临床医学专业研究生预防医学教育现状与对策研究

医学模式和健康观念的转变迫切需要大量具备预防医学知识和技能的高层次临床医学专业人才.本文分析了临床医学专业研究生预防医学教育的现状及其存在的问题,并提出了相应的对策以强化临床医学专业研究生的预防医学素质,进而不断适应"预防为主"的战略需求.

Abstract：

With the transformation of medical model and health concept, a large number of high level clinical medical professionals with prevention medicine knowledge are needed. The paper analyzed the situation and existing problems of preventive medicine education for clinical medical postgraduates, and put forward countermeasures accordingly to strengthen the prevention medicine quality of clinical medical postgraduate to adapt the "prevention first" strategy requirement.     

Initiating Hehe (和合) medical system of traditional chinese medicine and biomedicine to realize health cycle of human beings

This paper suggests a novel approach concerning the medical treatment of human beings,which appears to be economically and practically superior to either biomedicine or traditional medicine.A brand new medical system—Hehe(和合) medicine,has been proposed based on a preventive-biomedical-psycho-social treatment model.This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life.Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means.Medical services would be firstly provided to the prevention of potential disease germinating in the human body,and clinical medical treatment would be the last resort of systematic medical practice.This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine,especially how both medical systems compare in cognitive style,on a cultural level,and on a technical level.     

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.     

A study on the model of “taking electronic medical records as the core for information construction in hospital”

Background This paper has discussed on new model of "taking electronic medical record as the core for information construction in health care" in Xinhua hospital and has expounded the true essence of EMR and the structured EMR framework model. Methods The paper emphatically introduced the new functionalities of this kind of EMR, such as "closed-loop management for medical process and medical orders", "clinical decision support", "controlled medical terminology". This paper study the concepts and features of EMR system, and summery the experience in Xinhua hospital. Results EMR system can be integrated into the original systems seamlessly. It not only supports the existing clinical workflow smoothly, but also proposes brand new medical concepts like close-loop management, clinical pathway and CMV etc. EMR system information construction will improve and optimize the existing medical workflow efficiently. Conclusions “Taking electronic medical record as the core for information construction in health care" follows the Ministry of Health “EMR System functional application-oriented classification of evaluation methods and standards (Trial)”. It lights the way for creating new EMR system in China. In conclusion, it shared the experience of implementation.     

探索结合医学的全新模式

This article provides global and Indian scenario with strengths and limitations of present health care system. Affordability, accessibility and availability of health care coupled with disproportionate growth and double burden of diseases have become major concerns in India. This article emphasizes need for mindset change from illness-disease-drug centric curative to person-health-wellness centric preventive and promotive approaches. It highlights innovation deficit faced pharmaceutical industry and drugs being withdrawn from market for safety reasons. Medical pluralism is a growing trend and people are exploring various options including modern, traditional, complementary and alternative medicine. In such a situation, knowledge from Ayurveda, yoga, Chinese medicine and acupuncture may play an important role. We can evolve a suitable model by integrating modern and traditional systems of medicine for affordable health care. In the larger interest of global community, Indianand Chinese systems should share knowledge and experiences for mutual intellectual enrichments and work together to evolve a novel model of integrative medicine.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

Pilot Study on the Model of Clinical Nursing Teaching

The levels of nursing education in China have developed fast. Many nursing educators are devoted to the research of nursing teaching. How to culture nursing students with higher quality has received more and more increasing attention over the past several years. In the course of clinical nursing teaching, we implemented a reform and achieved the noticeable effect as follows. Perfect monitor system of clinical teaching has been established, teachers＇ consciousness has been Strengthened, power of teacher exemplar and students＇ principal role have also been embodied. The new clinical teaching method has disinterred nursing students＇ potential and enhanced their abilities of creative thinking.     

