PBL医学教学模式在中等专业学校病理学教学中的应用

为提高病理学的教学质量,培养学生自主学习、开拓创新能力,养成良好的学习习惯,增强其团队合作精神,笔者在病理学课程的部分章节中采取了PBL教学法,取得了良好的教学效果.     

PBL教学法在神经内科见习中的应用研究

目的：探讨PBL教学法在神经内科见习中的应用效果。方法：将我校2009级临床专业神经病学见习学生随机分为实验组（60人）和对照组（59人）,对照组沿用传统的教学方法,实验组采用以问题为基础的教学方法。结果：对照组的理论成绩优于实验组,而实验组的病例分析级神经系统查体成绩优于对照组。实验组在学习积极性,扩大知识面方面等主观评价优于对照组。结论：PBL教学模式在神经内科见习中能取得较好的教学效果,但在运用过程中要加强系统基础知识的学习。     

Can we enhance the training of clinical supervisors? A national pilot study of an evidence‐based approach

Clinical supervision plays an essential part in maintaining professional standards and in achieving the National Health Service's objective of a modern workforce. Paradoxically, little is known about how supervisors themselves acquire competence, leading to lament that ‘something does not compute’. To contribute to a solution, a supervisor training manual that guided trainers in delivering continuing professional development to supervisors in an evidence‐based approach to clinical supervision was piloted nationally, in terms of the reactions of trainers (N = 25 tutors from clinical psychology courses) and their workshop delegates (N = 256 clinical psychology supervisors). Trainers were allocated randomly to either manual‐alone or to a manual‐plus consultancy group. The trainers all rated the manual favourably (mean rating of 78%), but there was no significant difference between the two groups. However, the supervisors within the consultancy group rated the sessions significantly more highly than their counterparts. It is concluded that brief training in an evidence‐based approach appears feasible and acceptable, making more rigorous evaluations appropriate. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message:

• Clinical supervision is now recognised as essential, yet supervisors tend to receive little or no training, which tends not to be evidence based.
• A training guide in evidence‐based clinical supervision has been disseminated and evaluated, in terms of the acceptability of the approach taken to supervision.
• The reactions of trainers and supervisors (all associated with clinical psychology training programmes) to this guide were positive, indicating that it merits further development and more rigorous evaluation.

     

Critical thinking ability of new graduate and experienced nurses

Title. Critical thinking ability of new graduate and experienced nurses. Aim. This paper is a report of a study to identify critical thinking learning needs of new and experienced nurses. Background. Concern for patient safety has grown worldwide as high rates of error and injury continue to be reported. In order to improve patient safety, nurses must be able to recognize changes in patient condition, perform independent nursing interventions, anticipate orders and prioritize. Methods. In 2004–2006, a consecutive sample of 2144 newly hired nurses in a university‐affiliated healthcare system completed the Performance Based Development System Assessment consisting of 10 videotaped vignettes depicting change in patient status. Results were reported as meeting or not meeting expectations. For nurses not meeting expectations, learning needs were identified in one of six subcategories. Results. Overall, 74·9% met assessment expectations. Learning needs identified for nurses not meeting expectations included initiating independent nursing interventions (97·2%), differentiation of urgency (67%), reporting essential clinical data (65·4%), anticipating relevant medical orders (62·8%), providing relevant rationale to support decisions (62·6%) and problem recognition (57·1%). Controlling for level of preparation, associate (P = 0·007) and baccalaureate (P < 0·0001) nurses were more likely to meet expectations as years of experience increased; a similar trend was not seen for diploma nurses (P = 0·10). Controlling for years of experience, new graduates were less likely to meet expectations compared with nurses with ≥10 years experience (P = 0·046). Conclusion. Patient safety may be compromised if a nurse cannot provide clinically competent care. Assessments such as the Performance Based Development System can provide information about learning needs and facilitate individualized orientation targeted to increase performance level.     

How well do poor language scores at ages 3 and 4 predict poor language scores at age 6?

The purpose of this study was to describe findings and associations at the group level, and predictive accuracy at the individual level, for three measures of language obtained from a single prospective cohort of US children assessed at three ages during another investigation. Participants comprised all children (n = 414) who had a score at each of three ages (3, 4, and 6 years) on three language measures: Peabody Picture Vocabulary Test-Revised (PPVT); mean length of utterance in morphemes (MLU); and total percentage of phonemes correct (TOTPPC) in a nonword repetition task. At the group level, mean differences and correlations over ages were calculated. At the individual level, the extent to which low scores (1.5 SDs or more below the sample mean) at an earlier age increased the relative risk (R’) of low scores at a later age was calculated. At the group level, scores on all measures increased significantly with age. Earlier and later scores on each measure were significantly correlated; r² values were generally modest (12–59%). A low score at age 3 did not increase the risk of a low score age 4 or age 6 for any of the measures; a low PPVT score at age 4 significantly increased the risk (R’ = 5.0) of a low PPVT score at age 6. For these generally healthy children and these language measures, predictive accuracy at the individual level was generally poor between the ages of 3, 4, and 6 years. Large, longitudinal studies are needed to identify and validate measures for use in identifying preschool children at risk for later language deficits.     

Finger tapping, handedness and grey matter amount in the Rolando's genu area

The morphology of the central sulcus (CS), at the level of the hand primary motor cortex, has been shown to be related to hand preference and skill. Differences in the cerebral functional organisation of left and right-handers have been described, notably with respect to hemispheric specialisation, which might cause the neural substrate of hand dominance or skill to differ between the two groups. Here, we further explored the relationship between the anatomical variability of the central sulcus and hand skill in two groups of young male subjects differing by handedness (n = 56 right-handers and n = 55 left-handers). Grey matter volume (GMV) in the upper region of the central sulcus was estimated with Voxel Based Morphometry, using a probabilistic region of interest approach, while hand motor skill was measured with the finger tapping test. No significant anatomical differences could be evidenced between the two hand preference groups, a rightward hemispheric asymmetry being observed in both samples. However, multiple regression analyses showed that, in the right-handed group, the maximum tapping rate of the right hand correlated positively with the left central sulcus GMV, but negatively with the right. Similar analyses showed that, in left-handers, the maximum tapping rate of the non-dominant right hand was strongly correlated with the GMV of the ipsilateral CS but not significantly with that of the contralateral CS. These results may be due to differences in the organisation of motor systems between these two groups, possibly concerning a left hemispheric specialisation for fast repetitive movements in right-handers, which would be different in left-handers.     

循证医学促使医学发展科学化

1992年,加拿大一个EBM工作组首次提出循证医学的概念,在短短二十几年的时间里,循证医学席卷了整个医学界,冲击了世界,为什么循证医学会在这么短的时间内产生如此巨大的冲击波,循证医学究竟在医学界产生哪些作用,本文述之。     

制药工程专业英语教学改革的研究与实践

专业英语是大学英语教学的一个重要组成部分。按照制药工程专业培养目标对专业英语进行了教学改革。在“听、说、读、写、测试”五个方面贯彻制药工程专业培养目标，优化专业英语的教学内容和教学模式，培养学生以英语为工具交流专业信息的能力。     

中风病的中西医结合辨治思路与方法

中风是一致死率和致残率极高的危急重症,其急性期的治疗直接关系到疾病的预后。本文探讨将中医辨证与西医医技检查手段相结合以认识、辨治本病,以求提高治愈率,减低致死率和致残率。