循证医学在医学检验教学中的应用

循证医学本是一种新的临床医学模式,其理念和方法已经扩展到整个医学教育领域.七年制临床医学专业(医学检验方向)是为培养高层次医学检验医师而设立的新专业方向,在医学检验中引入循证医学理念具有重要意义.本文对循证医学原则在提高学生临床检验技能、培养学生科研创新能力、教会学生终身主动学习以及提高医学检验在临床实践中的地位等方面的应用进行了初步探讨.

Abstract：

Evidence-based medicine(EBM) is a new model of clinical medicine and its concepts and methods are extend to the field of medical education. Seven-year laboratory medicine program is a new professional, which is to train high-level laboratory examination physician. EBM is of great significance in laboratory medicial education. This article reviewed the principles of EMB in improving the students clinical examination skills, the students innovation ability, the students life-long learning habits and improving the status of laboratory medicine in clinical practice.     

坚持"早正严实"教学指导原则着力培养合格临床医生

本文概述了中山大学医学教育近10年来,传承"三基三严"优良教育传统,创新"三早教育模式",坚持"早正严实"教学指导原则,强化医学生职业素质、实践能力和创新能力,培养合格医学生的理念和实践,以期为学院教育医学生的培养提供借鉴.

Abstract：

This paper presents an overview on the school-running concept and practice of the Medical School of SUN Yat-sen University in recent decade. While inheriting the fine educational tradition of Three "Bs" and Three "Ss" ( emphasizing the mastery of basic theories, basic knowledge and basic skills, as well as the development of serious attitudes, strict operating and stringent requirements for a high standard level ) , we established the Three-early-involvement Educational Model (early involvement in clinic practice, early involvement in scientific research, and early involvement in social practice ). In light of the integrated principles simplified as "earliness, integrity, strictness and solidity" in medical education (including the three-early-involvements; professional morality and medical ethics; the "Three Ss" and "Three Bs" ; solid clinical basics and sound monitoring) , we consolidated the professional quality, practical and innovative abilities of medical students in the cultivation qualified medical graduates. The paper can provide favorable reference for other medical schools in the training of qualified medical students.     

Chinese medicine pattern diagnosis could lead to innovation in medical sciences

Chinese medicine(CM) pattern diagnosis(Bianzheng or syndrome differentiation),as another patient classification approach,has been incorporated with biomedicine diagnosis in clinical practice in China,and the clinical experience has proven that the integration of biomedicine and CM is better in the treatment of many diseases.CM pattern diagnosis is completely different from the diagnosis in biomedicine,and it must take an active role in innovation for medical sciences.This paper is trying to discuss how CM pattern diagnosis lead to innovations in basic research,clinical research and new drug discovery.Scientific basis of CM pattern in innovation of basic research,clinical efficacy and safety,CM pattern based clinical trial design,CM pattern and clinical practice guideline in innovation of clinical study, CM pattern based indication finding,and CM pattern based network pharmacology in innovation of new drug discovery have been discussed.     

临床教学中强化医学生医患交流能力培训的思考

医学生医患交流能力的培训是保证医学教育教学质量的重要环节,目前医学教育中对医学生医患交流能力的培训重视不够.本文探讨了临床教学中强化医学生医患交流能力培训的意义、医学生医患交流中存在的问题,并就如何做好医学生医患交流能力培训提出了建议,以期能够促进医学生医患交流能力的提高.

Abstract：

The education of physician-patient communication for the medical students is an important part, which can guarantee the quality of medical education in the work of clinical teaching. But in the present, medical colleges don't pay much attention to the training of physician-patient communication in the clinical practice for the medical students. This study discusses the importance to cultivate the ability of physician-patient communication for the medical students, the medical students' problems in the study of physician-patient communication in the clinical practice, and the learning suggestions of physician-patient communication for the medical students in the clinical practice, in order to provide reference for clinical teaching work.     

转化医学及其对中国医学的影响

Translational research has become a globally recognized model of medical research. Chinese government and doctors have begun to discuss the plan for its development. But most articles are focusing on the advantages rather than its pros and cons. In this essay, the authors discuss the disadvantages of translational research, its effects on clinical work and medical education, highlighting some potential problems and risks in theory and practice on case basis. Some important research management requirements are summarized in this essay to help bring the therapy from the research laboratory to the patient’s bedside.

