主题推进式高校心理健康教育的探索与实践

心理健康教育一直是学生全面发展的前提条件,但是随着生活水平的提高,学生已不用再为物质生活担忧,充足的物质保障给学生提供了丰富的课余生活,但是在物质生活极大丰富的时代里,学生的心理问题并未减少,反而大幅度上升。为了更好地解决学生的心理问题,哈尔滨医科大学大庆校区护理学院多年来积极探索主题推进式心理健康教育活动,取得了一定经验和成效。本文主要介绍了主题推进式教育的含义,描述了不同年级、生源、性别、专业及是否独生子女等学生的心理特征,对针对不同类别学生实施的主题推进式心理健康教育模式及具体措施进行了阐述。     

Teaching the quality improvement process to junior medical students: the Nebraska experience

To teach the continuous quality improvement (CQI) process to junior medical students at the University of Nebraska during their rural family medicine preceptorship, we designed and implemented a population health project in 1998. This project requires students to select a problem affecting a population in their preceptor's practice, analyze that problem, and suggest a solution or remediation using CQI principles. Support for the students during their project includes Web-based examples and readings. Results of this project have included national presentations and changes in several preceptors' practice patterns. This project has been well accepted by preceptors and students.     

The teaching of behavioural sciences

Summary. Medical science over the last few decades has undergone vast changes. Technologically it has advanced at a rapid pace. There has been a realization as well that the behaviour of individuals and communities also influences the occurrence of disease. Medical schools around the globe have realized the need for incorporating behavioural sciences as an integral part of the basic sciences taught to medical students.
This paper presents the experience of Christian Medical College, Veilore in teaching behavioural sciences. Students are taught sociology, psychology and medical anthropology through a community-based, problem-oriented teaching programme. The students have first-hand experience of living in a community and learn by observation and interaction. Pre- and post-assessment has shown a significant improvement of their knowledge and attitude. Feedback from students also indicates that they find this programme relevant and interesting.     

河南省2012-2016年实施营养改善计划中小学学生生长发育变化状况

了解学生营养改善计划实施以来贫困农村地区学生的生长发育变化状况,为评价营养改善计划效果提供参考依据.方法 从河南省26个试点县实施营养改善计划的学校中各抽取10%~ 30%的小学和初中进行营养状况监测.对2012和2016年监测结果进行分析.结果 2012年实施营养改善计划地区学生的身高、体重整体低于2010年全国学生体质调研河南省农村地区学生.实施营养改善计划以来,从2012-2016年,贫困农村地区男生平均身高增加2.27cm,平均体重增加1.95 kg;女生平均身高增加2.05 cm,平均体重增加1.75 kg.且2016年实施营养改善计划地区部分年龄组学生的身高、体重已赶上甚至超过2014年河南省体质调研农村地区同性别、同年龄组学生.营养改善计划4年间贫困地区7~16岁学生身高和7~13岁学生体重的年均增长速度均高于体质调研4年间整个农村地区学生.结论 实施学生营养改善计划切实提高了贫困农村地区学生的生长发育水平.     

西宁市某县改水降氟效果测评

目的对西宁市某县36个村实施改水后6 a(2004—2010年)的效果进行测评。方法调查实施改水前后粮食产量、人均收入以及学生氟斑牙患病情况。结果共检查8～12岁学生1 199名,其中改换低氟水源的29个村检查887名,氟斑牙患病率为24.46%;未改水源的7个村检查312名,氟斑牙患病率达41.67%,差异有统计学意义(χ2=32.38,P0.01)。改换低氟水源的8～12岁学生患病率达到30%的病区控制标准。年人均粮食产量由改水前的205 kg增长到316 kg。人均经济收入由改水前的226元增长到392元。结论该县的改水降氟工程有显著的社会效益和经济效益;改水后的管理工作应加强。     

Using PDSA (Plan-Do-Study-Act) to establish academic-community partnerships: the Cleveland experience

The Schools of Medicine and Nursing at Case Western Reserve University and the Program in Health Administration at Cleveland State University have created an interdisciplinary course in continuous improvement that emphasizes learning through experience, accommodates a large number of students, and has created new partnerships with Cleveland area health care organizations. An approach that respects these partners as customers and refines the relationships with serial tests of change (e.g., PDSA) has contributed significantly to this program's success.     

