医学检验技术专业“双岗位”人才培养模式改革之思考

随着医学检验技术专业招生规模的扩大,传统的医院检验科、血站和疾控中心等单位对医学检验技术人才需求越来越少,而医学检验相关企业却快速发展,人才需求旺盛。传统的以医院临床检验岗位为主的"单岗位"人才培养模式所培养的学生越来越不能适应行业需求,尤其是企业的需求,为了改变目前这种现状,彻底改变学生的就业观念,拓宽学生的就业空间,提高学生的就业能力,促使更多学生首选企业就业,满足行业发展需求和专业的长远发展,必须改革传统的"单岗位"人才培养模式,建立既适应医院临床岗位需求又适应医学检验相关企业岗位需求的"双岗位"人才培养模式,为医院和企业培养适应性人才,实现医院和企业人才的互通。     

重庆市高职高专医学检验技术专业人才需求

目的了解重庆范围内高职医学检验技术专业人才需求情况。方法通过问卷调查法对37家医院、4家企业进行人才需求调研及资料收集。采用SPSS21.0对结果进行统计分析。结果未来5年83.8%(31/37)的医疗单位需要医学检验技术专业人才,其中三级医院的人才需求达到94.4%(17/18);目前医学检验技术专业专科毕业生在各级医院及企业工作时,扎实的基本功用人单位是最为看重的素质。结论重庆市范围内医学检验技术人才需求仍有较大缺口,对高职高专毕业生仍有一定需求。     

基于校企协同育人平台探索高职医学检验专业实践教学创新模式

在当前高职院校创新创业教育深化改革下,以校企共建医学检验所的产教深度融合和转化检验医学理念的引入为契机,遵循职业认知和职业岗位要求,结合漳州卫生职业学院2014年-2016届高职医学检验技术专业毕业生就业岗位调研分析,进一步探索"一体化、双融合、三联动、四递进"的实践教学创新改革思路,构建"基于工作过程"递进式高职医学检验技术专业校企协同育人实践教学模式,对实现实验实训教学与职业岗位零距离的融合、提升专业创新人才的培养及拓展多元化的就业具有重要意义,为今后重构全新实践教学课程体系的研究提供参考价值。     

医学检验技术专业工学结合人才培养模式研究

当前高职教育坚持"以服务为宗旨,以就业为导向,以能力为本位,以素质教育为根本,以工学结合为特征"的职业教育办学指导思想[1],原有的医学检验技术专业的人才培养模式不能适应高职教育发展的需要.本文以高职医学检验技术专业学生为研究对象,探索特色鲜明的医学检验技术专业"医教结合,校院共育"人才培养模式;构建基于工作过程的"能力模块"型课程体系;实施以学生为主体的"教学做评"一体化工学结合教学模式;开发形式多样的特色教学资源;形成一支"专兼"结合、素质优良、具有创新精神的教学团队."医教结合、校院共育"人才培养模式为高职医学院校工学结合的最佳途径和方式,可供校内外医学及医学相关专业借鉴.     

高等职业院校医学检验技术专业人才培养的岗位核心能力调查分析

目的调查分析高职医学检验技术专业人才培养的岗位核心能力。方法从专业能力、方法能力和社会能力共三个方面设计岗位核心能力问卷,对四川和重庆部分地区共69家医疗机构检验科专家进行调查。结果高职医学检验技术最重要的3种专业能力是临床常规检验、生物化学检验、免疫学检验;最重要的3种方法能力是临床检验质量控制和质量管理、实验室程序和记录书写、传染病的报告与处理;最重要的3种社会能力是敬业精神、服务意识、团队协作能力。结论医学检验技术人才培养应以专业能力、方法能力和社会能力为出发点,突出岗位核心能力的培养。     

高校医学检验技术专业开设输血检验辅修专业的探索

输血医学已经发展成1门独立的专业学科,但大多数血站机构检验科工作人员、医院输血科和检验科(血库)医技人员的输血专业背景只是在医学院校学习时接受过少量的输血检验相关知识的教育,难以胜任输血医学学科发展的需求;因此培养输血检验专业人员是1项非常紧迫而重要的任务。在借鉴检验医学院和大连市血液中心拥有共同开办血液检验专业方向经验的基础上,我们在医学检验技术专业中设立了输血检验辅修专业,优选对输血感兴趣、学有余力的学生学习输血医学(检验)专业知识,确保其在有限的时间内尽量掌握更多的输血检验的相关理论和技术。由于在输血检验教学模式、教学方法作了配套改革和探索,使辅修输血检验专业的学生未来就业多了1个选项并可以更好地适应血站、医院的输血检验工作之需。     

我国现阶段输血医学本科生培养的方式和效果——以2所医学院校输血医学方向的本科生培养模式为例

目的探讨我国高等医学院校本科专业输血医师和输血技师2个培养体系对输血专业人才的培养效果。方法对分别在临床医学和医学检验专业内培养输血医学方向学生的2所高校(高校A和高校B)输血医学方向学生的培养情况、毕业去向及学生反馈等做调查分析,其中学生反馈采用调查问卷的方式。结果 2所高校毕业生对课程安排、实习安排、现工作的满意度、本科所学知识在工作中的实用性以及对输血医学发展前景的评分(分)分别为:81.00±9.40、78.43±10.37、81.35±9.84、79.74±10.30和73.38±14.58,高校A毕业生中就业于输血相关岗位的占30.12%,低于高校B的88.23%。结论临床医学专业和医学检验专业培养输血方向本科生都不失为输血医学人才的有效培养模式,但是如何使输血方向本科生在输血行业中站稳脚跟,尤其是如何使临床专业培养的输血方向本科生不断充实和稳定在输血医学队伍中,是解决我国输血人才缺乏、推动输血医学发展的关键。     

