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.     

临床医学成教专升本生理学教学的探索

在临床医学成教专升本生理学教学中,开展系列生理学专题讲座及学生读书报告会的教学改革,有效地调动了学生的学习主动性,促进了学生能力的培养和综合素质的提高.     

结构方程模型及其应用

目的探讨结构方程模型方法,并运用该方法分析医学领域培训效果的影响因素.方法应用结构方程模型对培训效果领域的数据进行拟合,建立相应的测量模型与结构模型,通过参数估计揭示出变量之间的关系;而后进行参数的合理性检验与模型的显著性检验.结果采用结构方程模型方法,拟合了医学成人教育领域培训效果的数据.结构模型决定系数为0.60,意味着结构模型解释了因变量变异的60%.拟合优度指数GFI=0.909,调整的拟合优度指数AGFI=0.891以及其他指标,表明运用结构方程模型,较好地拟合了数据,合理解释了影响培训效果的因素.结论模型提示,培训效果可以用工作技能、工作适应性的提高以及考核成绩来进行表述,而影响培训效果的因素则表现为行医资历、培训形式、专业与服务人口总量、培训需求和教育程度.     

The effect of intensive care on in-hospital survival

Intensive Care Units (ICU) are one of the most powerful and expensive technologies within inpatient care. However, its effect on survival is still an issue under discussion. The objective of this paper is to assess the effect of General ICU on in-hospital survival. We assessed the effect of ICU on survival using Linear and Probit regressions. Since admission to IC is not random and depends on unobserved (to the researcher) heterogeneity, we reassessed the IC effect by Instrumental Variables (IV) and Bivariate Probit techniques, using crowding in the IC unit as an instrument. The results show that a simple Probit of the IC effect on survival is 7–10 percentage-points (pts). The IV estimate of the IC effect on survival is 21–34 pts, and the Bivariate Probit estimate is 17–21 pts. We conclude that although admitted patients are at lower risk of death, as determined by their observable (to the researcher) characteristics, controlling for observable differences, those with a higher unobserved risk of mortality are more likely to be admitted. The implications for an optimal admission policy are discussed.     

Kirkpatrick四层评估模型对疾控系统应急机制建设培训评估的启示

目的：探讨疾控系统应急机制建设培训评估的途径和方法。方法：运用计算机与手工检索相结合的方式对国内外相关文献数据库及学术刊物进行检索。结果：国内疾控系统尚未建立统一有效的培训评估模式和方法。结论：Kirkpatrick评估模型能有效指导我国疾控系统的培训评估工作。     

2005年山东省开展农村改厕知识培训效果评价

[目的]为了解山东省各级农村改厕人员对《农村改厕基本知识》、《农村改厕技术知识》的知晓情况,评价培训效果。[方法]对2005年山东省举办的国家农村改厕知识培训班学员有关测试资料进行分析。[结果]227名培训学员对农村改厕各项知识平均得分,培训前为(89.07±37.68)分,培训后上升到(165.11±23.82)分,后者高于前者(P<0.01)。及格率培训前为49.78%,培训后上升到94.71%,后者高于前者(P<0.01)。知晓率培训前为53.57%,培训后提高到85.73%,后者高于前者(P<0.01)。[结论]培训后227名学员对农村改厕各项知识的平均得分、及格率和知晓率都有显著提高,效果良好。