One-year follow-up results of combined use of CO<Subscript>2</Subscript> laser and cold instrumentation for Reinke’s edema surgery in professional voice users

The purpose of this study was to present our experience with combined use of CO₂ laser and cold instrumentation for Reinke’s edema surgery and to evaluate 1-year follow-up results of the technique in a series of professional voice users. Fifteen patients with Reinke’s edema who underwent microlaryngoscopic surgery were included. Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year follow-up, no recurrence of Reinke’s edema was encountered. Significant postoperative improvement was obtained in the quality of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological examinations. Combined use of CO₂ laser and cold instrumentation provides a reliable and safe method for Reinke’s edema surgery, and cessation of smoking, voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke’s edema and provides better quality of voice. However, it does not imply that our method is superior to others’, but this procedure constitutes an effective treatment of choice for Reinke’s edema patients, including professional voice users.     

浅谈临床教师的角色素养及道德要求

探讨了临床教师的角色特征;认为临床教师的角色要求与现实状况之间存在反差;据此就其原因进行了分析。提出要强化临床教师的角色意识;在教学实践中自觉加强对其角色素养的自我锻炼和培养。     

基于ISD模型的突发公共卫生事件全员培训设计与应用分析

目的 北京市某三级医院为提升全员应对突发公共卫生事件的应急处置能力,最大限度保障职工职业安全,实现所有工作人员零感染,开展全员职业培训与考核。方法 采用ISD（instructional system design）模型进行培训课程的系统设计,对全院人员在线学习、电子试卷考核和现场培训、考核结果使用Excel、SPSS 22.0进行分析。结果 参加培训人员经培训后平均得分由84升至100,答题时间由平均308 s缩短为179 s,不同职称人员培训前后考核分数存在差异,不同部门间人员培训前后的考核分数存在差异。结论 在突发公共卫生事件发生时,全员培训及考核是必要的,应用ISD模型有助于快速制定培训方案。在线学习考核的应用是应急全员培训的首选有效方式。     

国外一流大学公共卫生硕士研究生教育的经验与启示

为借鉴国外一流大学硕士研究生教育先进经验,本研究以哈佛大学、约翰霍普金斯大学和伦敦卫生与热带医学院为研究对象,分析对比其公共卫生硕士研究生培养模式、课程设置及教学资源等方面的优势和特点,为我国公共卫生与预防医学硕士研究生教育改革发展提供参考。     

Assessing graduate programs for healthcare information management/technology (HIM/T) executives

This paper describes a methodology to assess health/medical informatics graduate-level education curricula. The authors used the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS) as the basis for their assessment. The authors compared the 69 CPHIMS exam objectives against four health/medical informatics program course objectives as stated in the selected program's online graduate catalog. Results showed that the two programs with management as a focus addressed the majority (67 and 59%) of the CPHIMS objectives within core and elective courses combined. Overall, the other two programs addressed closer to a third of the CPHIMS objectives (36 and 32%). This methodology could prove to be useful in assisting students interested in graduate-level training programs with a tool by which to measure the congruence of the curricula of different programs with the mission of the programs and with their own professional interests.     

经典名方当归补血汤的古代文献分析与考证

当归补血汤出自金元时期李东垣《内外伤辨惑论卷中·暑伤胃气论》,是一首被历代医家传承发扬的补气生血经典名方,已被收录于2018年国家中医药管理局公布《古代经典名方目录（第一批）》。通过系统梳理古籍文献及现代文献,并结合古代经典名方关键信息考证原则,对经典名方当归补血汤的历史源流、组成、剂量、炮制、制法与煎服法、功效与应用进行考证分析。共收集相关古籍文献信息604条,其中涉及中医古籍186部,其中40部（金元5部,明19部,清16部）中医古籍详细记载了组成、炮制、剂量等内容。有关当归补血汤组成,主要为当归和黄芪;根据古今剂量折算,黄芪37.3~38.1 g,当归7.5~7.6 g;黄芪宜采用蜜炙,当归为酒当归;加入水600 mL,煎至300 mL,饭前温服。该方古籍主要记载功效为血虚发热,证见肌热、燥热,烦渴引饮,目赤面红,昼夜不息,脉洪大而虚,重按无力,是补气生血名方。现代研究表明,当归补血汤常用于治疗各种贫血、糖尿病肾病、肿瘤、心脑血管疾病。上述研究结果为经典名方当归补血汤后期开发研究提供了参考依据。     

The optimal usage of the ISCP by trainee and trainer

The Intercollegiate Surgical Curriculum Programme (ISCP) provides the Curriculum with the specialty syllabus, trainee’s portfolio of activity, and the process and recording of assessment. It is an excellent resource and in order to gain the optimal benefit trainees and trainers are recommended to invest some time in navigating through the site and understand its functionality. The launch of the 2021 Surgical Curricula is an important change with the new assessment tool of the Multiple Consultant Report (MCR) and the trainee input with their self-assessment. The ISCP has incorporated the MCR assessment process (Generic Professional Capabilities and Capabilities in Practice) into the learning agreement structure such that the progression through to the higher-level outcome of the curriculum, defined as a day 1 consultant in a specialty, is enhanced by frequent and focussed feedback specific to the trainee. To achieve the optimal outcomes, it is important to have strong engagement with the ISCP and the useability has been enhanced to facilitate this.     

How does French initial osteopathic training value relational competency,patient education,and the competency-based approach? A cross-sectional survey

BackgroundDespite the promotion of international osteopathic recommendations and registration guidelines, relational competencies and patient education practices present a challenge in the clinical setting due to lack of training. In France, the latest national osteopathic standards for education and practice defined a relational competency that includes patient education. Little is known about its integration in curricula and how French osteopathic practitioners are subsequently trained for relational competency.ObjectiveTo determine teaching, learning, and assessment methods related to relational competency in French initial osteopathic training programs and identify the role of patient education in this relational competency.MethodsAn online questionnaire was designed and sent to all initial training institutes in France (n = 28). Eight institutes answered the survey.ResultsThe relational competencies appeared in various courses, enhanced by clinical learning. However, the courses were not specific to this competency and the volume of hours was relatively low. Patient education was seen as part of relational competency but was poorly implemented. This competency-based approach is still considered an emerging practice in these institutes.ConclusionsThere is a misalignment among intended learning outcomes, teaching, and assessment. Current educational practices are not sufficient to support relational competency, specifically regarding patient education. Further research is needed on how French standards are understood, how they are assimilated by educators, and how they are translated into educational practice. In addition, the adequacy of educators' training for effective implementation of the competency-based approach should be questioned.