住院医师规范化培训考评标准与评价方法研究

本文报告了住院医师规范化培训考评与定性定量的客观指标，评价方法，培训考评内容以及相关政策，并将每个接受培训医师的德，才能，绩表现转换成分值，使国家及军队住院医师培训工作形成规范化，制度化，提供一套实用的标准及管理办法，为加快卫生技术干部的培养扩大了研究思路。     

非影像专业住院医师在放射科规范化培训的现状与实践初探

【摘要】住院医师规范化培训是毕业后继续医学教育的重要组成部分，是每一位临床医师成长的必由之路。放射科作为住院医师规范化培训的公共平台科室之一，对于培训高层次临床医师、提高医疗质量至关重要。本文针对住院医师在放射科规范化培训的现状和问题，并结合我院的实际情况，从规章制度制定、轮转计划安排、培训过程落实、考核体系建立、培训质量监督等方面进行初步实践探索，希望对新模式下的非影像专业住院医师在放射科轮转培训提供一些启示和借鉴。     

我院住院医师规范化培训的实践与思考

住院医师规范化培训是临床医师成长的重要阶段,对于培养临床医师的综合能力至关重要,对于培养高能力、高素质的临床医师队伍、确保医疗质量具有非常显著作用.总结我院住院医师规范化培训的经验,并提出进一步完善规范化培训工作的建议.     

全军临床住院医师规范化培训考评方案及软件研讨会会议纪要

1994年总政干部部、总后卫生部联合下发了《全军临床住院医师规范化培训试行办法》和《全军临床住院医师规范化培训计划》后,各大单位都选择了三所医院进行试点。在试行的过程中,发现对住院医师的考评缺乏统一的标准和评分指标。全军各医院住院医师的考评范围也不一致。为此,卫生部于1994年指定北京军区解放军第266医院负责研究全军临床住院医师规范化培训考评方案。266医院成立了以潘义民副主任为组长的9人课题小组,他们先后     

规范化培训的儿科住院医师影像技能的培养及问题探索

<正>住院医师规范化培训是培养高水平医学专业人才的重要手段和必经途径,住院医师的成长和发展关系到医疗队伍的整体素质,关系到医院的医疗质量、前途和命运。而住院医师的培训是一个复     

开展继续医学教育及住院医师规范化培训工作的几点体会

继续医学教育和临床住院医师规范化培训是一项新的工作,是关系到卫生事业的一件大事,也是关系到医疗技术水平的提高和本世纪医学发展的重大问题。大力开展继续医学教育及住院医师规范培训,建设一支高素质医疗卫生队伍,努力提高专业技术人员思想道德和业务能力素质,这是摆在科教部门面前一项刻不容缓的重大任务,几年来,我院通过开展继续医学教育及住院医师规范化培训工作,使医疗、服务管理等的质量得到了明显提高,对此笔者谈以下几点体会1对开展继续医学教育及住院医师规范化培训工作的深刻理解是做好此项工作的前提1998年为逐步建立起我区继…     

美国放射住院医师培训介绍及体会

近年来,随着我国医疗体制改革推进,医师培训制度也发生了很多可喜变化。在很多城市已经逐步实施住院医师培训制度规范化,这方面美国经验值得借鉴。本文系统介绍美国放射住院医师培训制度以供放射学同道参考。     

住院医师规范化培训之“333”制管理模式运行与思考

调查本院103名“333”制人员,主要是临床类研究生和住院医师的“333”制活动出勤情况,结合我院以往住院医师规范化培训的相关情况,对取得的经验进行总结,探讨规范化管理“333”制人员的方法和最佳运行机制。     

美国放射科住院医师胜任力评价系统解读与思考(七):核医学Milestone胜任力评价系统

【摘要】核医学分阶段目标胜任力评价系统，是由美国毕业后医学教育认证委员会（ACGME）与美国核医学会（ABNM）联合倡议发起的用于评价核医学专科医师培训考核系统的一部分，该考核评价体系考核并记录核医学专科医师在培训过程中所须具备六项胜任力，包括病患照护（PC），医学知识（MK），基于系统的实践（SBP），基于实践的学习（PBL），职业素养（PROF），人际沟通技巧（ICS）。核医学分阶段目标胜任力评价系统为核医学科住院医师的规范化培训提供了统一的培养框架，对我国核医学科住院医师规范化培训和评价提供了新的借鉴和启示。     