     

非直属附属医院持续性发展的探索与实践

在我国高等医学教育规模迅速扩张的形势下,建立非直属附属医院是保证高等医学院校临床教学质量、实现科学发展的重要举措.非直属附属医院承担高等医学教育、科研任务,也是现代社会科学技术综合化、经济发展集约化和高等教育社会化的必然趋势.如何按照"资源共享、优势互补"的原则,不断加强高等医学院校与非直属附属医院的医、教、研合作,推动双方的共同持续性发展,是摆在医学教育管理者面前的重要课题.本文在总结南方医科大学多年校院合作实践经验的基础上,对高等医学院校与非直属附属医院的合作与发展提出了建议.

Abstract：

Under the condition of higher medical education scale rapidly expanded, it is not only an important measure of establishing hospitals affiliated to medical universities to ensure the quality of clinical teaching and to achieve scientific development, but also inevitable trend of integration of science and technology in modem society, economic development and socialization of higher education for non-affiliated hospitals' bearing higher medical education and research tasks. It is an important task in front of medical education administrator that how in accordance with the principle of "sharing of resources and complement of each other' s advantages" , continue to strengthen the cooperation between medical colleges and non-affiliated hospitals in the field of medical treatment, higher education and scientific research, promote continuous development of both sides. The article summarized many years of practical experience of cooperation between universities and hospitals, put forward some ideas about cooperation and development between universities and hospitals.     

高等医学教育中营养学课程设置的探讨

高等医学教育中涉及营养学的教学内容在不同专业中差别较大,对于临床医学专业,教学内容少,深度亦不够,教学质量难以保证,主要原因在于营养学课程在高等医学教育中的重要性尚未得到充分的肯定.营养学课程的设置是必要的也是可行的,应当注重临床医学专业学生的营养学教育,充实教学内容,加强临床实践,不断提高教学质量.

Abstract：

The teaching contents about nutrition are different among majors in higher medical education.For clinical medicine,because of little content and inadequate profundity, teaching quality is hard to be ensured. The main reason is that the importance of nutriology in higher medical education hasn't been confirmed sufficiently.In fact course offering of nutriology is necessary and feasible. To improve teaching quality, nutrition education for clinical medicine should be emphasized by means of enriching teaching materials and enhancing clinical practice.     

Principles of ethics review on traditional medicine and the practice of institute review board in China

As one of the significant parts of medical science research in China,the research on Chinese medicine(CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture.Therefore,in the practice of ethics review on CM research protocols,besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study,we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values.In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics,and then attempted to summarize the key points for the bioethics review to CM researches in China,so as to serve as reference for the bioethics review to traditional and alternative medicine researches.     

Analysis of High Alert Medication Knowledge of Medical Staff in Tianjin:A Convenient Sampling Survey in China

The current situation of medical staff’s awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff’s average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation(F=4.86, P=0.003), education background(F=5.57, P=0.019) and professional titles(F=13.44, P≤0.001) contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.     

七年制医学生急诊医学临床实习教学实践与思考

本文回顾了七年制医学生急诊医学临床实习教学的实践,初步探讨了本门课程的临床实习教学规律.针对教学活动中存在的问题,结合当前医疗环境,实施了转变急诊医学临床实习教学理念,优化教学方法,注重培养急诊医学临床思维能力,加强急救技能培训,提高医患沟通能力与技巧,强化医疗、科研综合素质,建立和谐平等师生关系等举措,取得了良好的教学效果.

Abstract：

In this paper the writer reviewed the experience gained from the clinical teaching of emergence medicine of seven-year program students and primarily explored the teaching principles of this clinical course. Targeted at solving the problems found in teaching activities and taking the current medical environment into account, the writer proposed the following clinical teaching methods to achieve a better effect With the transformation of clinical emergence medicine teaching philosophy, the clinical teaching should lay its focuses on the cultivation of capability of scientific thinking and the practical skill training of clinical emergence medicine. Besides, the enhanced communication skills between doctor and patient, the strengthened comprehensive quality of medical practice and scientific research of teachers and the establishment of equal and harmonious teacher-student relationship would contribute greatly to the improvement of clinical teaching as well.     

