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All 115 graduates qualifying at Liverpool University Medical School in one year were sent a questionnaire in the final week of their preregistration year to assess the experience they had gained. Of the 105 graduates (92%) who replied, 99 (94%) considered the supervision that they had received to be adequate, 89 (85%) received most of their teaching from other junior doctors, and only 47 believed that they had learnt a considerable amount from their consultant colleagues. Half of the doctors received little or no training in terminal care. Although 100 (95%) felt competent in dealing with various medical emergencies, cardiopulmonary resuscitation skills were less developed; only 71 (68%) were confident in using a defibrillator, and 37 (35%) considered themselves to be competent in dealing with cardiac arrhythmias. A fifth of the doctors found interviewing relatives stressful. Of the 105 doctors who replied, 77 (73%) thought that their preregistration experience had had little or no effect on their choice of career.  相似文献   

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Campbell AV 《Bioethics》1995,9(3-4):252-258
The New Zealand health service has been extensively changed over the past four years, with the introduction of four new Regional Health Authorities, required to purchase services on behalf of the Government from a range of providers. In order to ensure fairness across the four regions a Core Services Committee has been set up to define which services must be purchased. However, no clear agreement has emerged about a "core" and no list, either positive (inclusions) or negative (exclusions), has been defined. Instead general criteria have been suggested and steps have been taken to consult the community on their priorities. This paper describes seven workshops run by the author in an effort to discover how the community would reach decisions on the rationing of scarce resources. The outcome of these workshops is that there is virtually no community support for an approach based on the social utility of individuals in need.  相似文献   

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《新西兰生态学杂志》2011,28(2):267-278
The striped skink (Oligosoma striatum) is a poorly known New Zealand endemic species rarely seen in the wild despite ongoing efforts to locate specimens. It is uncertain whether its threatened status is due to low numbers, or to unusual habitat use and activity patterns that make it difficult to detect. Anecdotal reports indicate the species may be partly arboreal. We carried out captive-based behavioural comparisons between striped skinks and the common terrestrial brown skink (Oligosoma zelandicum). Brown skinks are of similar mass to striped skinks and overlap in geographic range and habitat, but are easily captured by hand and pitfall trapping in the wild. They were therefore a suitable comparison from which to assess activity levels and arboreal tendencies in striped skinks, with the aim of improving survey methods. Point samples and total frequencies of behaviours were collected using time-lapse video recordings taken concurrently of individuals of each species occupying identical enclosures. Striped skinks had significantly higher levels of diurnal activity than brown skinks. They also showed periods of nocturnal activity associated with high moisture levels. When active, the types of behaviours carried out by each species were very similar, as were the proportions of active time spent carrying out each behaviour. Striped skinks spent significantly longer periods at greater heights within the enclosure than brown skinks, indicating stronger arboreal tendencies. High levels of arboreal activity and in particular nocturnal activity may make striped skinks more vulnerable to introduced predators such as rodents and possums. In order to accurately assess the status and carry out long-term monitoring of the striped skink, new survey and capture techniques will be required. Arboreal traps, visual canopy surveys and surveying felled trees are recommended.  相似文献   

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OBJECTIVE: To determine whether use of a log book improved the experiences of preregistration house officers. DESIGN: Confidential questionnaire and interview survey of preregistration house officers carried out as part of University of London inspection process. MEASURES: Preregistration house officers were asked to rate educational and pastoral elements of their posts and about the use made of previously distributed log books. SUBJECTS AND SETTING: Preregistration house officers in North Thames. RESULTS: The incumbents of 535 of 560 (95%) preregistration house officer posts in the region were surveyed between June 1994 and July 1995, 490 by questionnaire and interview, 45 by questionnaire alone. House officers who had discussed the log book with their consultant expressed more satisfaction with their induction, consultant supervision and feedback, and formal and informal education and were more likely to recommend their job to a friend. CONCLUSION: Preregistration house officers who had discussed the log book with their consultant expressed more satisfaction with the educational elements of their jobs. The structured discussion with their consultant about the job and their performance seemed to make the difference.  相似文献   

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《新西兰生态学杂志》2011,27(2):207-220
There is a lack of comprehensive and consistent information to inform policy makers about the status of New Zealand’s forest biodiversity. Three reasons for collecting such information are: assessing the effectiveness of management, reporting on the status of biodiversity under national and international requirements, and improving our knowledge of ecosystem dynamics for designing effective management systems. The challenge is to design monitoring systems that address these multiple needs simultaneously, and at a range of spatial and temporal scales. This article first considers principles for designing enduring monitoring systems based on past experiences, assessing how effectively these principles were implemented in designing New Zealand’s Carbon Monitoring System (CMS), and finally, suggesting future directions for forest biodiversity monitoring in New Zealand. At a national scale we support an unbiased, systematic sample of forests as implemented in several countries (e.g. Austria and the U.S.A.). We consider it best practice to monitor shifts in the fundamental compositional, structural and functional characteristics of ecosystems and use these to derive indicators. We suggest forest biodiversity indicators should include forest area and spatial arrangement, tree mortality and recruitment, exotic weeds, introduced herbivore impacts, and woody debris. Principles discussed in this paper are relevant to biodiversity monitoring in a wider range of ecosystems than forests. Without spatially extensive, robustly designed, biodiversity monitoring systems, New Zealand will remain in a relatively weak position nationally, and internationally, to report on the effectiveness of biodiversity conservation.  相似文献   

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OBJECTIVE--To determine the opinions, attitudes, and requirements of consultants responsible for preregistration house officers in the light of the General Medical Council''s Recommendations on General Clinical Training. DESIGN--A questionnaire was piloted asking 28 questions under the headings professional details, present training arrangements, effectiveness of current training, and perceived help required for implementing the recommendations. SETTING--Two teaching hospitals and nine district general hospitals in the Yorkshire region. SUBJECTS--33 consultants (19 physicians, 14 surgeons) responded to an hour long interview. RESULTS--The traditional teaching ward round, with clinical meetings, was the main educational provision for house officers. Under a quarter of respondents provided specific teaching, which rarely exceeded 30 minutes weekly. Many delegated teaching to other junior or non-medical staff. Few consultants assessed the effectiveness of teaching, and feedback to juniors was rudimentary. There was strong support for the apprenticeship system and concern that it should not be downgraded. Appointing educational supervisors and introducing a structured educational programme were approved theoretically. Pressure on consultants to work faster, participate in audit and management, and accept financial responsibility for their clinical work, coupled with the reduction in junior doctors'' hours, were considered to militate against educational developments. Many respondents felt frustrated and powerless. They would welcome an increased educational role but considered there must be conceptual, contractual, and financial changes. CONCLUSIONS--Fundamental changes are required by both consultants and management before the preregistration year can have proper educational value. Training in educational methods for consultants and a structured curriculum and formative assessment for trainees require recognition and financial support.  相似文献   

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The Safety Net is a clearing system that collects and distributes information about preregistration posts remaining unallocated after as many doctors as possible have been placed by local efforts. Provided that the local systems operate in the final year, the Safety Net should ensure that each student has a post allocated to him before he sits the final examination.  相似文献   

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