中国新型冠状病毒肺炎疫情期间医学寄生虫学的混合式教学

新型冠状病毒肺炎（简称新冠肺炎）的大流行促进了各高校线上教学模式的发展。各种线上教学模式都有其突出的优点和难以避免的缺点。线上与线下教学相结合的混合教学是一种新的教学方式,有利于充分发挥线上与线下教学的优势,在新冠肺炎疫情期间,甚至到后疫情时代都具有广泛的应用价值。医学寄生虫学是医学基础课,也是和临床医学、预防医学相衔接的桥梁课程。传统的《医学寄生虫学》教学存在诸多教学困境和痛点,如教学观念和教学模式陈旧,理论教学与实践教学脱节等。针对这些困境,《医学寄生虫学》教学改革采用了多种创新思路和措施,包括与时俱进更新教学大纲与教材、采用创新教学模式、运用混合式教学工具、建立多维度教学评价方法等。本文总结了新冠肺炎疫情期间我国《医学寄生虫学》混合式教学的工具、平台、方式、效果和评价方法,以期为后疫情时代的教学改革提供参考。     

基于SPOC的流行病学线上线下混合式教学的探索与实践

流行病学是预防医学的基础学科,具有很强的理论性和实践性。新冠肺炎疫情防控阶段,如何提高学生的实践能力,更好地为疾病防控服务是流行病学课程教学改革面临的重要问题。基于小规模限制性在线课程（small private online course, SPOC）概念的线上线下混合式教学是一种新兴的教学模式,目前已在多所高校推广应用。本文结合流行病学课程特点和教学现状,从开展混合式教学的必要性、流行病学SPOC混合式教学实践过程以及教学反思等方面进行了探讨,为流行病学教学改革工作提供参考。     

“钉钉”课堂在来华留学生人体寄生虫学课程教学中的实践与思考

“钉钉”线上教学是基于教育部门引领下的“互联网+教育”新模式,具有其他线上教学方式所没有的独特优势。全球新冠肺炎疫情背景下,安徽医科大学针对来华留学生开展了“钉钉”课堂线上教学实践。本文从“钉钉”课堂在留学生人体寄生虫学课程教学中的实践着手,总结“钉钉”课堂的优势及问题,提出线上教学建议,以期为来华留学生人体寄生虫学课程线上教学提供参考。     

研究性教学在航空航天生理学课程教学中的探索

航空航天生理学是航空航天医学的主干学科,也是培养航空航天医学人才的关键课程。为培养该专业学生的岗位任职能力,在课程教学中引入了研究性教学形式,采用课堂授课与专题讨论课、综合案例分析课、“开放式”论文撰写相结合的教学办法;配套更新了课程考核方式,使其更全面地反映学生的学习效果。探索研究发现,该方法不仅提高了学生的学习兴趣,同时,通过自主学习促进了个人知识体系的构建,提高了灵活运用理论解决实际问题的能力。此外,提升教师的综合素质以及建立专业的信息资源库有助于更好开展研究性教学。     

特色教学和科研结合创新航空疗养与康复课程

为贯彻新时代教育方针和加强内涵式发展要求，我校航空航天医学系不断创新教学内容，以更好地培养航空医疗和航空医学专业人才。现有的航空航天医学教学体系中针对航空疗养与康复的内容较少，而航空疗养与康复是飞行人员医学保障的重要内容。因此，我们分别在《航空临床医学》、《航空航天医学》和《航空航天医学前沿》三门已有课程中增加了航空疗养和康复内容。教材编写和教学内容设计突出需求，比如重点阐述心血管系统疾病的疗养与康复等，区别不同教学对象和课程教学重点、难点，将教学和科研有机结合，有效拓展了航空航天医学教学体系。     

