神经外科硕士研究生临床带教方法的探讨

神经外科硕士研究生的临床教学是研究生教育的重要组成部分,规范的临床教学能够提高硕士研究生的医疗综合素质和临床技能。在教学和培养过程中应重注培养学生树立良好的医德医风,夯实临床基本理论知识,提高专科临床诊疗操作技能,规范病历的书写并锻炼维系和谐医疗人际关系的能力,才能提高硕士研究生的临床素质。     

The Hierarchical Clustering of Clinical Psychology Practicum Competencies: A Multisite Study of Supervisor Ratings

Competency evaluation rating forms are widely used to assess a range of global and specific psychology practitioner competencies during and at the end of clinical placements. Surprisingly, there is little research examining the dimensional structure or the hierarchical clustering of items on these ratings. The current, multisite study examined supervisor ratings of clinical psychology trainees (N = 204) on the Clinical Psychology Practicum Competencies Rating Scale (CΨPRS). Based on the proximity criterion chosen, hierarchical clustering yielded either nine clusters or four super clusters: Good Practitioner Attributes and Conduct, Scientist Practitioner and Professional Management, Assessment and Intervention, and Psychological Testing. The study also tracked the developmental trajectory of competency attainment. CΨPRS ratings differentiated groups between early but not between later stages of training. Measurement issues and implications for training and practice are discussed.     

多元智力理论视阈下的医学信息学本硕博连读培养模式

［］本硕博连读研究生培养模式旨在培养具有原创精神和能力的研究型人才。本文从多元智力理论出发,从理论层面对本硕博连读培养模式进行阐述;结合研究生教育改革实践,从选拔标准、培养模式、过程管理、质量监控、分流淘汰机制、论文答辩以及学术成果要求等几个方面对医学信息学本硕博连读培养中的关键环节进行了分析。     

全国部分医学图书情报硕士研究生选题特征现状归纳

图书情报人才培养一直是图书馆工作中的重点内容,本文回顾了2004年以来全国部分医学图书情报硕士研究生选题,以选题特征为切入点,深入分析归纳了选题的特征、对象以及方法,总结了医学图情人才队伍培养面临的问题及发展趋势,为后续进一步研究医学图情硕士生培养提供参考依据。     

介入放射学研究生参与论文撰写小组教学模式的效果分析

目的初步探讨导师引导下介入放射学研究生参与期刊论文撰写小组的教学模式效果。 方法8名介入放射学研究生（4名硕士研究生、4名博士研究生）作为培养对象,另纳入2名具有丰富科研经验的医师作为培训老师,建立论文撰写小组,每两周组织一次论文撰写小组会议,针对研究生目前撰写的论文进行讨论分析,同时不定期组织研究生学习文献检索、统计学方法等论文撰写必备的相关理论知识。入组1年后分析培训结束时学术论文完成情况及质量。 结果经过论文撰写小组培训,所有研究生均可以熟练应用PubMed等数据库进行文献检索,均掌握了常见的统计学方法。1年中8名研究生均完成学术论文的撰写,3篇论文被SCI收录期刊录用,5篇论文被核心期刊录用。 结论介入放射学研究生参与论文撰写小组的教学模式有助于提高研究生论文设计、文献检索和论文撰写等科研能力,具有良好的教学效果。     

Normalization of urinary oxalate by taurine in glycolate-fed rats

Oral feeding of sodium glycolate (50 mg/d/rat for ten days) caused a significant (P less than 0.001) increase in oxalate and taurine excretion and a decrease in liver protein content (P less than 0.05), glycolic acid oxidase levels (P less than 0.01), and glycolic acid dehydrogenase levels (P less than 0.01) as compared to normal untreated rats. Taurine (100 mg/d/rat), when administered along with glycolate, prevented these effects of glycolate as evident from normal urinary excretion of oxalate, liver protein content, glycolic acid oxidase, and glycolic acid dehydrogenase levels in glycolate- plus taurine-fed animals.     

