我院住院医师规范化培训的实践与思考

住院医师规范化培训是临床医师成长的重要阶段,对于培养临床医师的综合能力至关重要,对于培养高能力、高素质的临床医师队伍、确保医疗质量具有非常显著作用.总结我院住院医师规范化培训的经验,并提出进一步完善规范化培训工作的建议.     

住院医师规范化培训考评标准与评价方法研究

本文报告了住院医师规范化培训考评与定性定量的客观指标，评价方法，培训考评内容以及相关政策，并将每个接受培训医师的德，才能，绩表现转换成分值，使国家及军队住院医师培训工作形成规范化，制度化，提供一套实用的标准及管理办法，为加快卫生技术干部的培养扩大了研究思路。     

浅谈军队边疆中小医院住院医师规范化培训

住院医师培训是医学生毕业后接受医学专业教育的阶段,对医师的成长有着非常重要的作用^（1）。一个医学生从医学院校毕业后进入临床工作,由于行业内部没有统一的住院医师培训的规范和要求,各用人单位在培训内容、培训方法以及重视程度等方面差距仍比较大。迄今为止,     

非影像专业住院医师在放射科规范化培训的现状与实践初探

【摘要】住院医师规范化培训是毕业后继续医学教育的重要组成部分,是每一位临床医师成长的必由之路。放射科作为住院医师规范化培训的公共平台科室之一,对于培训高层次临床医师、提高医疗质量至关重要。本文针对住院医师在放射科规范化培训的现状和问题,并结合我院的实际情况,从规章制度制定、轮转计划安排、培训过程落实、考核体系建立、培训质量监督等方面进行初步实践探索,希望对新模式下的非影像专业住院医师在放射科轮转培训提供一些启示和借鉴。     

全程导师制在军队住院医师规范化培训中的应用探讨

住院医师规范化培训(简称住培)是军队医学教育的重要组成部分,是培养合格军医的必要途径.传统的住培教育模式存在一定缺陷,忽略了军队住培医师的特殊性,影响住培质量.该文探索全程导师制在军队住培教育中的应用,对提高住培质量、提升部队卫生机构军医队伍素质具有一定意义.     

院级督导在住院医师规范化培训中的效果评价

目的通过对新疆生产建设兵团某医院的住院医师规范化培训进行调查,研究分析该医院院级督导效果评价,以期为新疆地区住培基地院级督导顶层设计提供合理有效的参考依据与理论支撑。方法以问卷星第三方平台开展网络问卷调查的形式,随机抽取该医院专业基地内的部分住培医师和带教老师为研究对象,通过Excel和SPSS 25.0进行数据整理和统计学分析,计量资料以（均数±标准差）表示,组间比较采用单因素方差分析,以P<0.05为差异具有统计学意义。结果带教师资岗位胜任力评价中,带教师资专业知识、教学能力和职业素养,年度间比较发现,2020年度及2021年度各维度得分比2019年度高。住院医师核心胜任力评价中,住院医师的职业素养（F=21.631,P<0.05）、知识能力（F=23.704,P<0.05）、沟通合作（F=28.138,P<0.05）、终生学习（F=14.692,P<0.05）在年度间比较,差异均具有统计学意义,随着时间的延长,住院医师的核心胜任力提高。住院医师年度考核结果显示,2019年住院医师的年度考核通过率为37.80%,2021年年度考核通过率为61.01%。...     

MSF教学方式在非影像专业住院医师放射科规范化培训中的应用

目的 探讨MSF教学方式在非影像专业住院医师放射科规范化培训中的应用价值。方法 选取神经内科、骨科、儿科专业的规培学员各20名,将60名学员分成两组,每组30名,由各专业随机抽取的10名组成;对照组采取传统方式教学,实验组采取MSF方式教学,根据不同专业医师的岗位胜任能力培育要求,设计不同的SPOC课程与翻转课堂课程,开展混合式学习;通过闭卷考试和问卷调查等方法对两组进行教学效果评价。结果 采取MSF教学方式的实验组学员考试成绩为(84.5±5.8)分,传统教学方式的对照组学员考试成绩为(77.3±6.2),差异有统计学意义(P<0.05);回收问卷60份,实验组总分(21.8±5.6)分,对照组(16.2±7.2)分,差异有统计学意义(P<0.05)。结论 将MSF教学模式运用于非影像专业住院医师的放射科规培教学中,强调以学员为中心和基于胜任能力的教学理念,课程内容与各专业岗位胜任能力相结合,充分发挥MSF的混合式教学优势,学员学习兴趣和教学效率得到提高,学习效果显著提升。     

中美放射科住院医师培训有感

简要介绍美国医学院毕业生从参加职业医师考试到申请住院医师培训,以及接受培训的全过程,重点介绍了美国严谨的放射诊断专业住院医师培训方式,同时对国内住院医师培训中存在的一些问题进行了分析。     

以问题为导向的教学模式在住院医师规范化培训中应用的Meta分析

目的对单孔电视胸腔镜（video assisted thoracoscopic surgery,VATS）前纵隔肿瘤切除术的临床效果进行初步评估,探讨其可行性和安全性。方法回顾分析2015年7月—2016年7月在海军总医院胸外科接受单孔VATS手术的前纵隔肿瘤病例24例,对术中出血量、手术时间、中转率、术后并发症、术后住院时间、围手术期病死率等进行汇总分析。结果手术时间26～240(66.4±18.2)min,术中出血量20~3 100(112±26.9)mL,术中发生严重并发症2例（8.3%）。术后住院时间3～15(6.3±2.3)d,术后无严重并发症或围手术期死亡病例。结论单孔VATS前纵隔肿瘤切除术是一种安全、可行的手术方法,具有创伤小、疼痛轻、恢复快、切口美观等优点,值得在临床进一步推广应用。     

