临床医学专业与其他医学专业大学生综合素质对比研究

目的对某医科大学临床医学专业和其他医学专业大学生的理想与信念、身心素质和人文素质进行对比分析，为提高医学生的综合素质提供科学的指导依据。方法对某医科大学213名临床医学专业和299名其他医学专业大学生进行综合素质问卷调查，用SPSS10．0软件进行统计分析。结果临床医学专业和其他医学专业学生在理想与信念方面8项有统计学意义，身心素质方面10项有统计学意义，人文素质方面12项有统计学意义。结论临床医学专业学生在理想与信念、身心素质、人文素质方面都要优于其他医学专业学生。     

构建国内器官捐献救助体系的思考

背景：进入21世纪,器官移植事业飞速发展,器官移植供体的短缺极大的限制了这项技术在临床领域的充分运用,而中国1：30的数量比更是阻碍中国器官移植事业发展的“瓶颈”。目的：探讨建立人体器官捐献救助体系的意义、内容及途径,分析目前中国器官捐献救助存在的问题,提出器官捐献救助的措施。方法：在CNKI和PubMed通过关键词“器官捐献、器官移植、救助”查阅相关文献,对来源于核心期刊的文章进行综合分析。同时,深入临床,通过交谈法了解器官捐献者和医务人员的呼声,为文章救助措施的提出提供了具有现实意义的依据。结果与结论：为了器官移植事业的快速发展,从社会、经济、心理等方面对器官捐献者给予一定的人道主义救助乃大势所趋,同时,从法律援助、制度设计、组织构建、工作人员配置几个方面提出构建符合中国国情的器官捐献救助体系,确保救助措施落到实处。     

关于医学人道主义与医院管理绩效相互关系的几点思考

医学人道主义是医学实践的永恒主题。医院的管理绩效体现在经济和社会效益上，而经济效益是通过医学人道主义的实现而转化的。合理的政策和制度设计，规范的内部管理，道德的系统构建是医学人道主义得以保证的重要条件。     

Orlando互动程序理论的应用及启示

介绍了Orlando以满足病人需求为中心的互动程序理论及以病人为中心的人本主义思想,论述了这一护理理论的主要应用情况及对我国护理学发展的启示。     

Sharing personal information about anatomical body donors: What first‐year medical students want to know and how it affects emotional responses to dissection

Among educators who teach in the human anatomy laboratory, there has been lively debate about sharing information about anatomical donors. One consideration in this debate is concern about the emotional effect of personalizing donors on the students. The purpose of this study was to evaluate student responses to being exposed to donor information (DI). Three cohorts of first‐year medical students (n = 284) were surveyed at four time points throughout the year. Surveys queried students about positive and negative responses to working in the laboratory, wanting to know specific DI, and if knowing this DI would/did affect their responses to working with donors. Analyses examined the relationships between desire to know DI and indices of the following: positive response index (PRI), negative response index (NRI), avoid‐approach index (AAI), and compassion‐respect index. Across all surveys, a majority of respondents wanted to know some form of DI. At all time points, a majority of respondents felt that knowing all types of DI would increase their positive responses to working with donors. A greater PRI and AAI tended to be associated with wanting to know more personal DI (e.g., names and personal histories). A greater NRI tended to be associated with anticipating that learning personal DI would increase their negative responses before entering the laboratory, which did not persist after dissection began. These data suggest that for a majority of students, knowing personal DI increases their positive response and does not elicit negative responses to dissection or working with anatomical donors. Clin. Anat. 32:1019–1032, 2019. © 2019 Wiley Periodicals, Inc.     

Do Gold Humanism Honor Society Inductees Differ From Their Peers in Empathy,Patient-Centeredness,Tolerance of Ambiguity,Coping Style,and Perception of the Learning Environment?