美国放射科住院医师分阶段目标胜任力评价系统解读与思考（二）——介入放射学分阶段目标胜任力评价系统

【摘要】介入放射学分阶段目标胜任力评价系统是由美国毕业后医学教育认证委员会（ACGME）与美国放射学会（ABR）联合倡议的用于评价放射学住院医师培训考核系统的一部分，该系统可以全方位、阶段性准确考核并记录放射学住院医师介入放射方面的培养成长过程，包括病患关切（PC）、医学知识（MK）、基于系统的实践（SBP）、基于实践的学习（PBL）、职业素养（PROF）、人际沟通技巧（ICS）共六大项目，二十个单项。考核内容全方位展示了美国住院医师胜任力培训的要点，值得国内住培机构学习借鉴；其培训过程中注重的而被国内所忽视的人文知识、职业素养、人际沟通、医疗质控的参与、卫生经济学等，都是我国住院医师规范化培训，甚至医学院校课程设置须着重发展完善的胜任力培训内容。     

Enhancing military primary care research.

Military primary care resident research training varies widely among internal medicine, pediatrics, and family practice programs. The level of resident physician participation in clinical investigations appears to be less than 30% in the federal physician training system. This paper reviews the current research activity in the Army, Navy, and Air Force primary care programs. It also reports on the results of a research training workshop and offers strategies to enhance resident involvement in clinical investigations.     

《军事训练伤诊断标准及防治原则》的编制应用研究及其意义

2001年8月中国军队第一次发布实行了《军事训练伤诊断标准及防治原则》(以下简称《标准》),明确规定了军事训练伤的定义、诊断标准及分类,规范了统一的防治原则。本文阐述了《标准》的主要编制内容,并重点介绍了军训伤预警指标的提出依据,指出在训练的3～4周内,肢体疼痛及关节周围肿胀的累计发生率为20％和10％时,应及时调整训练内容、时间及强度。同时还简述了《标准》历经十余年不断修改完善的过程。《标准》在试用应用过程中具有实用性、操作性强等特点,不仅为各类伤情报告、资料统计、科学研究、成果推广提供了统一的技术依据,而且为作训部门制定训练计划提供了可靠、可比、可信的理论依据,同时由于防治原则的统一规定以及强调了心理知识教育与指导的应用,全面有效地控制了军训伤的发生。全军10个军事训练伤监测点的流行病学调查统计结果证实,执行该《标准》后,年度训练周期军事训练伤的累计发生率从30％～45％降低至10％以下。     

湿润暴露疗法在野战训练中烧伤病人中的应用

目的：探讨湿润暴露疗法在野战训练中治疗烧伤的疗效。方法：应用规范的烧伤湿润暴露疗法(MEBT)处理野战训练中各种烧伤创面197例，并观察其疗效。结果：本组197例烧伤患全部治愈，无感染发生。结论：MEBO具有较强的抗感染作用，止痛作用，能减轻进行性损伤，促进创面愈合，且使用方便，操作简单，适于在基层连队推广。     

TRACE program: improving patient safety

The Tools for Radiation Awareness and Community Education (TRACE) program was designed as a two phase approach to radiation dose awareness and overall patient dose reduction achieved through patient and community education, physician awareness, staff training, and technological enhancements. It was made possible by the AHRA and Toshiba Putting Patients First grant program. Phase one of the program began by engaging radiation safety committee and management to address new radiation safety policy and procedures followed by patient and community education. Next, fluoroscopy dose reduction was addressed through physician awareness and dose notification. The final step was CT dose reduction through protocol changes. Phase two will contain three components: The implementation of software that will assist in recording and reporting dose; patient and referring physician notification for radiation dose >3 Gy; and CT dose reduction through technology and additional changes to protocols.     

