统计软件课程建设思考

目的了解不同层次医学生统计分析软件学习情况和教学影响因素,为提高教学效果提供理论依据。方法自行设计问卷,对某高校医学本科生和研究生进行问卷调查,调查对医学统计软件课程的认知、态度和行为,以及影响教学效果的影响因素。用SAS 9.4统计软件进行统计描述和分析。结果本科生和研究生在对医学统计学软件学习均表示有难度,但更多的研究生表示兴趣浓,更多的本科生认为会对以后学习帮助大。本科生喜欢先复习再做作业,研究生则偏向边看资料边完成作业。研究生和本科生均认为影响学生学习效果的主要原因有：课程自身特点、课程安排、学生的行为、教师授课情况、学生的学习态度;仅在“是否需要课下做练习”方面存在差异。结论需要针对影响因素提出提高教学效果的对策：充分发挥教师主导作用,教学方式多样化,给本科生适当地增加真实世界的非典型案例,端正学生对医学统计学的认识和态度,增加学生的兴趣和学习动机。     

An analysis of the deep social structure preventing the development of a national policy for children and families in the United States

The United States is one of the few economically developed nations without a national policy supporting children and their families. This paper suggests that the United States has a unique national ideology, based on the “Calvinistic Ethic,” which results in opposition to not only social programs for children and families, but to all government supported welfare programs. Such an ethic is not found in European countries. Finally, since the United States does not have a national family policy, millions of children and their families go without health care, lack social services, and suffer from inadequate economic supports.     

Accreditation of Undergraduate and Graduate Medical Education: How do the Standards Contribute to Quality?

Accreditation organizations such as the Liaison Committee for Medical Education (LCME), the Royal College of Physicians and Surgeons of Canada (RCPSC), and the Accreditation Council for Graduate Medical Education (ACGME) are charged with the difficult task of evaluating the educational quality of medical education programs in North America. Traditionally accreditation includes a more quantitative rather than qualitative judgment of the educational facilities, resources and teaching provided by the programs. The focus is on the educational process but the contributions of these to the outcomes are not at all clear. As medical education moves toward outcome-based education related to a broad and context-based concept of competence, the accreditation paradigm should change accordingly.     

Teaching clinical skills to new medical students: the Oman experience

The College of Medicine at the Sultan Qaboos University (SQU) in Oman took up the challenge of moving away from a didactic emphasis in the teaching of family and community health by actively involving students in health care, requiring some clinical skills, as early as possible. This paper describes the experience of the Department of Family and Community Health at SQU of the feasibility of training first-year medical students in the measurement of blood pressure within a few days. Our experience showed that proper training before starting field-work can teach clinical skills to students who have had no prior exposure to medical subjects. There was a strong correlation between the measurements of blood pressure of 638 individuals by the students and the supervisors. This experience at SQU has encouraged us to implement the idea of family- and community-based clinical exposure for every class. Teaching of clinical skills is feasible in the field for new entrants, provided there is adequate orientation beforehand and skilled supervision of the students in small groups.     

浅谈医学院校“形势与政策”课教学改革--基于四个课堂的打造

为更好发挥思想政治理论课的主渠道主阵地作用,切实做好新时代高校思想政治工作。近年来,滨州医学院马克思主义学院立足医学院校的实际和特色,不断强化"形势与政策"课教学改革,坚持内容为王的原则,从引领力、亲和力、塑造力和影响力四个维度入手,努力打造上医课堂、融合课堂、精准课堂和应用课堂,"形势与政策"课的实效性显著增强,受到学生的一致欢迎。     

Estimating the Residency Expansion Required to Avoid Projected Primary Care Physician Shortages by 2035

PURPOSE

The purpose of this study was to calculate the projected primary care physician shortage, determine the amount and composition of residency growth needed, and estimate the impact of retirement age and panel size changes.

METHODS

We used the 2010 National Ambulatory Medical Care Survey to calculate utilization of ambulatory primary care services and the US Census Bureau to project demographic changes. To determine the baseline number of primary care physicians and the number retiring at 66 years, we used the 2014 American Medical Association Masterfile. Using specialty board and American Osteopathic Association figures, we estimated the annual production of primary care residents. To calculate shortages, we subtracted the accumulated primary care physician production from the accumulated number of primary care physicians needed for each year from 2015 to 2035.

RESULTS

More than 44,000 primary care physicians will be needed by 2035. Current primary care production rates will be unable to meet demand, resulting in a shortage in excess of 33,000 primary care physicians. Given current production, an additional 1,700 primary care residency slots will be necessary by 2035. A 10% reduction in the ratio of population per primary care physician would require more than 3,000 additional slots by 2035, whereas changing the expected retirement age from 66 years to 64 years would require more than 2,400 additional slots.

CONCLUSIONS

To eliminate projected shortages in 2035, primary care residency production must increase by 21% compared with current production. Delivery models that shift toward smaller ratios of population to primary care physicians may substantially increase the shortage.     

民办高校与公办高校医学本科生心理素质差异性研究

目的探讨民办高校与公办高校医学本科生心理素质是否存在差异。方法采用"当代大学生心理素质研究问卷"对870名某民办医学院本科医学生及972名某公办医学院本科医学生进行调查。结果民办高校医学本科生的心理素质总分及意志、人际关系、社会适应、竞争等因子得分都显著高于公办高校医学本科生;不同性别、是否独生、不同年级、不同生源地的民办医学本科生与公办高校医学本科生在心理素质总分及多个因子分上差异有统计学意义。结论民办高校医学本科生的总体心理素质不低于同类型公办高校医学本科生,而且在某些因子(意志、人际关系、社会适应、竞争)上显著高于公办高校医学本科生。     

An innovative course: 'Vers l'Europe 1992'

Summary. A course in using French in the consultation is described. This proved a popular exercise with many general practitioners wishing to attend. A previous knowledge of French was essential for acceptance. The course consisted of 10 meetings with homework. Both formal and informal assessment of the course showed the success both from a group and an individual point of view.