基于网络环境下的医学生理学教学模式的探索

结合生理学教学改革,从网络课程内容和网络环境下生理学研究性学习模式方面介绍了网络教学的开展和应用,指出网络教学在医学生理学教学中的应用可提高医学生独立获取知识、信息综合分析及创新能力。     

基于多媒体技术的视听教材艺术创作

在应用多媒体技术进行视听教材的艺术创作中,结合《瘦素》的制作对视听教材中的自然形象、教学中的重点、难点的处理以及音响效果与典型画面的有机结合等问题进行了探讨。     

摄影技术在医学伦理教学中的运用

学习兴趣与学习效果成正比关系,如何提高医学生的学习兴趣成了深化教学改革题中之义。通过摄影技术在医学伦理学教学中的运用,激发医学生的学习兴趣,并指出摄影技术运用的价值。     

Comparison of anonymous student ballots with student debriefing for faculty evaluations

INTRODUCTION: Yearly evaluation of academic faculty teaching is required by institutions for advancement purposes and continued employment. The method in which these evaluations are collected may influence the outcome of that evaluation. We compared the results of three different data collection methods of faculty ratings. METHODS: Diagnostic radiology residents evaluated four behaviour categories of faculty in three different ways during the 1995-96 academic year. The individual anonymous ballot was compared to two student debriefing techniques. RESULTS: Ratings in individual categories and rankings of several of the faculty changed considerably depending upon the data gathering method. Individual anonymous ballots produced a higher average rating in all four categories evaluated. The average ratings were lowest in the closed meeting group. DISCUSSION: The method in which evaluation of faculty are collected influences both the numerical value of the rating as well as the ranking of the teachers within the group. Evaluation outcomes are highly dependent upon the method of data collection.     

Students' perceptions of the relative advantages and disadvantages of community-based and hospital-based teaching: a qualitative study

AIMS: To obtain the perceptions of first-year clinical medical students of the relative advantages and disadvantages of community-based and hospital-based clinical teaching. METHODS: A qualitative study. A purposive sample of first-year clinical medical students who had experienced both community-based and hospital-based teaching was invited to participate in individual semistructured interviews or focus groups. Interviews and focus groups were audiotaped and transcribed to facilitate content analysis of the data. A total of 24 students participated in individual interviews and a further 18 took part in focus groups. RESULTS: Respondents identified advantages and disadvantages specific to teaching in each setting. Chief advantages of hospital-based learning were perceived to include learning about specialties and the management of acute conditions, and gaining experience of procedures and investigations. Community-based learning was perceived as particularly appropriate for learning about psychosocial issues in medicine, for increasing students' awareness of patient autonomy and for improving communication skills. In addition, aspects of organization and of teaching methods employed by community tutors, although not site-specific, were viewed as conducive to a positive educational experience. Students perceived some areas, such as clinical skills acquisition, to be equally well learned in either setting. DISCUSSION: As community-based teaching forms a greater proportion of the undergraduate medical experience, medical educators must find ways of determining the specific advantages that community and hospital settings can contribute to undergraduate learning and of using these resources effectively to develop comprehensive and integrated curricula. Innovations in teaching methods may also be necessary to provide an effective educational experience and promote active learning.     

A comparison of performance by medical and midwifery students in multiprofessional teaching

AIM: At Dundee University, midwifery and medical students are taught obstetrics together in a 2-week intensive course. We set out to test the hypothesis that staff time and effort could be saved by using shared resources in teaching a multidisciplinary group of students to an acceptable level. METHOD: In order to measure the knowledge gain by two different groups of students, we tested the students before and after a timetabled computer-assisted learning (CAL) session focusing on how to interpret a cardiotocograph (CTG). Also, half of each student group was given extra CTG teaching before the CAL session. RESULTS: The medical students (n=38) increased their median score from 9 to 17 after the CAL (P<0.001) but the midwifery students (n=13) only increased their median score from 12 to 14 after the CAL (n.s.). However, when given a tutorial and CAL, the post-test scores for both medical and midwifery students were similar and significantly higher than pre-test scores (median score increase from 8.5 to 18 for medical students, P<0.001, n=34, and from 9 to 16 for midwifery students, P<0.01 n=11). There was no significant knowledge gain by the medical students who undertook the additional tutorial. CONCLUSION: We conclude that shared resources could be used by medical and midwifery students to reach equivalent levels of skill in CTG interpretation. However, in order to achieve equivalence, staff time and effort was wasted as medical students were given unnecessary tuition.     

