以案例教学为中心的法医病理学实验教学体系建设

法医病理学是法医学专业的主干课程,实验教学在法医病理学教学中具有十分重要的地位.传统的法医病理学实验教学主要是以观察大体标本和组织切片为主,不利于培养学生从事法医病理鉴定所需要的操作技能、思维方式、交流协作能力等综合素质.为了弥补这些不足,昆明医学院进行了以案例教学为中心的法医病理学实验教学改革.实践表明,教学改革使法医病理学实验教学更加贴近法医病理检验鉴定的实际,提高了法医病理学实验教学的质量.

Abstract：

Forensic pathology was one of the main subjects of forensic medicine, experimental teaching was laid in the most important position during the teaching of forensic pathology. Traditional experimental teaching of forensic pathology was given priority to observing specimen and tissue slice, that might make against the training of comprehensive abilities required by the judge of forensic pathology, which included operation skill, method of thought, the ability of communication and collaboration. The reform of case-based centered experimental teaching system in forensic pathology was carried out at Kunming Medical University. The results showed that the reform made the experimental teaching more close to the actual situation of forensic pathology judge and improved the effect of experimental teaching.     

利用共同条件分析及中草药配伍确定微观层次上痴呆的研究方向

Objective： To identify the position of traditional herbal medicine in dementia research field using mapping technology. Methods： Keywords for dementia and traditional herbal medicine for treating dementia were used to extract scientific articles from the Web of Science database from January 2000 to July 2010. A co- occurrence matrix was created based on the concurrent set of author＇s keywords occurring in each scientific article, and technology network maps were created from similarity index matrices. Results： Twenty specialized research areas were identified in the dementia field, and the relationship strength was 0.2-0.6. Many research fields were associated with diagnosis and risk factors for dementia. Additionally, the mechanism or cause of dementia is an actively studied field. Traditional herbal medicine for treating dementia was located on a map near the cortical dementia diagnosis and therapy, and frontotemporal dementia research field with a relationship strength of 0.53 and 0.31-0.33 respectively, which demonstrates that traditional herbal medicine for dementia occupies an independent research area with a relationship to existing scientific research fields. Conclusion： Traditional herbal medicine can provide an alternative and complementary approach for treating dementia as evidenced by a scientific mapping analysis.     

电子模拟人优化心脏听诊教学的探讨

Objective To explore the assistant teaching effects with electronic simulated patients in the heart auscultation teaching. Methods 106 students were divided into the electronic simulated patient teaching group (experimental group ) and the traditional method teaching group (control group ) at random. Through the questionnaire survey, the written examination and the practice skill inspection form,we compared the students' learning situation of the two groups. Results There was no significant differ-ence in the written examination results between the two group students ( P ＞ 0.05 ); the practice skill in-spection results of the experimental group was obviously higher than those of the control group, there being significant difference ( P ＜ 0.05 ). The questionnaire survey about teaching satisfaction degree with electronic simulated patients showd that 77.36% of the students appraiseot for good, 18.87% for general,3.77% for poor. Conclusions The assistant teaching with electronic simulated patients was helpful in improving students' practice operation skills. It had many merits, such as comprehensive contents, directviewing and strong repeatability, which might optimize the heart auscultation teaching.     

电子模拟人优化心脏听诊教学的探讨

Objective To explore the assistant teaching effects with electronic simulated patients in the heart auscultation teaching. Methods 106 students were divided into the electronic simulated patient teaching group (experimental group ) and the traditional method teaching group (control group ) at random. Through the questionnaire survey, the written examination and the practice skill inspection form,we compared the students' learning situation of the two groups. Results There was no significant differ-ence in the written examination results between the two group students ( P ＞ 0.05 ); the practice skill in-spection results of the experimental group was obviously higher than those of the control group, there being significant difference ( P ＜ 0.05 ). The questionnaire survey about teaching satisfaction degree with electronic simulated patients showd that 77.36% of the students appraiseot for good, 18.87% for general,3.77% for poor. Conclusions The assistant teaching with electronic simulated patients was helpful in improving students' practice operation skills. It had many merits, such as comprehensive contents, directviewing and strong repeatability, which might optimize the heart auscultation teaching.     