Recommendations on Strengthening the Development of Nuclear Medicine in China

This paper outlines briefly the role of nuclear medicine in life sciences and health care. Molecular imaging by using isotopic tracers can noninvasively visualize the chemistry or hidden process in the cells and tissues inside the body, obtaining ＂functional＂ images to provide early information of any disease and revealing the secrets of life. The vitality of nuclear medicine is its ability to translate bench into new clinical application that can benefits the patients. Although nuclear medicine community in China has made significant achievement with a great effort since 1950s, there are many obstacles to future development. Recommended measures are proposed here in an attempt to solve our existing problems.     

New understanding of the basic theory of traditional Chinese medicine

Traditional Chinese medicine(TCM) plays an important role in the medical system used in health care and treatment of diseases.This article reviews the basic theory of TCM based on its formation and contributions.Two new personal points are proposed as follows:Six Zang(六脏) theory and deemphasization of the five-element theory.The basic theory of Chinese herbs is also discussed.     

中医药在康复医学中的循证实践

Chinese medicine is among other traditional medical systems practiced either as a coadjutant intervention to Greek medicine or as the unique therapeutic intervention for illness prevention,treatment or rehabilitation.The complete spectrum from that traditional system includes acupuncture and moxibustion,herbal and food therapy,massage therapy(tuina),physical exercises(taijiquan),and breathing exercises(qigong).In this article,it is presented several randomized controlled trials and systematic reviews on the application of all therapeutic modalities from Chinese medicine in the physical rehabilitation scenario.The discussed studies encompasses both "positive" and "negative" results of Chinese medicine intervention for disabilities due to illnesses of the nervous,musculoskeletal or cardiovascular systems.Additionally,the importance of the personalized approach for Chinese medicineand rehabilitation is emphasized together with the need for reproducible methods for pattern differentiation and intervention selection.Chinese medicine resources are recognized as promising methods for therapeutic rehabilitation and can be incorporated into the rehabilitation science.The wide variety of therapeutic resources explains why Chinese medicine is currently a multidisciplinary practice for health protection and promotion,early diagnosis and treatment as well as rehabilitation with roles in the public health care system.     

培养临床医学专业学生社区卫生服务实践能力的探讨

探讨培养临床医学专业学生社区卫生服务实践能力。广州医学院自1997年起通过深化教学改革,将培养学生社区卫生服务观念和实践能力贯穿于医学教育的全过程,使临床医学专业学生提前融入社区卫生实践并加强了对其科研创新能力的培养。经过多年的探索和实践,培养了学生的社区卫生服务实践能力,取得了良好的教学效果。在医学教育过程中,培养医学生的社区卫生服务观念和实践能力,对适应我国的医疗体制改革、发展我国的社区卫生服务具有积极的意义。     

社区建立临床医学实践基地的探索

探索培养既懂治疗又懂预防,防治合一,医院与社区通用的“两栖型”临床医学专业人才的新途径。在社区建立临床医学实践基地,组织临床医学专业学生利用假期时间在社区开展健康宣教、体格检查、义诊、病例讨论、调查研究等各种形式的临床实践活动,参与基层社区卫生保健服务,培养医学生的实践能力。建立社区临床医学实践基地,不仅可以充实和丰富临床实践教学内容,促进医学生掌握预防医学知识和社区卫生保健技能,还可以为医学生提供临床实践的场所,缓解医学院校实习基地不足的紧迫局面,是一种于学校、学生、社会三方面都有利的教学形式,值得进一步深入探索和推广。     

社区卫生管理课程教学体系改革及其效果评价

文章讨论了社区卫生管理课程教学体系改革实践及其效果评价。以2006级-2008级190名公共卫生管理专业学生为研究对象,通过基于职业技能素质的课程结构体系、＂教学—实训实践—科研服务整合一体化＂的实训实践教育新模式、现代化教学方法和教学手段等措施,教改组学生对于社区卫生管理课程改革教学效果满意度为97.87%,开展社区卫生服务综合技能明显提高。     

基于基层医疗卫生机构岗位任务的预防医学课程改革

以基层医疗卫生机构公共卫生岗位工作任务为引领,论述面向临床医学（全科方向）专业学生的预防医学课程改革,从课程设计的理念、教学方法、教学活动形式、课程内容和考核方式等方面进行了探索和实践。     