Microfiches as an aid to teaching histology

A set of six colour microfiches and an atlas of black-and-white prints of the photomicrographs used in the microfiches have been prepared by the author and have been used for teaching an Histology course to medical students for 4 years. Student reaction to them and their use has been gauged by voluntary questionnaires. Of students who responded, 78% found the microfiches made the course easier for them; 76% like the microfiches because they can use them for home study; 77% find them useful for class discussion; 62% like them because of their colour reproduction. A small group of fifteen students, who failed the Histology course the year prior to the introduction of microfiches and subsequently repeated the course, felt they could revise better with the help of the microfiches. Also they felt the course was clearer. Comparison of the examination results of the students for the 4 years preceding the introduction of microfiches with those of the 4 years since, shows an improvement in mean percentage achieved together with a decrease in the standard deviation (s.d.).     

五年制高职女生痛经的护理探讨

[目的]探讨五年制高职校女生痛经的有效护理措施。[方法]把100名痛经女生分成实验组(n=50)、对照组(n=50),对实验组的同学实施纠正不良生活方式、培养运动习惯、宣教月经相关知识,心理护理等综合护理措施,对照组的同学不给任何指导,时间从2010年2～7月。[结果]实验组的同学中有21名痛经基本痊愈,有9名同学痛经明显减轻,有13名同学的痛经有一定的好转,有7名同学无明显改变,痛经治疗的总有效率为86%,对照组中有3名同学痛经明显减轻,有11名同学的痛经有一定的好转,有36名同学无明显改变,自然好转率为28%,两者比较,差异有统计学意义(χ2=45.408,P﹤0.01)。[结论]综合护理措施使痛经女生的认知、态度、行为和习惯发生了变化,提高了女生的保健意识,有效地控制了痛经的发生。     

高校体育社团活动对医学生心理健康的促进作用研究

目的：探讨体育社团活动对医学专业大学生心理健康的改善作用,为改进医学生心理健康教育方法提供依据。方法采用 SCL-90症状自评量表对273名参加体育社团的医学本科大学生和104名非体育社团大学生进行12个月的跟踪调查,运用 SPSS 21.0版本软件,采用独立样本 t 检验和配对试验 t 检验,对两者的测评结果进行比较和分析,显著性水平为 P <0.05和 P <0.01。结果体育社团成员大学生特别是女大学生心理健康的改善效果明显(P <0.01);表现难美类或集体性体育运动项目对大学生心理健康改善作用明显。结论高校体育社团活动改善医学专业大学生心理健康具有显著效果,体育社团活动要选择符合大学生心理发育特点的内容和方法,集体性体育锻炼项目更有利于大学生心理健康的发展。     

Evaluation of a strategy to improve undergraduate experience in obstetrics and gynaecology

Context Poor interprofessional relationships in maternity units have resulted in a number of suboptimal outcomes: students are reluctant to pursue careers in obstetrics and gynaecology (O&G); trainees feel bullied, and poor communication between professionals results in avoidable adverse events. Interprofessional learning has been advocated to improve interprofessional relationships, but recent interventions have not been successful at undergraduate level. This study aimed to address this issue locally and then to disseminate our lessons, successes and challenges. Methods A strategy for interprofessional team‐working was developed in a large maternity unit in the UK, with a variety of interprofessional interventions spanning the attachment and opportunities to participate in specific task or research teams. These interventions were evaluated before the strategy proceeded to large‐scale implementation, with a validated attitudes questionnaire (Pollard) and a reaction survey. Results Interprofessional relationships improved significantly (P < 0.05) after the O&G attachment. There was also some improvement of borderline significance (P = 0.05) in interprofessional teamwork and communication, as well as a non‐significant improvement in perceptions of interprofessional interactions. Most (17/27, 63%) students stated that O&G was their primary career intention after the attachment. They did not witness any bullying or interprofessional difficulties. Conclusions Contrary to findings in other studies, in which initial idealism has been reported to have collapsed after working with students from other professions, we achieved a positive reaction to the O&G attachment, harnessing students’ initial positivity towards interprofessional learning and cementing it into real optimism. Our promising initial results suggest that more work is needed to further increase the impact of such strategies and to determine whether the improvements in attitudes translate to improved clinical behaviour and thence patient outcomes.     

中国留守经历大学生心理健康影响因素和教育建议

留守经历会影响大学生的心理健康水平。影响留守经历大学生心理健康的因素包括留守时间、性别、生源地、人格、情绪调节能力、应对方式、社会支持、家庭教养方式、负性生活事件等。为优化留守经历大学生的心理健康状况, 高校心理健康教育需重视农村生源留守经历大学生、留守经历男大学生的心理健康教育, 重视留守经历大学生安全感、主观幸福感水平的提升, 优化留守经历大学生的人格、情绪调节能力和应对方式, 为留守经历大学生构建良好的社会支持系统。     

A Process Evaluation of Condom Availability in the Seattle, Washington Public Schools