构建特色专业，促进检验医学快速发展

特色专业建设是一项艰苦而复杂的工程。为适应当今检验医学发展的需要,构建国家级医学检验特色专业,培养既能从事临床检验工作,注重检验技术应用的研究,又能从事检验试剂研制、开发,注重检验技术方法学研究的一专多能的应用型人才。不仅需要投入极大热情、付出艰苦努力,更需要准确地把握学科发展方向。以学科发展和社会对人才的需求为导向,抓住机遇,精心安排,为促进检验医学的发展做出贡献。     

临床实践在临床输血学检验教学中的作用探讨

随着社会经济和医学科学技术的发展,社会对从事输血医学研究和临床输血工作人才的需求发生了变化,对培养临床输血技术应用型人才的输血医学教育也提出了新的要求和挑战。目前在各级医院输血科工作的人员绝大部分是检验专业毕业生。《临床输血学检验》是医学检验专业近年为适应学科进展以及我国检验专业教育改革的需要［1］,面向医院输血科（血库）、血站及血制品单位相关岗位实际所需而设的一门课程。输血科、血站是操作性很强的科室,必须具备很强的临床技能才能胜任输血科、血站实验室的各项工作,成为合格的输血工作者。笔者于2009～2011年在安徽省血液中心临床实践,掌握临床专业技能,完善教师自身知识结构的同时,体会了临床实践在临床输血学检验课程教学的作用,并在教学过程中采取一定措施,取得满意的教学效果。     

以需求为导向改革高等职业技术教育康复治疗专业课程

现代高等职业技术教育的生命力在于培养满足社会需求的高级技术应用性人才.高职康复教育应以适应和满足市场需求及岗位需求为导向,制定专业培养目标.构建课程体系,选择课程内容,实施课程评价.     

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.     

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.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.     

Imaging choices in occult hip fracture

Background: Hip fracture is a common injury, with an incidence rate of > 250,000 per year in the United States. Diagnosis is particularly important due to the high dependence on the integrity of the hip in the daily life of most people. Objectives: In this article we review the literature focused on hip fracture detection and discuss advantages and limitations of each major imaging modality. Discussion: Plain radiographs are usually sufficient for diagnosis as they are at least 90% sensitive for hip fracture. However, in the 3–4% of Emergency Department (ED) patients having hip X-ray studies who harbor an occult hip fracture, the Emergency Physician must choose among several methods, each with intrinsic limitations, for further evaluation. These methods include computed tomography, scintigraphy, and magnetic resonance imaging. Conclusion: We present an evidence-based algorithm for the evaluation of a patient suspected to have an occult hip fracture in the ED. Also outlined are future directions for research to distinguish more effective techniques for identifying occult hip fractures.     

Systematic Reviews Published in the April 2012 Issue of the Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD but monthly online. The April 2012 issue (second DVD for 2012) contains 5045 complete reviews, 2182 protocols for reviews in production, and 17,084 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 674,000 randomized controlled trials, and 15,400 cited papers in the Cochrane methodology register. The health technology assessment database contains just over 11,000 citations. One hundred and seventeen new reviews have been published in the last 3 months of which 12 have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 6.186. Readers are encouraged to access the full report for any articles of interest as only a brief commentary is provided.     

Platelets,thrombosis, coagulation,and atherosclerosis

When I first got the invitation to join a medical delegation going to Moldova, I thought for a moment that our destination was the fictional country in the old Marx Brothers movie Duck Soup. On further checking, it turns out that entertaining place was called Freedonia. I now know that Moldova is indeed a real country, bordered on the west by Romania and on the other three sides by the Ukraine. It is a proud country, rich with traditions, and its people are warm, giving, eager to learn ways to improve their healthcare system, and deeply appreciative of our attempts to help them in the task.     

Advance Care Planning

Predictors of patient wishes and influence of family and clinicians are discussed. Research findings on patient decision-making relating to preferences in end-of-life care are described. Advance directives and durable powers of attorney are defined and differentiated. Most patients have not participated in advance care planning and the need for more effective planning is documented. Appropriate times for discussions of such planning are described. Scenarios discussed include terminal cancer, chronic obstructive pulmonary disease, AIDS, stroke, and dementia. Patient satisfaction is discussed, as is a structured process for discussions about patient preferences. Results of patient responses to hypothetical scenarios are described. Invasiveness of interventions, prognosis and other factors that favor or discourage patient preferences for treatment are discussed. Findings resulting from research funded by the Agency for Healthcare Research and Quality (AHRQ) are discussed. This research can help providers offer end-of-life care based on preferences held by the majority of patients under similar circumstances.     

Spiritual Dimensions of Nursing Practice. edited by V. B. Carson

The Cochrane Library of Systematic Reviewsis published quarterly. Issue one for 2004 of the library was published in February 2004. This issue contains 3,329 reviews and protocols of which 1,921 are fully published reviews. The trials database now stands at over 400,000 records with an additional 4,427 one-page summaries of non-Cochrane reviews in the NHS database of reviews of effectiveness (DARE). This version of the library contains the results of an extensive search for RCTs on EMBASE. The latest library contains 84 new reviews, seven are considered relevant to practitioners in pain and palliative care. References are published in the same format as the citation for Cochrane reviews.     

Évaluation,par l’imagerie ultrasonore,du recrutement musculaire,de la force motrice et de la détente verticale du quadriceps après électromyostimulation (cas de 15 étudiants de l’INJS)

The increase of strength seems to be an element of performance in some sports.