Construct: Induction into the Gold Humanism Honor Society (GHHS) during medical school is recognized as an indicator of humanistic orientation and behavior. Various attitudes and interpersonal orientations including empathy and patient-centeredness have been posited to translate into behaviors constituting humanistic care. Background: To our knowledge there has never been a longitudinal, multi-institutional empirical study of the attitudinal and interpersonal orientations correlated with GHHS membership status. Approach: We used the American Medical Association Learning Environment Study (LES) data set to explore attitudinal correlates associated with students whose behaviors are recognized by their peers as being exceptionally humanistic. Specifically, we examined whether empathy, patient-centeredness, tolerance of ambiguity, coping style, and perceptions of the learning environment are associated with GHHS membership status. We further considered to what extent GHHS members arrive in medical school with these attitudinal correlates and to what extent they change and evolve differentially among GHHS members compared to their non-GHHS peers. Between 2011 and 2015, 585 students from 13 North American medical schools with GHHS chapters participated in the LES, a longitudinal cohort study using a battery of validated psychometric measures including the Jefferson Scale of Empathy, Patient-Practitioner Orientation Scale and Tolerance of Ambiguity Questionnaire. In the final survey administration, students self-identified as GHHS inductees or not (non-GHHS). T tests, effect sizes, and longitudinal generalized mixed-effects models examined the differences between GHHS and non-GHHS students. Results: Students inducted into GHHS scored significantly higher on average over 4 years than non-GHHS inductees on clinical empathy, patient-centered beliefs, and tolerance of ambiguity. GHHS students reported higher levels of empathy and patient-centeredness at medical school matriculation. This difference persists in the 4th year of medical school and when controlling for time, race, gender, and school. Conclusions: GHHS inductees enter medical school with different attitudes and beliefs than their non-GHHS classmates. Although humanistic attitudes and beliefs vary over time during students' 4 years, the gap between the two groups remains constant. Medical schools may want to consider selecting for specific humanistic traits during admissions as well as fostering the development of humanism through curricular interventions.     

“重人文”护理本科人才培养模式探讨

随着医院由技术竞争向服务竞争的转变,人文关怀式服务已成为医学文明和现代医院的重要标志。文章拟在护理本科生专业课课程具体内容体系、师资、教学方法和考核上突出人文关怀特色,为培养符合社会需要的、富有人文精神的高素质应用型护理本科人才作出有益探索。     

以人为本的护理管理在临床上的应用

目的观察以人为本的护理管理对提高护理质量的作用。方法采取一系列人性化的护理管理,包括群众参与管理;以科学发展观作为护理管理体系的核心;为护理人员构筑平等的发展平台等。结果经过一系列人性化的护理管理,与护理有关的医疗差错明显下降,护理人员的积极性充分调动起来,自觉学习业务知识,护理质量和科研的开展等都上了一个台阶。结论以人为本的护理管理可以充分调动护理人员的积极性和主动性,提高护理服务质量。     

Faculty ratings of resident humanism predict patient satisfaction ratings in ambulatory medical clinics

Objective: To determine whether patient satisfaction ratings can be predicted by faculty ratings or self-ratings of resident humanism. Design: A prospective three-month collection of patient satisfaction ratings in two ambulatory care clinics and simultaneous acquisition of faculty ratings and self-ratings of resident humanism using ABIM questionnaires. Setting: Two teaching hospital ambulatory care internal medicine clinics. Participants: Forty-seven internal medicine residents and 17 faculty internists were sent questionnaires for evaluation of humanism of individual residents. One thousand one hundred ninety-four consecutive outpatients cared for by the residents were eligible for patient satisfaction questionnaires. Measurements and main results: Thirty-three residents and 13 faculty completed evaluations of resident humanism while 792 patients completed satisfaction questionnaires, which were used for analysis. The faculty ratings of resident humanism correlated strongly with patient satisfaction ratings, while the resident self-ratings did not. Conclusions: Faculty ratings of resident humanism were highly predictive of patient satisfaction with the care rendered by internal medicine residents in two ambulatory care clinics. This suggests that ambulatory care settings are useful for evaluation of noncognitive behavioral features of resident performance. Received from McGill University, Departments of Medicine and Epidemiology and Biostatistics, Montreal General and Royal Victoria Hospitals, Montreal, Quebec, Canada. Supported by the Fonds de la recherche en santé du Quebec and the Royal Victoria Hospital Department of Medicine research and education fund.