南京医科大学七年制临床医学专业人才培养效果评价

通过对毕业生及其培养或用人单位的问卷调查,本文分析了南京医科大学七年制临床医学专业人才培养的成效,以及江苏省医疗卫生事业发展对高层次医学人才的需求.结果 显示,临床实践能力和科研创新能力是医疗卫生事业发展所需要的高层次医学人才的重要能力;在三级甲等医院工作,具有硕士/博士学位、在专业技术岗位的被调查者更加看重医学生的科研创新能力;而在"1年通识教育、4年医学专业教育(含1年临床课程及见习、1年临床通科实习)、2年二级学科轮转"模式下培养的七年制临床医学专业毕业生的临床实践能力较强,但是科研创新能力不足,且学业负担偏重.因此,应当加强对七年制临床医学专业学生科研创新能力的培养和临床实践能力的通科训练.     

儿科临床实践性教学改革体会

目的：改革传统的临床实践教学方法,以适应高等医学教育发展的要求,培养更多高素质、适应社会需要的儿科医学人才。方法：在教师方面,严格教师准入制度及教师教学综合能力培训、改良教师教学质量评估体系以提高师资教学水平。在学生培养方面,突出医学人文教育,注重医学生沟通能力培养;增加突出实践特色的儿科临床实践教学模块及临床技能模拟训练等。结果：儿科学教学达到了国际医学教育的基本标准,部分达国际医学教育高标准;学生质量社会评价良好;国家精品课程建设取得成功。结论：临床实践性教学活动开展具有学习、借鉴和推广的价值,将会对临床医学生的临床实践能力有极大的促进和提高作用,有助于为社会培养有用的人才。     

大型医院创新型高级临床医学人才终身教育体系的构建

针对我国大型医院创新型人才岗位任职需求,紧密结合创新型人才培养的标准,研究构建了创新型高级临床医学人才终身教育体系,以及"三位一体"的高级临床医学人才素质和能力终身培养的新机制。为解决目前医学毕业生岗位胜任能力不够强、在职临床医学人才发展缺乏引导、空间受限等固有问题提供参考。     

八年制临床医学神经病学教学方式的探讨

八年制临床医学教育是目前医学教育的最高层次,是一种精英教学模式。其中临床能力是基础,科研是紧跟医学前沿的国际化需求,英语水平则是两者结合的桥梁和手段。通过总结近年来八年制临床医学神经病学理论教学、临床见习和实习三阶段的教学实践,重点强调了培养学生临床思维和实践动手能力,提升专业英语应用水平,锻炼科研思维的重要性,从而造就具有较强的临床实践技能和初步科学研究能力、发展潜力远大、创新能力和国际竞争力强的临床医学专门人才。     

八年制医学生法医兴趣小组的组建方式及作用

八年制医学教育的目标是培养高层次、高素质的临床和科研人才。通过建立八年制医学生法医兴趣小组,着重培养学生的英语应用能力、实践动手能力、创新思维能力,弥补八年制医学教育培养中相对薄弱的环节,实现八年制医学教育与法医学教学改革的有机结合。     

