对住院医师规范化培训与专业型硕士培养并轨的探讨

在阐述住院医师规范化培训与专业硕士培养并轨必要性的基础上,分析住院医师规范化培训与专业硕士培养并轨的现状.结合国内外住院医师规范化培训经验,探索完善住院医师规范化培训制度.提出住院医师规范化培训与专业硕士培养并轨尚需解决的问题,提示应进一步完善住院医师规范化培训与专业硕士培养并轨机制.     

深圳市住院医师规范化培训实践

深圳市在多年的探索和试点工作基础上,从2010年开始面向全国各高等院校本科以上应届毕业生公开招考住院医师规范化培训学员,开始了新型住院医师规范化培训的实践.对住院医师规范化培训在政策、经费上予以大力支持,通过与全国多个医学院校附属医院建立委托培养关系,充分利用了国内优质资源,保证了深圳市住院医师规范化培训质量.作为我国住院医师规范化培训项目先行先试的城市之一,深圳市的住院医师规范化培训工作取得了一定的成绩,但仍需进一步完善住院医师规范化培训管理制度、积极探索各类医疗卫生人员的规范化培训模式、不断提高本市基地培养水平.     

住院医师规范化培训中存在的问题及创新性探索

住院医师规范化培训制度是医学生毕业后教育的重要环节,是深化我国医疗体制改革和医学教育改革的重大举措,为保障人民健康培养了大批医学人才。作为住院医师规范化培训基地,在住院医师规范化培训的临床实践教学中总结了影响教学质量的突出问题并进行了创新性探索,对提高培训质量,探索培养合格的医学人才具有重要意义。     

中美住院医师培训制度的外部环境比较分析

作者从能够影响住院医师培训效果的经济、教育、政策保障和职业环境等外部环境因素人手,分析了中美间的差异,并对加强我国住院医师规范化培训的外部环境建设提出了建议,着重加强我国医学院校教育与住院医师培训的衔接,加大对住院医师规范化培训的投入与管理,将住院医师规范化培训与基层医疗保健体系建设相结合等。     

新住院医师规范化培训制度下大学附属医院教育工作的思考

我国即将全面启动住院医师规范化培训工作,“5+3”的住院医师规范化培训模式是未来临床医师培养的基本途径.因此以医学本科毕业后教育为起点,以相应二级大学科专业为主要培训内容的住院医师规范化培训体系,将成为大学附属医院教育工作的重点内容.医院应及时将住院医师规范化培训工作纳入医学教育、学科发展和人才培养的主要内容,予以高度重视并采取相应措施.     

住院医师规范化培训的做法与体会

医学教育是个连续过程，即由医院基本教育、毕业后医学教育和继续医学教育三个不同阶段组成。住院医师规范化培训是毕业后医学教育阶段的主要组成部分，是培养高水平医学专业人才的重要手段和必经途径。住院医师规范培训越来越为人们所重视。我院历来重视住院医师规范化培训工作，早在1990年就制定了《住院医师继续教育实施细则》，对毕业新分配入院的医学本科生实施两年的系统轮转培训。为适应知识经济时代医疗卫生服务对临床医学人才的新要求，2000年在总结过去住院医师规范化培训经验基础上，又对住院医师规范化培训方法进行了进一步完善，取得较好的成效。     

解放军总医院住院医师培训工作探索

为适应医学模式的转变和医学教育的发展，走出住院医师培养的瓶颈，作者以解放军总医院近几年来在住院医师规范化培训工作的改革与实践为基础，介绍和探讨了该院建立“3＋X＋Y”模式住院医师培养制度的运行和效果，并对进一步深化住院医师规范化培训提出建议。     

住院医师在规范化培训中所需的意识形态

目的研究我国住院医师培养现状，探讨如何改进、完善规范化培训制度。方法研究国外住院医师培养制度及要求，结合我国住院医师培养现状，在完善规范化培训制度本身的同时，重视对住院医师的意识改进。结果我国的医师培养还停留在住院医师培养的初级阶段，其制度本身和主体意识与国际医学人才培养与使用的惯例不相适应，由此需要建立五种意识形态，即国际化、进取、科研、团队和操守伦理意识。结论建立住院医师应有的主体意识是成长进步的关键和动力，更是完善我国住院医师规范化培训的极大助力。     

脑病科规范化培训住院医师带教体会

住院医师规范化培训是医学生毕业后教育的重要组成部分,作为脑病科的一名带教老师,在带教实践中,重视规培医师的入科思想教育,加强规培医师业务能力的培训,培养规培医师良好的沟通能力,完善规培医师的考核制度。规范化培训阶段是住院医师成长为一名合格医生的重要阶段,进行规范化培训的住院医师是医院临床、教学和科研工作未来的主力军和后备力量。     

我国住院医师规范化培训现状的系统评价

目的:系统评价我国住院医师规范化培训现状,提出相应的政策建议.方法:以2014年1月至2020年12月为检索时限,"住院医师规范化培训现状""住院医师规范化培训进展""住院医师规范化培养现状""住院医师规范化培养进展"为主题检索词,系统检索中国知网、万方、维普等数据库的相关文献.结果:我国住院医师规范化培训总体实施效果...     

Cost--benefit concepts in health: examination of some prevention efforts.

As expenditures on health continue to increase it becomes important to determine the effectiveness of health care programs. In this paper we outline an approach to evaluating health care programs with particular emphasis on preventive programs. We argue that the most important and most difficult step in the process is assessing the differential impact a measure has on health status. Some specific programs including environmental control, the search for healthful life-styles, and screening programs are briefly considered.     