Evaluation of the effects of catheter sampling for the study of platelet behavior in the pulmonary and coronary circulation

To study the effects of sampling through cardiac catheters on indices of platelet function, we measured the levels of platelet factor 4 (PF₄), beta thromboglobulin (BTG), and platelet aggregate ratio (PAR) in 10 patients with atrioventricular accessory pathway (AVNAP), six patients with primary pulmonary hypertension (PPH), and six patients with critical narrowing of the left anterior descending artery (LAD). In AVNAP and LAD patients samples were drawn simultaneously from a peripheral vein, coronary sinus, and brachial artery; in AVNAP patients samples were also obtained from the axillary vein before the coronary sinus was entered. In PPH patients samples were drawn from pulmonary artery, aorta, and a peripheral vein; in these patients the effects of an intravenous infusion of prostacyclin (PGl₂) (2 to 8 ng/kg/min) on PF₄, BTG, and PAR were also studied at all sampling sites. In all patients arterial, coronary sinus, pulmonary arterial, and axillary venous levels of PF₄, BTG, and PAR significantly exceeded those measured in the peripheral vein. PGl₂ infusion resulted in a significant decrease of PF₄ at all sampling sites, while no consistent BTG changes were observed and PAR levels did not decrease in the peripheral vein. Although a considerable interpatient variability in PF₄ levels was observed, a significant (r = 0.91) correlation was found in patients with AVNAP between simultaneous coronary sinus and arterial PF₄ levels. The value of PF₄ coronary sinus-arterial difference in LAD patients was consistently higher than that calculated in AVNAP patients (54.5 ± 28.9 vs 4.2 ± 3.8 ng/ml). In conclusion: (1) a considerable and variable degree of platelet activation occurs with catheter sampling, preventing the measurement of absolute levels of platelet metabolites; (2) among the indices examined PF₄ appears the most sensitive for detecting changes in platelet activity; and (3) the measurement of coronary sinus-arterial PF₄ differences may provide information on directional changes in transcardiac platelet behavior.     

Creating global health leaders in pharmacy by evolving postgraduate training

There has been a push for increasing global health education and training opportunities within the pharmacy profession. Global health postgraduate learning opportunities are necessary to define pharmacy career paths in global health and develop global health leaders. There are many challenges to starting a global health postgraduate training program including economic burden, logistics of extramural rotations, local and international resources, and program sustainability. In the face of barriers inhibiting formal program establishment, different strategies can be used to incorporate global health topics into existing postgraduate training opportunities. Possible solutions include relating local health to global health to develop a global mindset, expanding upon existing partnerships to provide international global health experiences, use of technology and simulation for virtual global health interaction, and emphasis of implementation science principles to connect and translate local health interventions to a global scale.     

Context factors in consultations of general practitioner trainees and their impact on communication assessment in the authentic setting

ObjectiveAcquiring adequate communication skills is an essential part of general practice (GP) specialty training. In assessing trainee proficiency, the context in which trainees communicate is usually not taken into account. The present paper aims to explore what context factors can be found in regular GP trainee consultations and how these influence their communication performance.MethodsIn a randomly selected sample of 44 videotaped, real-life GP trainee consultations, we searched for context factors previously identified in GP consultations and explored how trainee ratings change if context factors are taken into account. Trainee performance was rated twice using the MAAS-Global, first without and then with incorporating context factors. Item score differences were calculated using a paired samples t-test and effect sizes were computed.ResultsAll previously identified context factors were again observed in GP trainee consultations. In communication assessment scores, we found a significant difference in 5 out of 13 MAAS-Global items, mostly in a positive direction. The effect size was moderate (0.57).ConclusionsGP trainee communication is influenced by contextual factors; they seem to adapt to context in a professional way.Practice implicationsGP specialty training needs to focus on a context-specific application of communication skills. Communication raters need to be taught how to incorporate context factors into their assessments.