重庆市首届农村订单定向医学生基层工作情况及对策建议

背景　国家发展改革委等5部门于2010年启动实施农村订单定向医学生免费培养工作，截至目前已为中西部乡镇卫生院培养了近5.7万名订单定向生，从规模上实现了为中西部每家乡镇卫生院培养1名从事全科医疗本科医学生的“全覆盖”。订单定向医学生在基层的工作和生活现况，以及基层医疗卫生单位对订单定向生的评价，是值得进一步关注的问题。目的　了解重庆市2010级首届订单定向生在基层的工作和生活情况，进而为订单定向生的培养与使用提供建议。方法　于2019年8-12月，以重庆市2010级完成5年本科医学教育、3年住院医师规范化培训并履约到基层工作的首批订单定向生为调查对象（n=160），采用研究组自行设计的调查表，调查其工作单位情况、薪酬待遇、服务期满后的工作计划、生活状况及面临的困难、对基层工作满意度等。另分别对重庆市永川区、南岸区、梁平区、黔江区订单定向生所在区（县）卫生健康委相关管理人员、签约乡镇卫生院的院负责人和中层管理人员共38人开展焦点小组访谈，主要访谈其对首届农村订单定向医学生的评价、影响订单定向生“扎根基层”的因素及培养建议等。结果　最终回收有效调查表121份（75.6%）。工作方面：43例（35.5%）订单定向生所在工作单位已设立全科医学科/全科诊室；16例（13.2%）在工作单位从事全科岗位；98例（81.0%）月收入<6 000元；97例（80.2%）已通过中级职称考试，但其中的90例（92.8%）尚未被聘为主治医师；81例（66.9%）近一年未参加过继续医学教育培训/学术会议；对于服务期满后的工作计划，66例（54.6%）表示不清楚，5例（4.1%）计划继续留在基层工作。生活方面：21例（17.4%）订单定向生表示单位提供免费周转房，93例（76.9%）认为单位不能为其解决部分实际困难。对基层工作的满意度方面：86例（71.1%）订单定向生对个人收入不满意，57例（47.1%）对工作岗位和承担任务不满意，24例（19.9%）对个人工作业绩不满意，22例（18.2%）对单位领导重视程度不满意。访谈结果显示：订单定向生在基层工作单位展现出较强的学习能力，综合素质较高，但收入欠佳；受多种因素影响，订单定向生长期服务基层的意愿不强；建议高校和住院医师规范化培训单位加强对订单定向生思想方面的引领，同时加强订单定向生与签约单位的沟通。结论　首届订单定向生在乡镇卫生院的工作满意度不高，基层单位对订单定向生重视程度不足，订单定向生培养模式和签约单位的需求“脱节”。教育培训单位应该进一步完善订单定向生培养模式，相关政府部门须全面落实薪酬及职称晋升等相关待遇，使订单定向生能够“下得去、用得上、留得住”。     

临床医学科学学位研究生培养模式探索

研究生教育是国家教育层次结构中最高的教育等级,承担着为国家提供高层拔尖创新人才支撑和自主创新的历史重任。目前,医学学位分为2种类型：临床医学科学学位和临床医学专业学位。与临床医学专业学位研究生不同,临床医学科学学位研究生有其重要性及特殊性,在招生、科研与临床能力培养及教育评价体系上面临诸多问题。通过改革招生计划、加强临床能力培养和建立健全教育评价体系,可提高临床医学科学学位研究生的培养质量。     

某省医疗机构病案管理人员需求调查分析

目的 对某省医院病案室工作人员及相关专业学生进行调研,以了解某省医疗机构对病案人员的需求情况.方法 2012年8月至2013年8月对某省19所医院以量表和访谈等形式进行调研,调研医疗机构中,有15所三级医院,3所为二级医院,1所社区卫生服务中心,对邻省9所医院进行了量表调研,以作参照.同时与病案专业实习生和毕业生就工作情况进行调研.结果 医院已经基本实现了信息化,病案管理专业工作人员的比例逐年提高.很多医院急需病案管理人才,但囿于人才规格的限制,需要本科以上学历,卫生信息管理等相关专业,故难以招到合适的人才.同时发现病案管理工作工作者普遍存在临床医学知识欠缺等问题.结论 我省的病案人才十分紧缺,须尽快建立完善的高等教育和在职人员再教育体系.针对一些三甲医院,可以尝试病案管理人员分科负责制,不断积累某一学科的临床知识,从而提高医院病案管理的效率和质量.     

浅议如何培养医学研究生的创新能力

研究生创新能力的培养是医学院校培养研究生的关键,其目的是培养和造就大批具有创新人格、创新意识、创新能力的复合型创新人才。本文从创新的内涵、医学研究生创新能力培养的重要性、创新能力培养的现状和途径四个方面阐述如何加强临床医学研究生创新能力的培养。     

从美国外科住院医师培训制度看如何改进我国临床研究生教育

临床研究生是我国继续医学教育的重要组成部分。借助美国住院医师培训制度的经验,对改进我国临床研究生教育,提高其临床工作能力提出一些建议。改变或摒弃目前临床硕士研究生的培养模式,适当降低临床博士研究生的科研要求,加强和完善博士生的临床考试和考核制度,对增加临床博士生毕业后的临床工作能力是有益的。将目前的临床研究生教育与专科医师培养制度衔接起来亦可以作为提高临床研究生工作能力的一种方法或作为全面推行专科医师培养制度的一个过渡阶段。