Vision, Visual Needs, and Quality of Life of Older People in Rural Environments: A Report and Synthesis of a Meeting

Vision as an aspect of rural aging was a major portion of the First International Conference on Rural Aging. Various perspectives on the relationship of vision to rural aging were presented in two symposia, two paper sessions, one workshop and the poster session (a total of 28 presentations). In summarizing this rich and varied material, the author emphasizes that: (a) vision is important to maintaining a healthy, active life as one ages; (b) impaired vision is generally preventable or treatable; (c) well-designed community programs can assist in prevention and treatment; and (d) assessing the effects of these programs requires evaluation of patients' quality of life. More research is needed to refine strategies for creating, maintaining and evaluating community-based eye care programs and integrating them with existing public health or other community programs.     

Effects of Regulation on Methadone and Buprenorphine Provision in the Wake of Hurricane Sandy

Hurricane Sandy led to the closing of many major New York City public hospitals including their substance abuse clinics and methadone programs, and the displacement or relocation of thousands of opioid-dependent patients from treatment. The disaster provided a natural experiment that revealed the relative strengths and weaknesses of methadone treatment in comparison to physician office-based buprenorphine treatment for opioid dependence, two modalities of opioid maintenance with markedly different regulatory requirements and institutional procedures. To assess these two modalities of treatment under emergency conditions, semi-structured interviews about barriers to and facilitators of continuity of care for methadone and buprenorphine patients were conducted with 50 providers of opioid maintenance treatment. Major findings included that methadone programs presented more regulatory barriers for providers, difficulty with dose verification due to impaired communication, and an over reliance on emergency room dosing leading to unsafe or suboptimal dosing. Buprenorphine treatment presented fewer regulatory barriers, but buprenorphine providers had little to no cross-coverage options compared to methadone providers, who could refer to alternate methadone programs. The findings point to the need for well-defined emergency procedures with flexibility around regulations, the need for a central registry with patient dose information, as well as stronger professional networks and cross-coverage procedures. These interventions would improve day-to-day services for opioid-maintained patients as well as services under emergency conditions.     

Physical education for Head Start children: A field-based study

Although Head Start Programs provide preschool children with essential academic readiness skills and experiences, a critical missing link in the curriculum is motor skill instruction. The purpose of this study was to examine the effects of a motor development program taught by physical education majors on Head Start children's gross motor development. Participants were 53 preschool children #op2 classes from each of 2 centers#cp who were enrolled in Head Start programs and 28 physical education majors who were enrolled in two separate motor development classes. The Test of Gross Motor Development #opUlrich, 1985#cp was used for assessment and instruction. Prior to teaching the children, the university students received approximately 12 hours of practical training in motor skill analysis and assessment through laboratory experiences and videotapes. The two Head Start centers #opgroups A and B#cp were pretested in October prior to the start of the instructional program. Group A received the instructional program during the next 10 weeks and then both groups were retested. During the following 10 weeks. Group B received the same instructional program and then both groups were again tested. A 2 #opGender#cp x 2 #opGroup#cp x 3 #opTest#cp repeated measures design produced a significant Group x Test effect. Gender differences were not significant. Post-hoc analysis revealed significant differences between tests 1 and 2 for group A and between tests 2 and 3 for group B. Results suggest that a competency-based motor development program taught by physical education students can provide valuable benefits for both Head Start programs and undergraduate teacher preparation programs.     

Price elasticity and pharmaceutical selection: the influence of managed care

State Medicaid programs are turning increasingly to managed care to control expenditures, although the types of managed care programs in use have changed dramatically. Little is known about the influence of the shifting Medicaid managed care arena on treatment decisions. This paper investigates factors affecting the selection of treatments for depression by providers participating in either of two Medicaid managed care programs. Of particular interest is the influence of medication price on the choice of treatment, since one vehicle through which managed care organizations can reduce total expenditures is by increasing the price sensitivity of participating providers. We take a new approach by phrasing the problem as a discrete choice, using a nested multinomial logit model for the analyses. Contrary to earlier literature, we find some evidence that physicians in both programs do take price into consideration when selecting among treatment options. HMO providers in particular demonstrate increased price sensitivity in the two most commonly prescribed categories of antidepressants.     

A framework for joint modeling and joint assessment of efficacy and safety endpoints for probability of success evaluation and optimal dose selection

The evaluation of clinical proof of concept, optimal dose selection, and phase III probability of success has traditionally been conducted by a subjective and qualitative assessment of the efficacy and safety data. This, in part, was responsible for the numerous failed phase III programs in the past. The need to utilize more quantitative approaches to assess efficacy and safety profiles has never been greater. In this paper, we propose a framework that incorporates efficacy and safety data simultaneously for the joint evaluation of clinical proof of concept, optimal dose selection, and phase III probability of success. Simulation studies were conducted to evaluate the properties of our proposed methods. The proposed approach was applied to two real clinical studies. On the basis of the true outcome of the two clinical studies, the assessment based on our proposed approach suggested a reasonable path forward for both clinical programs.     

Effect of public long-term care insurance on consumption, medical care demand, and welfare

Many governments allocate public funds to individuals who need long-term care (LTC) services as a result of chronic illnesses and functional problems. In this paper, I investigate the effects of two common eligibility criteria of LTC programs: means-tested and health-based programs. I find that publicly provided health-based LTC crowds out the medical spending among low health individuals. Furthermore, means-tested programs lead to higher initial spending on medical care and consumption goods among middle-wealth individuals. The welfare implications of these programs also depend critically upon the individuals' initial wealth and health status. Interestingly, it is possible for health-based programs to be less costly than means-tested programs.