特种兵高强度训练后集训疲劳行为的观察与防护

目的：改善与防护某特种兵队员高强度集训疲劳。方法：匀衡膳食营养,服用自制抗疲I号,分析血中酶等及SCL－90分值变化。结果：防护后血中LDH,α－HBDH,CK,CK－MB等得到明显改善IP＜0．01,0．05）,3例过度训练综合征得到防治,SCL－90显示：躯体化症状,强迫症状,睡眠饮食等分值整体呈下降趋势（P＜0．05,0．01）。结论：服用1号食品可有效防护过度训练综合征的发生,改善大强度体能,野战条件下各种军事课目集训产生的躯体和心身疲劳。     

武警某部女学员有氧耐力训练训练心率的研究

目的为指导和监控部队有氧耐力训练提供参考资料.方法对382名18～22岁女学员依照GJB1337-92和GJB2558-96规定的方法分别测定其安静心率和训练心率.结果安静心率均值为72.85±6.28b/min;按平均年龄21岁计算,中等训练心率为165.76±5.96b/min;最小训练心率为151.17±6.06b/min;最大训练心率为178.23±6.14b/min.结论女学员有氧耐力训练的适宜训练心率为151～178b/min.     

口腔修复科进修医师接诊前培训探析

为了提高进修医师的教学质量和医疗水平,我们在2006届进修医师教学工作中加强和细化了进修医师接诊前的培训,取得了良好的效果.实践证明,实施接诊前培训对于提高进修医师的医疗水平和自信心,实施规范化操作,克服诊疗中的盲目性,减少或避免医疗纠纷,进而提高进修医师的教学质量具有重要意义,值得推广和借签.     

Influence of fellowship educational experience on practice patterns for adrenalectomy: A survey of recent AAES fellowship graduates

BackgroundCurrent practice patterns for adrenalectomy among endocrine surgeons is a limited area of study. Here we survey relatively junior endocrine surgeons regarding educational experiences in adrenalectomy and correlate these with current practice.MethodsAn electronic survey was sent to recent AAES-accredited fellowships graduates (2014–2019), querying adrenalectomy volume and approaches during fellowship and current practice patterns.ResultsMost graduates (63.2%) performed >20 adrenalectomies in fellowship. Exposure was greatest to open (94.1%) and laparoscopic transabdominal (92.6%) adrenalectomy, followed by retroperitoneoscopic (86.7%). The majority (73.5%) of respondents stated their current practice patterns are the same as their exposure during training. Preoperative diagnosis, side of lesion, and patient comorbidities were all ranked as significant predictors affecting choice of approach (p < 0.001).ConclusionThe large majority of AAES fellowship graduates receive high-volume adrenalectomy experience in several approaches. The technique to which a trainee was exposed to most frequently was the greatest predictor for preferential approach in current practice.     

模拟器训练在实施股动脉穿刺点ExoSealTM封堵止血系统操作的多中心对照研究

背景与目的：介入手术已成为血管外科的主要治疗手段,对于手术直接相关的股动脉穿刺点封堵处理是手术操作收尾的一个重要环节。鉴于国内外目前尚缺乏关于封堵止血系统模拟器训练应用效果的高级别证据,本研究旨在评估模拟器训练在实施股动脉穿刺点ExoSealTM封堵止血系统操作的临床应用效果以及在血管介入操作基础教学培训中的应用价值。 方法：采用前瞻性对照设计,选择2020年5月—2020年10月7个中心的8名血管介入医师分别用两种不同方式进行封堵操作培训。4名血管介入医师通过阅读ExoSealTM说明书和观看视频进行培训（对照组）,另4名血管介入医师的培训方式为在前者基础上增加专业人员指导下的模拟器使用（研究组）。培训结束后,在主诊医师监管下,每名医师对接受血管介入手术,并在股总动脉使用6 F鞘管的患者,采用ExoSealTM封堵止血系统对穿刺点进行封堵。两组医师各操作50例患者,比较两组的操作时间、出血量、器械成功率、股动脉栓塞发生率、二次干预率、24 h内发生血肿率。 结果：研究组在ExoSealTM封堵止血系统操作中,所需的操作时间和出血量均少于对照组（24.50 s vs. 30.00 s,P=0.003;8.60 mL vs. 11.22 mL,P=0.019）。研究组的器械成功率（98.0%）高于对照组（96.0%）,但差异无统计学意义（P=0.558）。两组均无动脉栓塞、二次干预和24 h内发生血肿情况。 结论：ExoSealTM封堵止血系统模拟器的训练能够提高股动脉封堵的安全性和有效性。该模拟器的训练应常规用于血管介入操作的基础教学培训中。     