Patient-oriented learning: a review of the role of the patient in the education of medical students

AIM: To explore the contribution patients can make to medical education from both theoretical and empirical perspectives, to describe a framework for reviewing and monitoring patient involvement in specific educational situations and to generate suggestions for further research. METHODS: Literature review. RESULTS: Direct contact with patients can be seen to play a crucial role in the development of clinical reasoning, communication skills, professional attitudes and empathy. It also motivates through promoting relevance and providing context. Few studies have explored this area, including effects on the patients themselves, although there are examples of good practice in promoting more active participation. CONCLUSION: The Cambridge framework is a tool for evaluating the involvement of patients in the educational process, which could be used by curriculum planners and teachers to review and monitor the extent to which patients are actively involved. Areas for further research include looking at the 'added value' of using real, as opposed to simulated, patients; more work on outcomes for patients (other than satisfaction); the role of real patients in assessment; and the strengths and weaknesses of different models of patient involvement.     

Suppression of mixed lymphocyte reaction by cells of human first trimester pregnancy endometrium

In order to identify an immunological role for decidual tissue in pregnancy we have prepared single cell suspensions from the tissues of normal pregnant women and examined the effects of these cells on one-way mixed-lymphocyte reactions (MLR). The separated cells were heterogeneous, containing classical decidual cells, glandular epithelial cells, granular endometrial cells, macrophages and small lymphoid cells. [3H]Thymidine incorporation at day 6 of the MLR was suppressed by addition of the cells at the initiation of the cultures and the degree of suppression was inversely correlated to the gestational age of the decidual tissue, apparently through inhibition of the antigen recognition phase of the MLR. These findings support the view that the cells of the human first trimester pregnancy endometrium may play an important role in protecting the feto-placental unit from rejection, at least in the early phase of pregnancy.     

Teaching Diagnostic Skills: Clinical Vignettes or Chief Complaints?

Two formats of case presentation are traditionally used for teaching problem-solving skills: clinical vignette or chief complaint formats. While the first one is more commonly used, it does not completely reflect the actual problem-solving process during a real encounter, which may hamper the learners to integrate separately acquired data gathering skills into their reasoning process and affect their diagnostic performance in practice. The present study compared diagnostic accuracy when the reasoning stimulus was a case vignette containing all diagnostic information versus the patient's chief complaint only. Forty-two medical students, 53 residents and 60 general internists participated in the study. Diagnostic accuracy was significantly lower for the chief complaint format at the student, resident, and practitioner levels. Analysis of the data gathered in the chief-complaint format revealed that faulty diagnostic decisions resulted from a failure to gather critical data. The results suggest that data gathering techniques, semiology, and medical reasoning should be trained in association and that this effort should be pursued beyond medical school.This revised version was published online in October 2005 with corrections to the Cover Date.     

Existence of suppressor cells in the spleen of allogeneic and syngeneic primiparous pregnant mice

Mixed lymphocyte reaction (MLR) and in vitro induction of cytolytic cells against alloantigens were investigated using spleen cells from primiparous mice mated allogeneically or syngeneically. One-way MLR was reduced significantly in degree not only in allogeneic but also in syngeneic pregnant mice. MLR of virgin spleen cells was suppressed when mitomycin C-treated spleen cells taken from syngeneic or allogeneic pregnant mice were added as regulator cells. These suppressive effects disappeared when regulator cells were treated with anti-Thy 1 or anti-Lyt 2 serum plus complement. Generation of cytotoxic lymphocytes from syngeneic or allogeneic pregnancy spleen cells in MLR was depressed compared with that from virgin spleen cells. The addition of pregnancy spleen cells to MLR suppressed in vitro generation of cytotoxic lymphocytes from virgin spleen cells. These results indicated that reduction of in vitro cellular responses of pregnancy spleen cells was due to suppressor cells in the spleens. These cells suppressed non-specifically the reactions to alloantigens and could be detected both in allogeneic and syngeneic primiparous pregnancies.