线上学习+游戏互动式课堂对实践教学效果的影响

目的 利用寒冷血管扩张反应评价机体耐寒能力是职业卫生与职业医学实践教学的重要内容。为使学生更易掌握寒冷血管扩张反应及波动性皮肤温度变化与机体耐寒能力的关系,提出了线上教学资源学习+游戏互动的教学新模式。 方法 利用线上教学平台实现线上教学资源的分享与学习,随后通过游戏化教学设计完成线下课程的教学过程,学生对教学内容的掌握情况及新教学模式的认可度通过课后问卷调查进行反馈。 结果 发现线上学习+游戏互动式课堂与传统课堂相比,学生在课前就能通过线上教学资源完成VRCI测定方法与原理的学习。通过问卷及考试的方式可以发现,线上学习+游戏互动式课堂在学生理论知识巩固程度（p<0.001）、学习主动性（p<0.001）、考试成绩（p<0.01）及课堂满意度（p<0.05）等方面均表现出明显优势。 结论 游戏化教学设计不仅使学生充分掌握线上教学资源的相关内容,更能提高课堂学习兴趣。学生的参与度和知识掌握程度均有不同程度的提高。     

翻转课堂在航空航天心血管医学教学中的应用—以“失重对心血管功能的影响”为例

目的 探索翻转课堂在航空航天心血管教学中的应用方法和效果。 方法 以“失重对心血管功能的影响”章节为例,选取2018级航空航天专业学员49名学员,采用传统教学模式进行授课（对照组）,选取2019级航空航天医学专业44名学员,采用翻转课堂教学模式进行授课（实验组）。通过考试成绩、调查问卷结果对翻转课堂教学方法进行评估与分析。 结果 实验组学员失重相关章节试题考试成绩明显优于对照组（P<0.05）;问卷调查结果表明翻转课堂模式下教学效果明显优于传统教学模式。 结论 采用翻转课堂的教学模式能够解决航空航天心血管医学课程教学中的痛点问题,打破传统教学模式的限制,提高相关课程教学质量。     

新疆某高校卫生学课程线上教学满意度调查

目的 了解2022年秋季学期新疆某高校卫生学课程线上教学的满意度。方法 运用整群抽样方法对线上学习卫生学课程的本科生通过“学习通（超星）”平台开展线上问卷调查，问卷内容包括研究对象的基本信息以及对教学平台、自己学习状态及效果、课堂氛围、教师教学过程、师生互动情况的满意度。结果 收回有效问卷791份，对线上教学平台非常满意和满意分别占40.20%和50.44%；对自己线上学习状态非常满意和满意分别占18.71%和39.32%；对自己线上学习效果非常满意和满意分别占17.70%和36.03%；对教师线上教学过程非常满意和满意分别占32.37%和55.88%；对线上教学的课堂氛围非常满意和满意分别占23.77%和48.67%；对线上教学的总体非常满意和满意分别占33.76%和49.30%。结论 学生对卫生学课程的线上教学总体满意度较好，可通过积极调动课堂氛围及优化课堂互动提高学生的总体满意度。     

新冠疫情期间药物临床试验受试者的管理

2020年新冠疫情爆发以来，药物临床试验面临前所未有的困难，造成受试者访视超窗、脱落等一系列问题。根据国家和地方政府关于新冠疫情防控政策要求，国家肾脏疾病临床医学研究中心在遵守药物临床试验质量管理规范的基础上，加强各部门人员培训、协调沟通，及时调整随访方式、优化随访环节管理，保证受试者随访依从性，从而保障药物临床试验顺利开展。本文总结国家肾脏疾病临床医学研究中心在新冠疫情期间药物临床试验受试者的管理经验，为其他单位药物临床试验突发状况时受试者的管理提供参考和借鉴。     

航空航天心血管医学课程思政建设思考与建议

加强航空航天医学课程思政建设,使专业课程教学与思想政治教育同向同行,形成协同效应,是落实新时代军事教育方针的重要途径。本文对航空航天医学课程思政建设的必要性进行了分析,结合专业培养目标及任职需求提出了航空航天医学课程思政建设的整体思路和实践路径。     