Research on frequency of application with modern Chinese herbal medicine

Objective:To study the relationship between 500 kinds of commonly used Chinese herbal medicine and the classification of their efficacies in Chinese Materia Medica in relation to the common diseases listed in Internal Medicine.Methods:Database retrieval frequency of the quantitative statistical method was adopted.First,the 8 980 kinds of Chinese herbal medicine recorded in Chinese Materia Medica were used as the original search objects,and 4 493 kinds which were cited in more than five articles were picked out and then rechecked for further title citations.Second,as judged based on the Criterion,the numbers of articles which included the medicines in the line of standards were examined.As a result,500 species of Chinese herbal medicine were singled out based on their retrieval frequency and were then used for compilation of the classification statistics according to their efficacy and the common diseases in Internal Medicine.Results:From the classification of Chinese medicines,herbs with wide efficiency and a meek nature had higher frequencies, but those which were not appropriate as decoctions had relatively lower frequencies.However,according to the average frequency,the Chinese herbal medicine for nourishing qi and tonifying blood,at 36 346 times and 34 544 times,respectively,were the most commonly used.Analyzed from the frequency of application of the Chinese medicine in the treatment of common diseases,most of the top 10 kinds of Chinese herbal medicine with the highest frequencies generally coincided with the 500 selected medicines.In addition,the Chinese medicines with clear pharmacological efficiency were easily isolated and purified to be made into injections, although other forms are more commonly used.Conclusion:The results of the research objectively reflected the current applications of Chinese herbal medicine,and could be used as references in teaching,research,clinical applications,and in compiling and increasing the drugs in textbooks and Pharmacopoeia.     

循证医学网络教学平台的构建与实践

临床医学教学中引进循证医学教育是医学发展的必然要求.本文从循证医学网络教学平台的构建特色、教学实践的优势等方面进行了探讨,并提出了尚待研究的问题.

Abstract：

To introduce the evidence-based medicine (EBM) into clinical medical education is inevitable demand for modern medical development. Base on website, EBM teaching network platform was set up in Guangxi Medical University in order to solve the problems such as no EBM idea in present teaching, lack of class periods and teachers. The features of construction, practice and some questions to resolve for this network platform were discussed.     

High altitude medicine in China in the 21st century Opportunities and challenges

China has the largest plateau, Qinghai-Tibet Plateau, where inhabited the most high altitude populations. Moreover, millions of people from plain areas come to the plateau for travel and work purposes and the number of the newcomers has been increasing every year. The hypoxic environment of plateau raised a series of related health issues in the new immigrants, so have created a special medical discipline- High Altitude Medicine. Over the past decades, researches on high altitude medicine have never being ceased in China, and lots of research findings have been reported. Application and practice of these achievements have greatly decreased the mobility and mortality of highaltitude diseases, however, there remained lots of questions to be elucidated. In view of this, the authors were granted a special project from the National Health and Family Planning Commission of China, and conducted a multi-center, prospective, on-scene high altitude medicine study for the acute mountain sickness. Some innovative findings were achieved, and the parameters for diagnosis and application conditions were proposed. Furthermore, the different diagnoses and treatment effects were compared, and a more standardized, reasonable scheme was drawn up. Regarding the unbalanced medical resources in the vast high altitude area, an application system for the public and the army has been established. In the 21 st century, innovations in China and novel research approaches have provided great opportunities for the development of high altitude medicine. It is believed that the researchers in China are able to catch the opportunities and address the challenges.     

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.     

耳鼻咽喉-头颈外科学课程解剖生理双语教学模式初探

本文探讨了耳鼻咽喉-头颈外科学课程中解剖生理双语教学的模式、实施效果、优势及存在问题.教学实践表明,耳鼻咽喉-头颈外科学课程中解剖生理开展双语教学是可行的.为了提高教学效果,双语教学应当特别关注教学质量、提高学生学习主动性、提高师资外语水平及建立完善的双语教学评价体系等方面的问题.