公共卫生硕士专业学位研究生培养质量的调查研究

目的了解我国公共卫生硕士专业学位研究生的培养现状,探究培养质量影响因素,发现问题提出对策,为我国公共卫生硕士专业学位研究生培养提供依据。方法采用自编问卷对28所开设公共卫生硕士专业学位研究生教育院校的研究生进行问卷调查,采用描述性统计、探索性因子分析和多元线性回归分析对问卷结果进行分析。结果 53.68%的研究生认为课程教学中"重理论,与实践联系太少",9.81%的研究生表示没有专业实践机会,71.78%的研究生是单一导师制,44.79%的研究生在课题研究阶段进行基础类的实验研究。探索性因子分析降维提取"平台条件"、"专业实践"、"课程设置"、"导师队伍"、"奖惩机制"5个因子;多元线性回归分析发现"专业实践"、"导师队伍"和"平台条件"对研究生的自身培养质量评价呈正向影响。结论高校应该优化公共卫生硕士专业学位研究生的导师指导制度和导师队伍,规范专业实践培养过程,健全科研基础设备和完善专业实践基地建设,提高专业学位研究生的培养质量。     

儿科临床研究协调员职业培训现状的调查与需求分析

目的 了解儿科临床研究协调员（clinical research coordinator,CRC）职业培训现状,探讨儿科CRC基地化培训建设,以促进儿科CRC的能力提升。方法 采用匿名问卷调研法,于2023年7月25日至10月16日期间,通过问卷星向调查对象发放自行设计的问卷,以进行儿科CRC职业培训及基地化培训需求相关情况的调查分析。采用Excel对数据进行整理。计数资料以例数或者率表示。结果 回收有效问卷328份。调查结果显示,认为当前CRC培训充分且可以满足实际工作需求的仅为7.62%（25人）,另有4.88%（16人）的人认为没有CRC培训,46.34%（152人）的人认为培训不足以支撑实际工作的要求。87.50%（287人）的人认为CRC需要持续的培训。46.95%（154人）的人选择了有经验的CRC是较为合适的带教人员之一,但是需要3年及以上CRC工作经验。46.95%（154人）选择了CRC合适的培训时长为3个月。培训方式的选择从高到低为：有经验的CRC带教实习（90.85%,298人）、实操技能手把手带教（88.41%,290人）、案例分析讨论（87.20%,286人）、流程模拟（83.23%,273人）、授课（76.52%,251人）。培训后考核方式的选择从高到低为：案例分析（76.52%,251人）、操作模拟（74.09%,243人）、流程模拟（73.17%,240人）、笔试（66.16%,217人）、面试（63.72%,209人）。结论 目前,儿科CRC的培训还不足以满足实际工作需求,急需制定一个符合工作需要的CRC培训体系并进行推广实践,从基础上促进中国儿科临床研究健康生态的构建。     

浙江省农村卫生技术人员岗位培训需求调查

[目的]了解农村基层卫生工作人员的基本状况,分析其知识结构,掌握农村卫技人员对岗位培训的需求,为有关部门制订农村卫技人员的培训政策与计划提供参考。[方法]随机调查浙江省农村基层卫技人员,采用Access建立数据库、SPSS10.0进行统计处理。[结果]农村卫技人员中本科学历仅占2.8%,大专学历占28.8%,中专学历占43.4%,其余为无正规学历者;职称结构中,主治及以上占11.8%,医师占29.6%,医士占37.0%,其余为卫生员和无职称人员;83.9%的人在从医后参加过1年以上专业培训;86%的人愿意参加继续医学教育。[结论]浙江省农村卫技人员学历低,工作年限长,知识老化,期望得到继续医学教育以取得更高学历,更新医学知识,提高实际业务水平。     

Online-Kurs Notfallmedizin Kurrikulare Integration von Computer-based Training

Emergency medicine is characterized by rapid decision making to help patients in life-threatening situations. Teaching these skills requires a high level of interaction between medical students and the lecturer. We designed, implemented, and evaluated a generic computer-based training (CBT) system to provide a more active way of learning emergency medicine. The content of the training program is adapted to the knowledge of third year medical students and is focused on basic skills and real-world problems. The teacher presents the case with authentic video sequences and slides. The cases are classified into four groups: heart (e.g., myocardial infarction), respiration (e.g., asthma bronchiale), trauma (e.g., car accident), and loss of consciousness (e.g., coma). Within a realistic time frame, the students have to answer free text and multiple choice questions on a work-station. All answers given by the students are processed anonymously by the CBT system via a central server and displayed on a large video screen, thus enabling a detailed discussion without intimidation of individual students. This interactive technique allows for immediate feedback from the lecturer based on the specific knowledge of his group and his own experience. The IT concept, which is scalable to many subjects, is based on state of the art internet technology and therefore suitable for teleteaching. A major design objective for the program was a self-explaining and robust user interface. The system has been in routine use since 1998. We designed an evaluation form consisting of 21 items focused on subjective rating of learning success, acceptance of CBT, and technical feasibility. We analyzed forms from 138 students and found high scores for acceptance and learning success (median 5 on a 6-point scale). user problems with the program were denied (median 1 on a 6-point scale). Computer-based training with Internet technology can provide a successful method for interactive teaching of emergency medicine and is well accepted by students.