Evaluating resident training in radiology

Evaluation plays a key role in both the educational process and in its results. The evaluation established in the regulations for the Spanish residency system (MIR) is a two-step process that aims to teach. These steps are: a) continuous evaluation by the tutor and specialists at the training unit and b) an annual review by the evaluating committee. The resident's handbook and evaluation sheets from the rotations are the tools used for this task. Other techniques for evaluation, such as 360-degree feedback, examinations (conventional, case-based, and/or Objective Structured Clinical Examination [OSCE]), checklists, reviewing reports, or public presentation, can also complement or enhance the official evaluation. This article aims to provide information about the evaluation process and to open new possibilities to make evaluation more objective.     

The profile training of aviation doctors

Authors consider the trends of training doctors in the specialty "physician in aerospace medicine". First level is initial training for faculty training of doctors. The higher level is vocational retraining and advanced training in the departments of postgraduate and further education. It solved the issues of preparation of specialists in various areas of aviation medicine: medical-chairman of the Flight Commission, an expert medical doctor-flight expert committee, a specialist laboratory (Cabinet) of Aviation Medicine, the Medical Director of Aviation (enterprise, organization), etc. The highest level of training is residency. The necessity of legislative consolidation of an independent direction for the organization of training and medical support of aviation operations is proved.     

关于放射科住院医师培训的思考

最近,笔者在美国南加州大学医院放射科学习,深入接触和了解了美国放射科住院医师的培训制度,在Chi-Shing Zee教授指导下特撰此文,希望对国内有些借鉴.     

Radiation protection in pediatric imaging

The effects of medical radiation exposure in childhood can last a lifetime. As more American children are exposed to repeated diagnostic imaging examinations, concerns have been raised about the potential harm from early medical irradiation. Diagnostic imaging personnel have a responsibility to ensure strict and consistent observance of the "as low as reasonably achievable" (ALARA) principle. Radiation risks are greater for children, which makes strict compliance with radiation protection practices a public health imperative. Radiologic technologists play a central role in radiation protection for children. This Directed Reading reviews the biologic effects and risks of ionizing radiation among children and the use of radiation protection to minimize medical radiation doses in the pediatric population.     

The effect of training of military skills on performance in cold environment

This study was conducted to evaluate how training for disassembling and assembling a weapon and patrol data message terminal and loading a magazine in different temperatures affected the ability to perform those skills in a cold environment. One group trained six times on separate days in a warm environment (19 degrees C), the second group trained three times in a warm environment and then three times in a cold environment (-15 degrees C), and the third group trained six times in the cold environment. Training first in warm and then in cold shortened performance time by 6% to 28%, in comparison to training only in a warm environment. Also, training in cold made the subjects faster than training in warm. In conclusion, before performing military operations in a cold environment, it is most beneficial to train first in warm and then in cold. Training only in warm produces the lowest level of performance in a cold environment.     

Diagnostic radiology resident perspectives on fellowship training and career interest in emergency radiology

Purpose

(1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents.

Materials and methods

A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach.

Results

Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10.2%). Gender proportion was nationally representative (female?=?24.5%; p?=?0.57), with a slight R1 predominance (p?=?0.034). Of the residents, 88.8% were aware that an ER subspecialty exists, 82.0% were aware that ER fellowships exist, but only 51.7% were aware that the American Society of Emergency Radiology (ASER) exists. Nearly a quarter reported no ER division or ER resident rotation. Residents in a program without an ER division or rotation were nearly twice as likely to be unaware of the existence of ER subspecialty, ER fellowships, and ASER compared to others (p?=?0.017). The presence of an ER division and rotation significantly increases the knowledge of ASER (65.5% vs. 40.7%, p?<?0.001) and increases residents’ ratings of their ER training (p?<?0.001). The following factors were ranked as the most important for fellowship choice: (1) personal interest, (2) intellectually stimulating, and (3) work hours. When asked if ER had an appealing work schedule, the mean response was 56 out of 100 (0?=?disagree, 100?=?agree).

Conclusion

US radiology residents with the greatest exposure to ER during residency are more familiar with ER training, ER career opportunities, and ASER and had a more favorable perception of the field. Subspecialty leaders should focus on ER’s inherent intellectual appeal and reframe its nontraditional schedule as positive (flexible).

     

Analysis of radiology education in undergraduate medical doctors training in Europe

Objectives

The purpose of the present study is to describe how undergraduate radiology teaching is organized in Europe and to identify important characteristics of undergraduate radiology curriculum.

Methods

An electronic survey on undergraduate teaching was distributed by the European Society of Radiology (ESR) to 38 national delegates of the ESR Education Committee.

Results

The “classic type” of radiology teaching method is more frequent than the “modular type”. In 38% of medical training centres the first experience with radiology is in pre-clinical years. The students enrolled in the fourth medical year experience the largest involvement in radiology education. The total number of teaching hours (mean 89 h, median 76 h) varies across the countries and differs depending on the radiological topic (mean across all topics 14.8 h, median 13). Written tests and oral exams were the most frequently used examination modes. Clerkships are reported as a key part of training.

Conclusion

This first international comparative study of undergraduate radiological curriculum in Europe identifies a large number of differences in curriculum content and teaching methods throughout Europe. More research is needed to establish the radiological educational competences resulting from these differing curricula's to improve and to standardize the teaching according to (inter)national and institutional needs.