Abstract：

Bilingual teaching model and its effect, advantages and possible problems for the anatomy and physiology of otorhinolaryngology were explored in this article. It showed that bilingual teaching was feasible for teaching anatomy and physiology of otorhinolaryngology. In order to improve the teaching effect,special attentions must be paid to the teaching quality,the elevation of students' activity,the improvement of teachers' English level and the establishment of teaching evaluation system in bilingual teaching.     

Evidence-based practice method of integrative Chinese and Western medicine based on literature retrieval through PICO question and complementary and alternative medicine topics

An evidence-based practice method according to literature retrieval through PICO （Patients,Intervention,Comparison,Outcome） questions and complementary and alternative medicine （CAM） topics,which can obtain helpful evidence for guiding clinical practice,was introduced with a practical example in this paper.The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question,while searching by CAM topics may provide evidence for Chinese medicine （CM）.Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidencebased practice method for integrative Chinese and Western medicine （ICWM）.However,since the standard in CM evidence hierarchy is still under study,the value of the CAM thematic retrieval method remains very limited.In the future,studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.     

横跨医学检验专业主干课程的“三性”实验课设计与初步实践

医学检验专业主要包括临床微生物学与微生物检验、临床免疫学与免疫检验、临床生物化学与检验等主干课程,但长期以来各课程均独立开展实验课教学,存在部分实验内容重复,各学科间有机结合不够,学生对医学检验专业理论知识掌握和实验技能培训不连贯等问题。本文对检验医学各主干课程的实验课内容进行深入调研,寻找出彼此间重叠的实验内容与项目,重新整合设计出横跨医学检验专业主干课程的“三性”实验项目,并进行初步的教学实践与分析,为医学检验专业实验课的教学改革奠定了工作基础。     

临床医学本科专业公共选修课《法医学》教学探讨

本教研室在临床医学本科专业公共选修课《法医学》教学过程中,从教学整体设置、案例和讨论式教学的有效实施、多媒体和网上课堂教学手段的充分运用、参观实践和师生座谈会的组织开展等方面进行了有益尝试,通过上述努力,提升了公共选修课《法医学》教学质量。     

“5S”管理在医学生临床实践教学中的应用研究

目的：探索提高医学临床实践教学质量、提升医学生综合素质的方法。方法将源自日本的“5S”管理方法运用于医学生实习科室、教学和学生管理等多领域,从主客观方面改进临床实践环境、教学质量、医学生自我学习和生活管理,并通过试验组和对照组成绩比较、带教老师、患者满意度比较进行效果评估。结果试验组学生内、外、妇、儿、中医、社区6个专业的五站式出科考试（问诊、查体、辅助检查、写病历、口试）总分比对照组高近13分,除中医略低外,各专业成绩均高于对照组;患者、教师对试验组学生满意度评分均值比对照组分别高5.78分、4.1分,差异有统计学意义（P<0.01）。结论多层次“5S”管理对提高医学生临床实践效果、患者和教师满意度,提升医院教学工作质量有一定效果。     

"5+3"一体化临床医学专业表面解剖学教学的实践探索

表面解剖学是从人体解剖学中分化出来的一门新兴边缘学科,与临床应用密切相关。从2015年开始,福建医科大学在"5+3"一体化临床医学专业中将表面解剖学融入人体解剖学课程,建立"价值引领—解剖实践—临床应用—科研创新"的渐进式教学模式,通过学生评教、问卷调查、成果展示等方法评价教学效果。结果显示,此教学模式实现了专业教育与人文教育的有机融合,促进高层次医学人才的培养。     