Challenges of routine diabetes care during COVID-19 era: A systematic search and narrative review

BackgroundThe world is facing the current COVID-19 pandemic. The pandemic response is affecting routine health care provision all over the world. We aimed to review the relevant literature and highlight challenges in the provision of routine care for patients with diabetes during the COVID-19 outbreak.MethodsWe systematically searched PubMed, ScienceDirect, and Embase databases up till August 13, 2020 and retrieved relevant articles published on difficulties on routine diabetes management during the COVID-19 pandemic.ResultsThrough our reading of the recent literature discussing the difficulties of routine healthcare provision for patients with diabetes amid the COVID-19 pandemic, we have identified nine themes as follows: lockdown of standard outpatient clinics, decreased inpatient capacity, staff shortage, medicine shortage, unaffordable medicine, delayed care seeking, limited self-care practice, transport difficulties, and undiagnosed cases/events.ConclusionDiabetes management during lockdown is particularly challenging. This review specified a summary of difficulties of diabetes care during COVID-19 pandemic. Healthcare policy makers as well as healthcare providers could take advantage of the results of this review to mitigate the adverse effect of the crisis on provision of routine care for diabetes as well as other chronic conditions.     

Adaptability on Shifting Ground: a Rapid Qualitative Assessment of Multi-institutional Inpatient Surge Planning and Workforce Deployment During the COVID-19 Pandemic

BackgroundDuring the initial wave of COVID-19 hospitalizations, care delivery and workforce adaptations were rapidly implemented. In response to subsequent surges of patients, institutions have deployed, modified, and/or discontinued their workforce plans.ObjectiveUsing rapid qualitative methods, we sought to explore hospitalists’ experiences with workforce deployment, types of clinicians deployed, and challenges encountered with subsequent iterations of surge planning during the COVID-19 pandemic across a collaborative of hospital medicine groups.ApproachUsing rapid qualitative methods, focus groups were conducted in partnership with the Hospital Medicine Reengineering Network (HOMERuN). We interviewed physicians, advanced practice providers (APP), and physician researchers about (1) ongoing adaptations to the workforce as a result of the COVID-19 pandemic, (2) current struggles with workforce planning, and (3) evolution of workforce planning.Key ResultsWe conducted five focus groups with 33 individuals from 24 institutions, representing 52% of HOMERuN sites. A variety of adaptations was described by participants, some common across institutions and others specific to the institution’s location and context. Adaptations implemented shifted from the first waves of COVID patients to subsequent waves. Three global themes also emerged: (1) adaptability and comfort with dynamic change, (2) the importance of the unique hospitalist skillset for effective surge planning and redeployment, and (3) the lack of universal solutions.ConclusionsHospital workforce adaptations to the COVID pandemic continued to evolve. While few approaches were universally effective in managing surges of patients, and successful adaptations were highly context dependent, the ability to navigate a complex system, adaptability, and comfort in a chaotic, dynamic environment were themes considered most critical to successful surge management. However, resource constraints and sustained high workload levels raised issues of burnout.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07480-x.KEY WORDS: COVID-19, hospital medicine, workforce planning, surge planning, focus groups, qualitative     

Rural infection preventionists’ experiences during the COVID-19 pandemic: Findings from focus groups conducted with association of professionals in infection control & epidemiology (APIC) members

BackgroundSARS CoV-2, the virus that causes COVID-19, was identified and quickly developed into a pandemic in spring, 2020. This event posed immense difficulties for healthcare nationally, with rural areas experiencing different challenges than other regions.MethodsThe Association of Professionals in Infection Control & Epidemiology conducted focus groups with infection preventionist (IP) members in September and October, 2020. Zoom sessions were recorded and transcribed. Content analysis was used to identify themes.ResultsIn all, 38 IPs who work at a critical access hospital or a healthcare facility in a rural location participated. Major challenges identified by IPs in this study included addressing the lack of access to personal protective equipment (PPE), overwhelming workloads caused by the pandemic and multiple roles/responsibilities, inaccurate social media messages, and generalized disbelief and disregard about the pandemic among rural community members.ConclusionsGaps in preparedness identified in this study, such as the lack of PPE, need to be addressed to prevent occupational illness. In addition, health disparities and inaccurate beliefs about COVID-19 heard by IPs in this study need to be addressed in order to increase compliance with public health safeguards among rural community members and minimize morbidity and mortality in these regions.     

