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。     

新时期我国医学院校与附属医院关系研究

临床医学教育作为高等医学教育的重要组成部分,对医学人才的培养、医疗水平的提高起到了至关重要的作用。通过梳理我国高等医学体制改革,对比我国和欧美发达国家高等医学教育管理体制差异,提出改革我国高等医学院校与附属医院关系的政策建议,以求更好地保障和提高临床医学教育质量。     

猫及家兔骨髓神经支配的形态学研究

有关骨髓神经支配的解剖学记载,很片断且不完善。尽管生理学的研究已经证明骨髓中的血管受血管运动神经支配(Foa),并以充分的实验事实证明了骨髓中有内感受器的存在,特别是指出了有非常锐敏的化学感受器的存在;临床上实行骨髓穿刺时常产生剧烈的疼痛,临床医学家则认为骨髓是有感觉的。然而关于骨     

循证医学应用于急诊临床教学的价值

被誉为“21世纪临床医学新思维”的循证医学（Evideneedbased medicine,EBM）日益引起广大包括急诊医师在内的临床医学工作者的关注。EBM的出现为现代医学教育提供了新的教学模式．在急诊医学临床实习教学中应用EBM．对促进循证医学的发展。培养高素质的急诊医学人才,提高医疗质量将产生重大的影响。     

临床护生综合能力培养的体会

我国卫生部在<中国护理事业发展规划纲要(2011~2015年)>中指出:完善护理教育方式,坚持以岗位需求为导向,促进理论与实践相结合,大力培养临床实用型人才,注重护理实践能力的提高;突出护理专业特点,在课程设置中加大心理学、人文和社会科学知识的比重,增强人文关怀意识[1].临床护理教学是护理教育的重要组成部分,其质量直接影响护生未来的职业素质和临床工作能力[2].因此,寻求合理的临床护生带教模式,提高临床护生的综合能力以适应快速发展的医疗服务和需要是不容忽视和亟待解决的问题.     

《生物医学工程与临床》征订启事

《生物医学工程与临床》是一本连接临床与生物医学工程的综合性刊物。是中国科技论文统计源期刊(中国科技核心期刊),并已被美国《化学文摘》(Chem Abstract)、俄罗斯《文摘杂志》(AJ of VINITI)、英国《国际农业与生物科学研究中心》(CABI)等国际检索系统收录。本刊宗旨是以生物医学工程和临床的理论与实践相结合,涵盖生物医学工程学及其相关的临床医学各学科,注重生物医学工程学在临床医学中的应用研究和新技术、新经验、新成果的推广。以生物医学工程高起点为目标,以突出临床医学为特色,内容涉及医疗仪器、生物力学、生物材料、     

“全国临床医学工程专家库”专家研讨会在京召开

由国家卫生部医院管理研究所及中华医学会临床医学工程学会主办的“全国临床医学工程专家库”专家研讨会于2005年7月25日～26日在北京召开。100多位来自全国各地的临床医学工程专家及有关主管机构的行政领导出席了会议。卫生部医政司张宗久副司长、卫生部医院管理研究所于宗河所长等领导与会讲话。中华医学会临床医学工程学会主委彭明辰教授、副主委谢松城教授及南京军区卫生部药材处姚一旦处长等多位专家教授作了专题报告。会议还安排半天时间进行分组讨论。代表们就：（1）怎样认识医疗环境下的仪器设备;（2）临床医疗所依赖的资源;（3）医疗技术评估与设备临床验收（如X线CT技术与CT装置等）;（4）创造条件,建立相应的数字医学技术评价组织等问题进行了热烈的讨论。     