ABSTRACT: In 1993, Seattle began making condoms available in all of its 15 high schools. As part of an evaluation of this program, 16 focus groups with students from 13 high schools were conducted to explore students' perceptions of the school environment, program effectiveness, and suggestions for program improvement. The study also included data from a student survey conducted in 10 high schools. The focus group results revealed that students support school condom availability but have concerns about privacy when obtaining condoms. Students prefer obtaining condoms from baskets in private areas of school-based clinics to obtaining them from vending machines. Students do not believe that having condoms available has affected sexual activity or condom use among students. Recommendations for improving school condom availability include access to free condoms in private locations.U Sch Health. 1997;67(8):336–340)     

Gender differences in oral health knowledge and behavior of the health science college students in Kuwait

Dental caries and periodontal diseases have been declining in most industrialized countries, but this positive trend has not been seen in the Middle East. This study aimed to determine oral health knowledge and behavior of the students at the Health Sciences College in Kuwait as well as possible associated factors. This study was first conducted at the college of the male students (n = 153) during the autumn semester in 2001. A similar questionnaire study was then conducted at the college of the female students (n = 547) during the spring semester in 2002. The samples were merged for this study, for a total sample of 700 students. The response rate was 84% (n = 128) among the male students and 73% (n = 400) among the female students. Most of the students had visited a dentist during the past year, and quite a high proportion was seen for an examination or prevention. Female students reported twice-a-day tooth-brushing frequency much more often than did male students. They also used fluoride toothpaste more often than male students. Oral health knowledge (as a summary variable) was statistically significantly higher among the female students than among the male students. It was also strongly associated with the older age among the female students. The knowledge and oral health behavior of the Health Sciences College students in Kuwait, especially among the male students, seems to be poor and calls for an urgent improvement of health education programs.     

Teaching and assessing clinical skills: a competency-based programme in China

The objective of this study was to develop a compentency-based clinical skills teaching and assessment programme in China utilizing modern teaching techniques. Medical teachers from three schools agreed on items for inclusion in the complete physical examination of an asymptomatic adult, an outline for an adult and paediatric history, and important interviewing skills. Lesson plans, performance checklists, and written and videotape training materials were developed. Standardized patients were trained at one school to assist with the teaching at that school and with the assessment at all three schools. A national, a provincial, and a local medical school in China were used. Before beginning the new curriculum for students in their first year of clinical training, baseline data were collected on skills of students at various levels of training in the previous curriculum at all three schools. Although in the previous curriculum there was some improvement in clinical skills among advanced compared to more junior students, performance was lower than expected by staff. One year after implementation of the new curriculum, students were evaluated. These students significantly outperformed their counterparts as well as the more senior level students tested the previous year. This project has established a competency-based teaching and assessment programme in China that allows for rapid improvement in the clinical skills of students. Within a short time, a sophisticated group of medical educators has been formed, who now function as consultants to other educators in their own country. Many aspects of this programme are being adapted throughout China and are applicable to medical schools throughout the world.     

2012 - 2017年内蒙古贫困农村学生血清维生素A和D变化趋势分析

目的 了解“农村义务教育学生营养改善计划” 内蒙古重点监测县扎赉特旗学生维生素A、D营养状况,从而评价其实施的效果,为下一步学生营养改善计划更好地实施提供建议。方法 在内蒙古实施“学生营养改善计划”的重点监测县扎赉特旗,随机抽取小学和初中各1所,再从各年级抽取1～2个班的学生,达到每个年级40名学生左右。每年10—11 月,对学生采集空腹静脉血,分离血清,用液相色谱串联质谱仪(LC - MS/MS)检测血清维生素A和维生素D。结果 （1）2016年女生血清维生素A为（324.9±68.3） μg/L高于男生的（307.3±64.9） μg/L;2013 - 2016年,初中生血清维生素A 水平均高于小学生,差异均有统计学意义( 均P＜0.05)。除2014年外,其他年份男生血清维生素D水平均高于女生, 2012 - 2017年小学生血清维生素D水平均高于初中生,差异有统计学意义。（2）2013 - 2016年小学生血清维生素A 亚临床缺乏率分别为38.8%、65.5%、39.1%、37.5%,均高于初中生的10.1%、32.6%、25.0%、24.5%。从2012 - 2017 年学生维生素A亚临床缺乏率由56.0%降为45.7%,缺乏率由14.2降为3.1%,均呈下降趋势,有统计学差异(均P＜0.05)。（3）2014 - 2017年女生维生素D不足率均高于男生,2015 - 2017年初中生血清维生素D不足率高于小学生,有统计学差异;2012年、2013年和2015年女生维生素D缺乏率高于男生,2012年和2014年初中生血清维生素D缺乏率高于小学生;从2012 - 2017年学生维生素D不足率由65.6%降为30.9%,缺乏率由19.7%降为0.6%,均有下降趋势,有统计学差异( 均P＜0.05)。结论 2012 - 2017年,内蒙古实施“学生营养改善计划”的重点监测县扎赉特旗学生血清维生素A、D营养状况有所改善,但仍不容乐观,应继续坚持实施“学生营养改善计划”, 鼓励学校积极使用“学生电子营养师”软件,进行科学合理配餐,改善学生微量营养素缺乏状况,保障儿童青少年健康成长。     

Can brief workshops improve clinical instruction?

