护理留学生胸心外科ICU临床见习带教模式的应用研究

摘要 目的：探索科学可行的胸心外科ICU护理留学生临床见习带教模式。方法：在护理留学生临床见习带教过程中,建立并应用护理留学生临床见习带教模式,模式主要包括：优选临床带教老师、科学制定临床见习带教计划、 实施专人带教和PIO教学法和切实评估进行带教效果。结果：护理留学生对带教满意度高,除吸痰和体外除颤术这2项外,其余13项在见习后掌握程度提高明显。结论：科学的带教模式是提高见习带教质量的关键。     

交互式教学在医学留学生见习课堂中应用

目的 探讨交互式教学模式在留学生临床见习中的应用及效果,为完善留学生临床见习课教学方法,提高临床见习带教质量提供参考。 方法 选择2012年9月－2013年1月在四川大学见习的留学生77名,针对留学生临床见习和特殊性的学习特点及见习要求,尝试采用交互式教学模式,并采用座谈会及无记名问卷调查方法,在学生见习结束后就交互式教学模式效果的满意度进行统计分析。 结果 77名留学生中共有64名完成有效问卷调查,其对小组病例讨论满意度最高,为87.1%;临床进展专题讲座和专人带教上满意度较低,仅为72.6%和62.4%,这两点尤为需要改善。 结论 交互式教学模式有助于留学生临床见习效果的提高,但目前见习教师安排在一度程度上不利于留学生见习,有待改进及完善。     

ECS模拟教学在《内科护理学》教学中的探索与实践

目的 评价ECS模拟教学用于<内科护理学>教学中的效果.方法 将研究对象分为三组,同时接受理论课教学.2个月后,A组为接受ECS模拟见习教学,B组为接受真实临床见习,C组为空白对照组,未接受见习.比较三组学生对专科理论和实践知识的掌握程度.结果 ECS模拟见习教学组知识掌握情况优于其它两组.结论 ECS模拟见习可以作为护理专业学生临床见习教学的补充方式,能够较好的弥补当今临床见习存在的问题与不足,对临床护理见习目标的实现具有很好的补充作用.     

医学留学生内科见习的带教体会

随着我国经济的发展和国力的增强,越来越多的外国人来华留学,其中包含大量的医学留学生[1].医学是一门经验科学,需要大量的实习、见习与理论知识结合.临床见习对于原本存在语言交流障碍的留学生有一定难度,加之文化背景的不同更导致这些学生与中国学生的理解和表达方式不同,因此带好外籍学生的见习至关重要.本文结合作者近年来的留学生临床见习带教经验总结出了一些体会和思考,同大家一起共同探讨.     

283名护理本科生临床见习满意度的调查研究

目的了解护理专业本科学生对临床见习的满意度情况。方法采用自行编制问卷对283名护理专业本科学生的临床见习满意度进行调查,调查内容包括见习安排、医院教学硬件设施、见习教学质量、见习效果及教学管理5个方面。结果学生对临床见习的总体满意度为71.5%;其中对临床见习安排满意度最低为57.2%;满意度最高的是临床见习教学质量为78.1%。结论护理专业本科学生临床见习满意度有待提高,应采取措施进一步加强临床见习教学管理,提高临床见习教学质量。     

临床教学见习中促进护生自主学习能力培养实践

护理临床教学见习是护理教学的重要环节,是实现从课堂理论教学走向临床护理实践的桥梁.通过临床教学见习,不仅能使学生从临床实际病例中,获得对课堂知识的感性认识,从而加深对理论知识的理解和掌握;同时学生在接触临床患者中,尝试用课堂学习获取的理论知识对临床问题进行分析思考,以实现培养学生解决临床问题能力的教学目标,护理临床教学见习是确保教学质量的重要手段.近年来,通过对我校内科护理临床教学见习过程的改革逐渐认识到,科学分析护理临床教学见习所面临的问题,变革传统的临床教学见习方式,转变护生在临床教学见习中的角色定位,将有助于缓解当前临床护理教学资源不足与护理教育规模增大之间的矛盾,并能有效促进护生自主学习能力的培养.     

影响有效临床护理见习的原因分析及对策

护理学是一门实践性非常强的学科,临床见习是护理临床教学的重要环节[1].我校的见习教学是采用课间见习的方式,采取边看边讲授的"床边带教模式",使见习与课堂理论紧密结合.但近几年通过学生座谈会、教学管理部门对实践教学质量监控中发现这种见习形式目前存在一些问题,影响临床教学的有效性.现汇总如下,旨在促进临床带教老师改进临床带教方式,增强学生对临床见习的积极性,提高临床见习的教学质量.     

护理本专科生临床见习模式的现状

护理专业是一门实践性很强的学科,临床见习作为实践教学的第一个环节, 是学生真正与病人接触的开始,学生通过与病人交流和查体,可以在实践中获得感性认识,印证并丰富课堂上所学的理论知识,提高临床基本技能,培养临床工作思维能力,为今后成为一名合格的护理人员奠定基础.因此,临床见习日益受到护理教育工作者的重视,并且为了提高见习质量在形式、方法和内容上做了不少改革.现将提高本专科生专科见习质量的教学方法进行综述.     

护理学专业临床见习教学模式的改革与实践

目的对临床护理见习教学方法进行探讨,为提高临床护理见习教学质量提供参考意见。方法选取2006级护理本科生182名,随机分成两组,对实验组见习进行Seminar教学法干预,见习后对两组分别采用护理表现六维量表进行调查,同时对期末考试成绩进行分析比较。结果实验组学生的单科病例分析成绩、总成绩及护理专业表现方面与对照组学生比较,差异有统计学意义（P〈0．05）。结论新的见习教学方法能够提高护生的临床护理、人际沟通、计划与评估等能力,值得推广。     

标准化病人在留学生见习教学中应用的思考

2007年首都医科大学国际学院迎来了首批海外留学生;到目前为止,已招生6届,其中3届学生经历了临床见习阶段。目前,留学生见习教学方法延续我国医学生的教学模式,实践中遇到一些影响教育效果的问题;其中,患者不愿配合和不能顺利配合是一个突出的问题。有鉴于此,并借鉴国外医学教学的经验,标准化病人的应用可能是解决这一问题的方法。1首都医科大学留学生特征及见习教学的现状资料显示[1],首都医科大学留学生进入临床见习阶     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."