基层医院输血科工作现状及改进

输血是现代医学中重要的抢救、治疗手段,临床输血是一门极其复杂的学科。血液及其制品的管理是一项科学的系统工程,是保证血液质量、提高医疗用血效率、促进输血事业和科研技术水平不断发展的关键。输血科是医院的重要部门,具体负责临床用血的技术指导和技术实施,确保贮血、配发血和其他科学、合理用血措施的执行,其基本目的是将血液及成分安全、有效、合理而便宜的输注给需要的病人并取得疗效。输血科如何履行好职能,保证临床输血安全、科学、合理、有效,已成为当前基层医院首先需要解决的问题。本文就基层医院输血科的工作状况进行了分析,并提出完善规章制度,严格执行操作,更新输血观念,科学合理用血,开展业务新技术,保证输血有效性等相应整改措施,在实际运行中取得可喜的成绩。     

《生物医学工程与临床》征订启事北大核心CSCD

《生物医学工程与临床》是一本连接临床与生物医学工程的综合性刊物。是中国科技论文统计源期刊(中国科技核心期刊),并已被美国《化学文摘》(Chem Abstract)、俄罗斯《文摘杂志》(AJ of VINITI)、英国《国际农业与生物科学研究中心》(CABI)等国际检索系统收录。本刊宗旨是以生物医学工程和临床的理论与实践相结合,涵盖生物医学工程学及其相关的临床医学各学科,注重生物医学工程学在临床医学中的应用研究和新技术、新经验、新成果的推广。以生物医学工程高起点为目标,以突出临床医学为特色,内容涉及医疗仪器、生物力学、生物材料、     

创新性教育在长学制医学生人体解剖学教学中的探索与实践

人体解剖学是医学科学中一门重要的基础课程.长学制医学教育是一种新模式,创新性教育是一种新理念.为了探索长学制医学生人体解剖学的创新性教育,我系在过去五年中以国家精品课程建设为契机.以"培养创新人才"为指导思想,更新教学思想,实行PBL教学,引入"RA"的训练体系,推行青年教师培养的"六个一工程"和国内、国外互动发展的人才培养新模式,取得了初步成果.本文对此进行总结,以期抛砖引玉,引起更多同行的共鸣而促进<人体解剖学>课程的建设.     

“分子与细胞”翻转课堂教学模式在临床专业教学中的探究

提高医学创新人才培养手段是医学教育改革的重点内容之一。"分子与细胞"是临床医学教育改革的重点专业基础课,也是一门全新的整合课程,具有学时多、难度大且要求和临床专业紧密结合的特点。如何转变临床专业课程的传统教学模式,是临床专业课程改革创新的焦点。该研究通过基于嵌入式文献阅读和临床案例式的翻转课堂教学模式,将传统的面对面授课转化为以学生为中心的授课方式,将课堂主阵地由线下转移至线上,为线下课堂提供了更多创新融合的方式,同时增强了医学生对于生命学基本原理的理解,为培养具有精准医学专业背景的医学生提供了理论基础。通过三年的翻转课堂实施,临床专业卓越医生试点班学生对教学满意度以及学生成绩显著提升,说明在临床专业整合课程开展翻转课堂教学具有积极意义。     

我国本科护理专业开设循证医学课程的现状

循证医学是二十一世纪医学实践的新模式,是指导临床医生和医学生进行科学医疗实践的一种工具,又是实现临床医生终生自我教育的一种好的方法。循证医学的理念和方法对护理专业的影响,必将促进护理向科学化护理迈进,而循证医学教育是促进护理人员掌握循证医学知识和技能的关键,本文重点论述了我国本科护理专业开设循证医学课程的现状以及存在的主要问题。     

Knowledge Levels and Training Needs of Disaster Medicine among Health Professionals,Medical Students,and Local Residents in Shanghai,China

Background

Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education.

Methods

A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%.

Results

Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001).

Conclusions

Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current needs of disaster preparedness. Continuing medical education and public education plans on disaster medicine via media should be practice-oriented, and selectively applied to different populations and take the knowledge levels and training needs into consideration.     

Flexner redux

Medical education in the 20th century has been vastly influenced by the Carnegie Foundation Flexner Report. The basic tenets of the modern four-year medical curriculum and the dominant role of the associated university teaching hospital were cemented into place and have remained the paradigm of the present-day medical educational process. The Flexner Report contributed importantly to the development of the modern health-care system. Despite enormous success, a number of current problems have been identified in today's medical educational curricula and have catalyzed the generation of a new Carnegie Foundation report that emphasizes the building of strong bridges across the artificial divide that separates the basic science and clinical years and lays the foundation for the growth and development of translational medicine. In addition, the report raises crucial issues regarding a national medical workforce policy.     