基于军事卫勤的整合式临床诊断课程体系建设与实践

空军军医大学经过精心设计，构建了本科学员基于军事卫勤的整合式临床诊断课程体系。该体系以诊断证据为导向，以诊断方法为牵引，以诊断病例为实践，结合疫情新形势形成了三位一体“四为”混合式的教学模式，实现了理论与实践穿插的教学过程的优化。同时，将军事医学内容有机融入其中，使课程体系更加完善。该课程体系确定了具体的知识、能力、素养3个层次的教学目标，完成了核心课程建设。通过教学实践表明，教员和学员满意度大幅提升，军事医学技能考核优秀率明显提高，更好地满足了空军卫勤人才培养的现实需求。     

构建以职业能力为本位的临床医学专业课程标准的思考

开发与我国医疗卫生体制改革相适应的临床医学专业教学基本要求是当前医学教育改革的热点之一。本文分析了高职高专教育临床医学专业课程标准的现状;提出了以职业能力为本位建立专科层次临床医学专业课程标准的必要性;探讨了课程标准的5项原则,包括素质教育应当贯穿于医学教育全过程,课程标准应当突出职业性,课程标准应当与执业标准接轨,教学设计应当具有实践性、开放性和职业性,教育评价体系的建立必须有学校方、教师学生方、相关利益方三方的共同参与。     

社区实践在临床专业预防医学教学改革的研究

目的:评价社区实践对临床专业学生预防医学知识及实践技能的影响。方法:将临床专业本科生随机分为实验组和对照组,分别采取传统教学和社区实践教学,比较教学效果。结果:实验组学生的理论及技能成绩明显高于对照组。实验组学生的现场调查能力、解决问题能力、综合分析能力、合作能力、人际沟通能力、利用网络获取信息的能力、文献检索能力、语言表达能力等方面的评价明显高于对照组。结论:社区实践性教学使学生较好掌握预防医学理论和技能,提高学生各方面的能力。     

医学生对社区医疗卫生服务认知情况的调查分析

通过对福建医科大学临床医学专业学生进行社区卫生服务认知情况调查,了解学生对社区卫生服务的认识和建议。结果显示多数学生对社区卫生服务缺乏了解,部分学生对现有的教育与社区卫生管理体制提出了意见与建议。医学院校应加大社区卫生服务相关知识的教育力度,促进我国社区卫生服务工作的开展。     

定向培养预防医学专业实践教学模式初探

[目的]从实践教学角度初步探讨应用型预防医学专业人才培养模式。[方法]对定向培养预防医学人才实践教学进行改革,并以本校首届预防医学专业毕业生为调查对象,借助问卷星对实践教学效果进行评价。[结果]整合实验课程进行实验教学大纲修订,形成模块化教学体系;结合课程和学校特色,教学方式多样化;加强实践教学基地建设,充分利用优势教师资源;注重专业实习,因地制宜进行合理调整;注重培养学生职业敏感性,关注公共卫生领域新热点。对于本科生参与疫苗接种、空气污染、共享单车等热点公共卫生问题的社会实践活动和课外研学,83%的毕业生认为非常有价值或者有价值。结合自身工作经验和体会,毕业生对实践教学改革总体满意度为81%。[结论]以基层为导向的实践教学举措与定向培养预防医学专业人才的教学需求较为相符,结合基层工作实际的实践教学改革有待进一步深化。     

有效实施社区中医预防保健服务的新思考

推进中医药预防保健服务体系的建设是我国医疗卫生改革和中医药事业发展的重要方向之一,这在一定程度上与社区卫生服务中实现六位一体模式的最终目标有着共通点。本文在对社区中医预防保健服务的内涵和现实意义阐述的基础上,着重研究和探讨了社区预防保健服务的实施路径,即开展以预防保健为主的中医特色健康教育活动及设计多元化的健康促进与健康干预方案。最后针对构建社区中医预防保健服务体系良好运行的配套机制提出相应的措施和建议。