Succeeding in Aging Research During the Pandemic: Strategies for Fellows and Junior Faculty

Fellows and junior faculty conducting aging research have encountered substantial new challenges during the COVID-19 pandemic. They report that they have been uncertain how and whether to modify existing research studies, have faced difficulties with job searches, and have struggled to balance competing pressures including greater clinical obligations and increased responsibilities at home. Many have also wondered if they should shift gears and make COVID-19 the focus of their research. We asked a group of accomplished scientists and mentors to grapple with these concerns and to share their thoughts with readers of this journal.     

Challenges of diabetes care management in developing countries with a high incidence of COVID-19: A brief report

Background and aimsDiabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in developing countries.MethodsWe reviewed the literature to obtain information about diabetic care during the Covid-19 crisis. We also seek opinions of clinicians working in undeveloped countries.ResultsCurrent challenges faced by clinicians in the management of diabetic patients in developing countries are as follows: lack of preventive measures, inadequate number of visits, loss of the traditional method of communication with the patient, shortage of medications, impaired routine diabetic care, and absence of telehealth services.ConclusionsDeveloping countries are faced with many challenges in diabetes management due to a lack of resources.     

The Virtual Hospitalist: a Critical Innovation During the COVID-19 Crisis

A virtual hospitalist program expanded our ability to confront the challenges of the COVID-19 crisis at the epicenter of the pandemic in New York City. In concert with on-site hospitalists and redeployed physicians, virtual hospitalists aimed to expand capacity while maintaining high-quality care and communication. The program addressed multiple challenges created by our first COVID-19 surge: high patient census and acuity; limitations of and due to personal protective equipment; increased communication needs due to visitor restrictions and the uncertain nature of the novel disease, and limitations to in-person work for some physicians. The program created a mechanism to train and support new hospitalists and provide and expand palliative care services. We describe how our virtual hospitalist program operated during our COVID-19 surge in April and May 2020 and reflect on potential roles of virtual hospitalists after the COVID-19 crisis passes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06675-y.KEY WORDS: COVID, telemedicine, hospitalist     

基于航空航天医学本科生岗位胜任能力培养的心血管教学模式的实践

新时期航空兵部队的快速发展对航空航天医学本科生岗位胜任能力提出了更高的要求,鉴于目前航空航天医学本科生岗位胜任能力的现状及存在的问题,我们在航空航天医学教学中进行了一系列改革。本文以心血管系统为例,介绍了我们在航空航天医学教学改革中的一些实践经验和心得体会。     

Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus

Background and aimsPeople with diabetes have multiple psychosocial issues related to diabetes and its complications and this may be exacerbated during the COVID-19 pandemic.MethodsWe reviewed the psychological adaptative difficulties in people with diabetes especially during natural disasters including the prevailing COVID-19 pandemic.ResultsThere are significant concerns regarding worsening of glycemic control, unavailability of appropriate medicines, inaccessibility to health care or acquiring SARS- CoV-2 infection and subsequent poorer outcomes during the COVID-19 pandemic. Although there are some guidance documents for managing diabetes and associated complications during COVID-19 pandemic but very few address the psychological issues in people with diabetes. We discuss the psychological adaptive difficulties and an approach to address the psychosocial concerns in people with diabetes during the COVID-19 pandemic.ConclusionsPeople with diabetes have significant diabetes distress and psychological adaptive difficulties that is aggravated by the COVID-19 pandemic. An integrated multidisciplinary approach is needed to manage the prevailing psychological issues amongst people with diabetes during the COVID-19 pandemic.