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1.
肖传实 《中国全科医学》2010,13(22):2424-2427
目的 利用教学医院高水平的医学理论知识、丰富的临床诊疗经验及具有社区医疗实践的全科医师师资团队,探寻规范化、实用性强的全科医师骨干培训教学模式.方法 选择山西医科大学第二医院为全科医师骨干核心培训基地,选择2007年、2008年山西省全科医师骨干培训班学员131名为研究对象.应用<中西部社区卫生人才培养项目评估指标体系>评估全科医师骨干培训基地;收集学员对培训需求程度的信息反馈表;比较131名学员培训前、后的理论与操作考试成绩及培训后131名学员与其相应单位同事的综合服务能力;评价目前全科医师骨干培训教学计划的实施效果.结果 我院社区卫生人才培训项目总评分>60分,评估结果合格;学员最需要的是关于"社区常见病、多发病的诊断、鉴别诊断"与"急诊处理及转诊指南"方面的培训;学员培训前后的理论考试成绩与技能操作成绩比较,差异有统计学意义(P<0.05);参加培训与未参加培训者综合服务能力多项指标提高情况比较,差异有统计学意义(P<0.05).结论 目前教学医院主要承担全科医师骨干的培训工作是可行的,教学计划也能基本满足学员的社区需求,但还需进一步完善社区实践基地的建设、带教师资认定的标准等.  相似文献   

2.
"四阶梯"教学法在全科医师师资培训中的应用效果研究   总被引:1,自引:0,他引:1  
目的 评价"四阶梯"教学法应用于全科医师师资培训中的效果.方法 来自全国各地的全科医师共21人参加在北京协和医院举办的为期4天的培训班,通过"理论授课、模拟教学、临床带教和独立实习"四个阶梯进行全方位教学.在培训前后针对参加学习学员的理论水平、临床操作技能、授课能力进行评价,对比反映此次培训的实际效果.结果 培训后学员的理论考核平均成绩为(74.0±7.0)分,较培训前的(45.6±6.9)分有了明显提高,差异有统计学意义(P<0.01);对于心肺复苏的掌握由培训前仅有4人(19%)基本合格,达到培训后的16人(76%)合格,差异亦有统计学意义(P<0.01);授课技能方面从无人能自己组织课件、制作幻灯到培训后掌握了幻灯制作、现场授课、归纳总结等基本授课技能.结论  "四阶梯"教学法在全科医师师资培训中效果显著,可以作为新型的教学方法进行推广.  相似文献   

3.
目的 评估全科医生临床能力培训的效果,为今后进一步完善培训方案、提高培训质量提供科学依据.方法 以2011年7月至2012年10月期间参加上海市全科医生临床能力培训的759名学员为研究对象,比较这些学员参加培训前后的理论和操作成绩,分析影响培训效果的因素,评价培训的实施效果.结果 759名学员中,男性260名(34.26%),女性499名(65.74%);平均工作年限(13.6±7.1)年.学员培训前后理论和实际操作的总成绩分别为(67.40±8.57)分和(73.61±7.20)分,培训前后成绩的差异具有统计学意义(=17.96,P<0.01).培训后实际操作成绩的提高更为明显,培训前后体格检查的成绩分别为(12.90±3.76)分和(14.00±3.51)分,而临床技能成绩分别为(9.41±4.80)分和(13.40±4.02)分,前后成绩的差异均有统计学意义(t值分别为6.31和19.01,均P<0.01).在体格检查项目中,心肺体检、腹部体检、甲状腺检查和神经系统体检4个项目的培训后成绩高于培训前,且差异具有统计学意义(均P <0.05或0.01);而临床技能的所有7个项目的培训后成绩均明显高于培训前(均P<0.01).多元线性回归分析显示,学员培训效果影响因素包括性别、教育程度、专业类别及培训前成绩(P<0.01或<0.05).结论 全科医生培训后理论知识和实际操作能力都有提高,尤其是临床技能操作水平提高更为明显.今后的培训内容应结合社区全科医生实际工作特点,注重临床技能培训,提高社区全科医师的综合素养.  相似文献   

4.
刘明婷  廖淑梅  刘萌 《中国全科医学》2010,13(22):2428-2429
目的 分析社区骨干护士培训的效果,为有效地开展培训提供理论依据.方法 以湖南省2009年参加社区骨干护士培训班的111名学员为调查对象,采用问卷形式进行调查.结果 培训后,学员社区护理相关知识得分由培训前的(17.39±3.23)分提高到了(23.07±3.07)分,培训前后比较差异有统计学意义(P=0.000).培训转变了学员对社区护理的态度,培训后,非常愿意从事社区护理工作的学员由39.3%增加到69.6%;学员对社区护理发展前景非常看好的比例由50.5%提高到77.5%;学员工作的自信度也有所提高,认为自己可以胜任(包括完全可以胜任和差不多可以胜任)社区护理工作的比例由51.4%提高到92.2%.培训前后学员从事社区护理工作的意愿、对职业前景的预测及对自身胜任社区护理工作自信度比较差异均有统计学意义(P<0.05).结论 培训提高了学员的社区护理相关知识,强化了社区护士对自身角色的认同.  相似文献   

