A modality-specific somatosensory evoked potential test protocol for clinical evaluation: A feasibility study

ObjectiveWe aimed to establish an objective neurophysiological test protocol that can be used to assess the somatosensory nervous system.MethodsIn order to assess most fiber subtypes of the somatosensory nervous system, repetitive stimuli of seven different modalities (touch, vibration, pinprick, cold, contact heat, laser, and warmth) were synchronized with the electroencephalogram (EEG) and applied on the cheek and dorsum of the hand and dorsum of the foot in 21 healthy subjects and three polyneuropathy (PNP) patients. Latencies and amplitudes of the modalities were assessed and compared. Patients received quantitative sensory testing (QST) as reference.ResultsWe found reproducible evoked potentials recordings for touch, vibration, pinprick, contact-heat, and laser stimuli. The recording of warm-evoked potentials was challenging in young healthy subjects and not applicable in patients. Latencies were shortest within Aβ-fiber-mediated signals and longest within C-fibers. The test protocol detected function loss within the Aβ-fiber and Aδ-fiber-range in PNP patients. This function loss corresponded with QST findings.ConclusionIn this pilot study, we developed a neurophysiological test protocol that can specifically assess most of the somatosensory modalities. Despite technical challenges, initial patient data appear promising regarding a possible future clinical application.SignificanceEstablished and custom-made stimulators were combined to assess different fiber subtypes of the somatosensory nervous system using modality-specific evoked potentials.     

案例教学法在消化内科见习课的应用效果评价

目的探讨案例教学法在消化内科见习课的教学效果和体会。方法选取2017年10月—2017年12月在消化内科进行见习课的2015级39-40班护理本科学生44例(全部为女生),抓阄分成对照组(22人)和试验组(22人),对照组给予传统的带教方法,试验组给予案例教学法教学,比较两组护生在理论、技能、综合能力和对带教满意度方面有无差异。两组学生在性别、年龄、专业前的课程成绩比较,差异无统计学意义(均P>0.05)。结果观察组在理论考核成绩、操作考核成绩、教学满意度等方面均高于对照组。结论案例教学法能提高护理教学的教学效果,增加学生的理论、操作能力,提高护理临床思维能力,提升学生的学习主动性和积极性。     

国内外护理学本科生毕业考核现状与分析

教育测量与评价对实现教育目标具有重要作用。科学的教育评价既促进学生学习,又为教育决策提供依据,以实现持续质量改进。"健康中国2030"的整体目标、医学科学的发展及人民的健康需求,对新时代护理人才的培养提出了更高、更具体的要求。高等护理院校应以国家和社会对护理人才需求、院校培养目标为导向,以测量理论为基础,制定完善的学业评定标准,科学地开展毕业考核,保证人才"出口"质量。毕业考核作为终结性评价,测试内容在评价质量中起核心作用,应符合国家护理学专业培养标准,并与院校培养目标、课程目标契合。院校应关注护理本科生毕业考核质量,在保障测试信度的同时,做到实施公平、评价适当、标准一致,以确保测试的效度。教育管理部门及各院校应优化评价体系,加强对护理本科生毕业管理,在充分开展系统调查与分析的基础上,基于胜任力导向和结果导向,建立综合性评价体系,在教学过程中进行全方位反馈评价管理。文章结合国内外护理学专业本科生毕业考核的现状,从考核目的、内容、方式、评价主体、质量控制等方面进行综述与分析,为我国加强护理学本科教育,完善护理学专业本科生毕业评价体系建设提供借鉴。     

Innovation in Indigenous Health and Medical Education: The Leaders in Indigenous Medical Education (LIME) Network as a Community of Practice

Problem: The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students. Intervention: In this article we explore the utility of Etienne Wenger's “communities of practice” (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform. Context: The Network operates across all medical schools in Australia and New Zealand. Outcome: Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students. Lessons Learned: By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity.     

聚焦解决护理模式结合健康教育对银屑病患者心理状态、应对方式的影响

目的 探讨聚焦解决护理模式结合健康教育对银屑病患者心理状态、应对方式的影响。方法 选取2020年2月至2021年2月我院收治的100例银屑病患者,随机分为观察组(聚焦解决护理模式结合健康教育)与对照组(常规健康教育)。比较两组的心理状态及应对方式。结果 干预后,观察组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组(P<0.05)。干预后,观察组的面对评分高于对照组,屈服、回避评分低于对照组(P<0.05)。干预后,观察组的病耻感评分低于对照组(P<0.05)。结论 聚焦解决护理模式结合健康教育可有效改善银屑病患者的不良情绪,减轻病耻感,转变疾病应对方式。     

The scope of computerized simulation in competency-based maxillofacial training: a systematic review

Oral and maxillofacial surgery (OMS) teaching is set to undergo a paradigm shift towards competency-based training. With increasing focus on resident skill development and patient safety, computerized simulators are likely to play a more mainstream role in OMS training. A systematic review of the available literature was conducted, in accordance with the PRISMA guidelines, to highlight the scope of computerized simulation in OMS teaching. A PubMed search was performed by two independent reviewers, and 35 articles published in English between 2010 and 2021 that reported the use of computerized simulation for teaching maxillofacial procedures were included in the analysis. Eight articles on minor oral surgery, seven on orthognathic surgery, five on maxillofacial trauma, five on cleft lip and palate surgery, three articles each on nerve block techniques, endoscopic procedures, and reconstructive surgery, and one article on fibre-optic intubation reported the use of computerized simulation that can be applied to OMS training. Ten randomized controlled trials were identified in the search. However there was marked heterogeneity among the studies. Simulator training for skill acquisition mentored by an expert OMS educator could offer holistic resident training; however more studies that test common themes of resident training such as knowledge acquisition and skill development are necessary.