基于基础医学虚拟仿真实验平台的"早期临床" "早期科研"实践课程体系构建及应用

目的构建以虚拟仿真实验平台为基础、以早期接触临床和早期接触科研为核心思想,以临床病例、科研成果为主体,以虚拟仿真和多媒体为主要形式的基础医学实践教学模式。方法围绕基础医学各学科的教学大纲,选取体液系统、循环系统、血液系统、心脏系统、呼吸系统等典型临床病例和科研案例,将转化成标准化的虚拟案例投入虚拟仿真平台使用。在临床医学“5+3一体化”专业中随机抽取班级进行教学实践,并通过问卷调查、成绩分析评价教学效果。结果目前建成虚拟案例10个,问卷调查结果显示,观察组学生对教学满意度为93.3%,高于对照组的77.8%（P < 0.05）;在激发学习兴趣方面观察组为91.1%,高于对照组的77.5%（P < 0.05）;在有利于未来临床或科研工作方面,观察组为95.6%,明显高于对照组的59.1%（P < 0.01）;在有利于拓宽知识面、学习效率、知识获得能力、加深对课程理解方面,2组差异均无统计学意义（P>0.05）。观察组学生综合性实验课期末成绩为（81.54±15.12）分,与对照组的（80.62±14.32）分差异无统计学意义（P>0.05）,但观察组学生期末考试成绩优秀比例优于对照组（P < 0.05）。结论基于基础医学虚拟仿真实验平台的“早期临床”“早期科研”实践课程体系初步构建成功,通过该体系进行案例讨论教学可以实现虚拟临床场景、科研场景与理论知识的有机结合,有利于提高学习的兴趣,使学生尽早建立临床思维和科研思路,学生满意度较高,对医学教学改革有较好的推动和促进作用。     

五年制临床医学专业学生对法医学教学的认知调查

目的了解临床医学专业学生对法医学课程的需求和认知、认可程度,以期指导和调整法医学的教学改革。方法对嘉兴学院医学院2006级临床医学专业本科生进行无记名问卷调查。结果医学专业学生普遍认同法医学课程,并认为结合具体实际案例进行教学是较好的教学方式。结论法医学教学应从授课内容、教学方法、实践、考核等方面进行相关的调整。     

“3+2”模式教学查房的管理研究

临床医学院在承担五年制临床医学专业班"3+2"新模式的临床教学中,实践了教学查房的教学管理研究。建立和健全了教学管理组织,实施四级督导,确定查房目标,推进"团队学习",构建查房任务。增强了带教老师的教学意识,提高了教学能力;保证了教学查房的完整性;实现了质量调控的及时性;提高了医学生临床基本技能和临床思维能力。     

法医学PBL教学实践之思考

在法医学教育中引入PBL教学法是培养创新型高素质法医学人才的一个重要手段,但其实践尚处于探索阶段。结合法医学PBL教学实践的体会和经验,从学生和教师的准备工作、教学内容编排和课时调整、教案的编写、PBL相关教学资源及PBL教学评价体系等方面,对法医学PBL教学现状及存在问题进行深入的剖析,并针对现存问题提出几点浅见,以期为今后更好地开展法医学PBL教学提供借鉴与参考。     

五年一贯制医学影像技术专业“3.5+0.5+0.5+0.5”工学结合人才培养模式探索

医学影像技术专业是实践性很强的“医工结合”专业,该专业课程种类多,教学难度大,专业设备价格高、更新快,目前的教育投入远不能满足医学影像技术专业人才培养所需的实训教学要求,必须走校院合作之路。五年一贯制高等职业教育的招生对象为应届初中毕业生;实践显示,分段渐进、理实一体、情景教学、工学结合等策略适合五年一贯制高职教育教学;由此探索医学影像技术专业“3.5+0.5+0.5+0.5”工学结合人才培养模式。     

浅谈“开四关”论治肝郁证

肝郁证是中医脏腑证候中常见证候之一,其临床常表现为情志抑郁、胸胁胀满、善太息等。肝郁证见于多种中西医病证中,且以中年女性更为多见,严重影响患者的心理及生理健康。笔者在临床实习治疗中,发现"开四关"在治疗肝郁所致疾病中疗效显著,然其治病机理尚未明确。故笔者现将"开四关"治疗肝郁所致疾病的临床研究及其机理进行总结和分析,以供后续研究进行,并更好地服务于临床。