Resident bullying in diagnostic radiology

PurposeWorkplace bullying has been reported in multiple medical specialties outside of diagnostic radiology within the United States. The purpose of this study was to survey diagnostic radiology residents in the United States to determine if: (1) residents had experienced bullying, (2) residents had witnessed bullying of other residents, (3) residents were aware of zero-tolerance policy for workplace bullying at their institution, (4) residents were aware of no retaliation policies for reporting bullying at their institution.Materials and methodsIn December 2017, a weekly E-mail for 4 weeks was sent to diagnostic radiology residents in the United States (residents) who had attended the July 2017, September 2017 and October 2017 4-week American Institute for Radiologic Pathology (AIRP) resident course to participate in an online, anonymous, voluntary survey.Results28% of radiology resident respondents reported workplace bullying during their residency. One third of radiology residents have witnessed workplace bullying of another radiology resident at their facility. Approximately one half (48%) of respondents did not know if their institution had a zero-tolerance policy for workplace bullying, and approximately one half (55%) of respondents did not know if their institution had a no retaliation policy for reporting workplace bullying.ConclusionOur survey of diagnostic radiology residents across the United States confirms workplace bullying during residency, and the opportunity for implementation of zero-tolerance and zero retaliation policies for reporting workplace bullying in residency training institutions.     

Motivation: how to create a cohort of engaged,energized, and happy radiology trainees

Burnout among physicians continues to be a “hot topic” as medical culture struggles to adapt to the changing marketplace, where clinical demands are ever increasing but healthcare systems are pivoting to prefer value and cost-savings. To date, many attempts to understand and battle burnout center around the individual physician, rather than the system, limiting the medical community's ability to counter it successfully. The training environment is a common nidus for burnout. By promoting an understanding of motivation, happiness, and engagement in the workplace, we suggest several changes that training programs can make to minimize burnout and promote resident wellness. Creating a culture of support, promoting a positive work environment, building a cohesive team, and encouraging wellness both inside and outside the workplace stands to create engaged, happy, and motivated trainees who will hopefully continue to promote those strategies as they advance their careers.     

Interpretation of Emergency Department radiographs: a comparison of emergency medicine physicians with radiologists, residents with faculty, and film with digital display

OBJECTIVE: We determined the relative value of teleradiology and radiology resident coverage of the emergency department by measuring and comparing the effects of physician specialty, training level, and image display method on accuracy of radiograph interpretation. MATERIALS AND METHODS: A sample of four faculty emergency medicine physicians, four emergency medicine residents, four faculty radiologists, and four radiology residents participated in our study. Each physician interpreted 120 radiographs, approximately half containing a clinically important index finding. Radiographs were interpreted using the original films and high-resolution digital monitors. Accuracy of radiograph interpretation was measured as the area under the physicians' receiver operating characteristic (ROC) curves. RESULTS: The area under the ROC curve was 0.15 (95% confidence interval [CI], 0.10-0.20) greater for radiologists than for emergency medicine physicians, 0.07 (95% CI, 0.02-0.12) greater for faculty than for residents, and 0.07 (95% CI, 0.02-0.12) greater for films than for video monitors. Using these results, we estimated that teleradiology coverage by faculty radiologists would add 0.09 (95% CI, 0.03-0.15) to the area under the ROC curve for radiograph interpretation by emergency medicine faculty alone, and radiology resident coverage would add 0.08 (95% CI, 0.02-0.14) to this area. CONCLUSION: We observed significant differences between the interpretation of radiographs on film and on digital monitors. However, we observed differences of equal or greater magnitude associated with the training level and physician specialty of each observer. In evaluating teleradiology services, observer characteristics must be considered in addition to the quality of image display.     

美海军舰载航空医学保障特点及启示

简要介绍美海军舰载航空医学保障的特点，主要有建立完善的保障体系、系列化的标准规范、注重人员教育培训、重视需求牵引科研等，在此基础上提出在舰载航空医学保障理念、模式、研究、装备和力量建设等方面对我军的启示。     

A residency policy for pregnancy and parental leave

Residency programs need to anticipate the parental needs of their residents as more residents have children during residency. Ad hoc or crisis mode responses to resident pregnancy result in individual and group distress and dysfunction. Described in this paper is a maternity and parental leave policy for a psychiatric training program at a military hospital. This policy provides a framework for policies in other residency and military work situations.