医院科研管理与创新对转化医学实施的推动作用

转化医学是近年来国际医学界推崇的一个重要医学理念,正日益成为生命科学和医学研究关注的热点。转化医学已不仅强 调临床医学与基础医学的结合,而且涉及多个学科之间的融会贯通。因此,医院科研管理的支持和重视程度转化医学实施的主要 动力,而科研项目的创新性、可行性是决定转化医学研究立项的关键。我院自2010 年成立转化医学研究中心以来,已将多项成果 成功转化并应用于临床实践,为生命科学研究领域中人类健康计划的发展提供了借鉴。本文结合我院实际,分析科研管理对转化 医学成果实施的促进作用,为医疗机构的科研管理人员提供参考。     

提高临床实习教学质量的实践与体会

临床实习是医学生大学教育阶段的重要组成部分,是医学生向临床医生转型的过渡时期。临床实习质量的高低直接关系到医学生的培养质量。在实习期间培养出扎实的临床基本功、科学的临床思维和高尚的医德医风对于医学生而言是非常重要的。同时,临床实习教学也是医学院校及教学医院的工作重心。作为教学医院,我院多年来积极推进教学改革,不断探索提升临床实习质量的方法,部分科室率先开展了PBL等新的教学模式,并取得了卓越的成效。我院领导阶层也通过抓好教学准备、提升带教质量、严格实习考核等方面的工作,全面提升了临床实习教学质量,从而提高了医学生的综合素质,也为提高执业医师考试通过率打下了坚实的基础。     

Developing a Curriculum for Evolutionary Medicine: Case Studies of Scurvy and Female Reproductive Tract Cancers

Most early evolutionary thinkers came from medicine, yet evolution has had a checkered history in medical education. It is only in the last few decades that serious efforts have begun to be made to integrate evolutionary biology into the medical curriculum. However, it is not clear when, where (independently or as part of preclinical or clinical teaching courses) and, most importantly, how should medical students learn the basic principles of evolutionary biology applied to medicine, known today as evolutionary or Darwinian medicine. Most clinicians are ill-prepared to teach evolutionary biology and most evolutionary biologists ill-equipped to formulate clinical examples. Yet, if evolutionary science is to have impact on clinical thought, then teaching material that embeds evolution within the clinical framework must be developed. In this paper, we use two clinical case studies to demonstrate how such may be used to teach evolutionary medicine to medical students in a way that is approachable as well as informative and relevant.     

Using a high-fidelity patient simulator with first-year medical students to facilitate learning of cardiovascular function curves

Students are relying on technology for learning more than ever, and educators need to adapt to facilitate student learning. High-fidelity patient simulators (HFPS) are usually reserved for the clinical years of medical education and are geared to improve clinical decision skills, teamwork, and patient safety. Finding ways to incorporate HFPS into preclinical medical education represents more of a challenge, and there is limited literature regarding its implementation. The main objective of this study was to implement a HFPS activity into a problem-based curriculum to enhance the learning of basic sciences. More specifically, the focus was to aid in student learning of cardiovascular function curves and help students develop heart failure treatment strategies based on basic cardiovascular physiology concepts. Pretests and posttests, along with student surveys, were used to determine student knowledge and perception of learning in two first-year medical school classes. There was an increase of 21% and 22% in the percentage of students achieving correct answers on a posttest compared with their pretest score. The median number of correct questions increased from pretest scores of 2 and 2.5 to posttest scores of 4 and 5 of a possible total of 6 in each respective year. Student survey data showed agreement that the activity aided in learning. This study suggests that a HFPS activity can be implemented during the preclinical years of medical education to address basic science concepts. Additionally, it suggests that student learning of cardiovascular function curves and heart failure strategies are facilitated.     

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。