5.
目的了解广州市2009—2010年全科医师培训的效果,为改进培训策略和方法提供科学依据。方法采用分层随机抽样的方法,对参加广州市全科医师岗位培训的199名培训学员及其主管领导、同事进行自填式问卷调查。结果 62.81%(125/199)的培训学员对培训项目总体评价为"较好"或"很好",培训学员对培训师资的满意度得分为(4.13±0.66)分,课程安排丰富程度得分为(3.59±0.78)分,师资和学员的互动满意度得分为(3.58±0.80)分。培训学员认为知识技能得到较大改善、很大改善率较高的项目包括重点人群保健(76.88%,153/199)、健康教育(75.88%,151/199)、社区现场应急救护(74.37%,148/199)。主管领导和同事对学员培训后的工作表现均给予了较高评价,认为所有项目总改善率均达到90%以上。结论全科医师岗位培训取得了较好的效果,今后培训过程中,应重视培训内容的安排和设计,促进师资与学员的互动交流,加强临床诊疗技能、医疗管理能力及科研能力的训练,以期进一步提高全科医师培训的效果。  相似文献   

6.
目的了解广东省家庭医生式服务能力建设师资培训效果,为今后进一步完善培训方案,提高师资培训效果提供科学依据。方法采用整群抽样方法 ,在培训前后分别对参加2014年广东省家庭医生式服务能力建设师资培训班的学员进行无记名自填式问卷调查,分析培训前学员对全科医学知识与技能掌握的必要性、学员对本次培训的满意度、培训前后学员对全科知识和技能掌握程度自评情况。结果被调查的251名学员中,95%以上的学员认为,这种类型的培训能巩固全科基本理论,加强专业知识,改善服务技巧及培养教学与科研能力;学员对本次培训总体上满意,满意度排在前两位的是授课师资(98.0%)和授课方法 (92.4%);培训后提高最明显的前三位是:家庭医生式服务理念和能力(215人,85.7%),全科团队服务理念和能力(210人,83.7%),对社区卫生的信心(163人,64.9%)。学员自评被调查的18项全科知识和技能的掌握程度,培训后各项的掌握程度均高于培训前(P<0.05)。结论广东省家庭医生式服务能力建设师资培训的总体效果满意,但仍需要继续完善家庭医生式服务能力建设师资的培训方案,进一步提高培训效果。  相似文献   

7.
目的 了解云南省全科医师师资培训的效果,探索全科医师师资培训模式.方法 采用问卷调查方法,整群抽取2010年云南省第二期全科医师师资培训班的108名学员进行调查.结果 54.63%的学员对课程内容设置满意,99.07%的学员认为培训对提升自身带教能力有帮助,75.92%的学员认为5 d的培训时间较短.学员的笔试平均成绩为(75.27±5.12)分,各类师资笔试成绩构成间差异有统计学意义(P<0.01).结论 开办短期培训班能有效提高全科医师师资的带教能力,但需优化课程内容,丰富教学方法,适当增加培训时间,加强师资的规范管理.  相似文献   

8.
目的:观察门诊药房药师规范化培训的方法及效果。方法:对16名门诊药房药师进行规范化培训,对培训前后的药学知识、操作能力、沟通能力进行测试;并对培训前后各120例患者进行对药房的满意度调查,对药房的服务态度、等候时间、用药讲解、方便程度等进行评价。结果:规范培训后,门诊药房药师的药学知识(86.61±7.03)分、操作能力(91.17±4.57)分和沟通能力(84.62±6.97)分,得分较培训前均有明显提高,差异有统计学意义(P<0.05);患者对门诊药房的服务态度(8.89±0.83)分、等候时间(9.05±0.41)分、用药讲解(8.76±1.13)分和方便程度(9.29±0.48)分的满意度评分较培训前均有明显提高,差异有统计学意义(P<0.05)。结论:门诊药房药师经过规范化培训后执业素质和患者的满意度均能得到明显提高。  相似文献   

9.
目的 对黑龙江省全科医师的现状进行问卷调查,同时通过培训前后的技能考试结果,评价临床模拟技能教学对全科医师临床技能培养的效果.方法 采用问卷调查方法,调查黑龙江省全科医师的基本情况并对其培训前后技能考核成绩进行比较.结果 经过临床模拟教学系统培训的学员的技能考核成绩显著提高,比较培训前后的成绩,其差异具有统计学意义(t=13.501,P<0.05),18项技能考试前后成绩对比差异均有统计学意义.结论 通过临床模拟技能中心对全科医师进行技能培训,可以有效提高全科医师的临床技能操作水平和诊疗能力.  相似文献   

10.
目的:探究以问题为中心(PBL)教学模式在神经内科住院医师规范化培训临床教学中的应用情况。方法:系统回顾从2019年1月~2019年12月间进行规培的神经内科住院医师中选取46名作为本次研究对象,按照不同带教风格特点分为对照组与研究组,各23名。对照组应用传统教学方法培训,研究组在传统教学方法基础上增加PBL教学,对比两组学员的教学效果及对教学模式的认可度。结果:研究组学员的神经内科出科考试中理论测试和技能测试成绩分别为(43.02±6.45)分、(43.46±6.18)分,而对照组神经内科的出科考试理论测试和技能测试成绩分别为(38.46±6.55)分、(37.40±5.40)分,研究组神经内科成绩均高于对照组学员,差异有统计学意义(t=3.176、4.728,P<0.05)。研究组学员对传统模式结合PBL教学模式的认可度在"该教学模式能够提高教学质量""该教学模式能够降低学习难度""该教学模式对于提高自我学习能力有较好作用"等中的认可度高于对照组,差异有统计学意义(P<0.05)。结论:PBL教学模式在神经内科住院医师规培教学中应用价值高,能帮助学员提升神经内科专业知识和临床业务素质,同时学员对该教学模式的认可度也较高,值得推广。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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