联系,提高学生的临床实践能力和自主学习能力,有助于提高教学效果。     

针对留学生的医学微生物学教学体会与探讨

医学微生物学是医学院校各专业的一门重要基础课程,也是一门较难讲解的课程,针对留学生尤为如此。针对我校留学生在医学微生物学教学中出现的问题,在如何克服语言障碍、选择教材和教学内容、优化教学方法与手段、严格教学管理和考核制度等方面我们做了诸多尝试,现将我们的一些体会和经验与各位同仁共同探讨,以期提高留学生医学微生物学教学水平。     

留学生医学微生物学教学的体会与改革

通过分析留学生及医学微生物学的特点,从教师的选择、教材的选取、运用现代教育技术、改革考试方法和加强实验教学等环节改进留学生医学微生物学的教学;采用启发式教学、归纳对比法教学、典型病案教学法和以问题为基础教学法(PBL)来提高授课质量等,探索医学微生物学留学生教学,为医学微生物学留学生教学改革提供一定的依据。     

Can medical students teach? A near-peer-led teaching program for year 1 students

The General Medical Council states that United Kingdom graduates must function effectively as educators. There is a growing body of evidence showing that medical students can be included as teachers within a medical curriculum. Our aim was to design and implement a near-peer-led teaching program in an undergraduate medical curriculum and assess its acceptability among year 1 students. Students received six tutorials focusing on aspects of cardiac, respiratory, and blood physiology. Tutorials ran alongside standard module teaching. Students were taught in groups of ～30 students/group, and an active teaching approach was used in sessions where possible. Using anonymous evaluations, student feedback was collected for the program overall and for each tutorial. The program was voluntary and open to all first-year students, and 94 (of 138) medical students from year 1 at Brighton and Sussex Medical School were recruited to the study. The tutorial program was popular among students and was well attended throughout. Individual tutorial and overall program quantitative and qualitative feedback showed that students found the tutorials very useful in consolidating material taught within the module. Students found the small group and active teaching style of the near-peer tutors very useful to facilitating their learning experience. The end-of-module written examination scores suggest that the tutorials may have had a positive effect on student outcome compared with previous student attainment. In conclusion, the present study shows that a near-peer tutorial program can be successfully integrated into a teaching curriculum. The feedback demonstrates that year 1 students are both receptive and find the additional teaching of benefit.