CONTEXT: The impact of faculty development activities aimed at improving the teaching skills of clinical instructors requires elucidation. Since 2003, all instructors at our school of medicine have been required to undertake a brief workshop in basic clinical instructional skills as a prerequisite for promotion and tenure. The impact of this has, so far, remained unknown.OBJECTIVE: This study aimed to examine to what extent participation in a brief workshop can improve clinical instructors' performance in the long run, and which particular dimensions of performance are improved.METHODS: The study included a sample of 149 faculty members who undertook a required workshop in basic instructional skills. The teaching performance of these faculty members was measured by student feedback a year after the workshop. The study used pre- and post-test design, with a comparison group of 121 faculty members.RESULTS: Student ratings for 5 dimensions of clinical instruction increased significantly, but only for the study group who had participated in a workshop. The comparison group's ratings were unchanged. The highest improvement in the instructors' performance related to availability of teachers to students.CONCLUSIONS: The study supports previous findings about the added value gained by longterm improvement of instructional skills after participation in even a brief workshop. The meaningful improvement in instructor availability to students is associated with the workshops' emphasis on a learner-centred approach and the need to provide continuous feedback.     

Instructions in learning skills: an integrated approach

Summary. The transition from school to university education and a medical school environment can be difficult even for the very best students. However, little appears to be done to assist students in making this transition and in developing study skills during the early stages of their training. This article outlines a scheme which has been called supplemental instruction. Although developed for medical students in the United States, it is particularly well suited to developing essential study skills in first-year medical students in the United Kingdom. The scheme has been successfully introduced into some degree and diploma subjects in this country, with improvement in course grades and lower attrition rates, but has yet to be introduced into medical education. Evaluation data for non-medical courses show that student participation in supplemental instruction significantly improves overall course marks and could be of significant value in the medical curriculum.     

中国4城市中小学生早餐行为调查

为了解中国城市中小学生早餐现状 ,为深入研究中小学生早餐问题 ,制定和开展我国“学校营养早餐计划”提供科学依据 ,在广州、上海、济南和哈尔滨四城市通过家长填写问卷的方式 ,对 76 17名 6～ 15岁中小学生的早餐行为进行了调查。结果显示 ,我国四城市中小学生不能保证每天吃早餐的比例分别为 18 9%和 16 6 % ,而吃早餐者其早餐食物品种单一 ,营养质量较差。提示中小学生的早餐行为应引起广泛关注     

Click it: assessment of classroom response systems in physician assistant education

The effect that classroom response systems, or clickers, have on knowledge retention and student satisfaction was studied in a physician assistant program. A clicker, a device similar to a remote control, was used by students to answer questions during lectures. This new technology has been marketed to educators as beneficial in keeping students actively involved and increasing their attentiveness in the classroom. To date, the results of studies on knowledge retention with the use of clickers have been mixed. For this pilot study, the students were divided into two groups with a pre- and post-test given in order to evaluate knowledge retention. One group received lectures in a traditional format, while the other group received the lectures incorporating clicker response questions. After the test scores from four lectures were analyzed, the incorporation of clickers did not alter knowledge retention. Retention of knowledge from both groups was similar and no statistical difference was found. However, student satisfaction regarding the use of clickers was positive. Students reported that clickers kept them more actively involved, increased attentiveness, and made lectures more enjoyable. Although the pilot study did not show a greater improvement in knowledge retention with the use of clickers, further research is needed to assess their effectiveness.     

Use of commercial ''authoring systems'' for medical education

A recent development in computer-assisted medical instruction has been the introduction of 'authoring systems'. Authoring systems are computer programs which can allow an instructor to prepare computer-based medical instructional materials without the need to know programming languages or have more than minimal familiarity with the computer hardware. This report documents the use of a commercially available authoring system that was used to prepare a tutorial for medical student instruction. This lesson presented information about paediatric developmental disabilities in both a text and question-and-answer format. Significant improvement in knowledge was demonstrated by the pre- and post-test results of the study group compared to the control group. The control group consisted of students who did not view the tutorial but had been assigned to a paediatric developmental disabilities clinic. The medical students who viewed the tutorial generally had very favourable comments about the use of such a system for the presentation of new information.