Neuroimaging the pain network – Implications for treatment

In this chapter, we provide an overview of neuroimaging studies in chronic pain. We start with an introduction about the phenomenology of pain. In the following section, the application of functional and structural imaging techniques is shown in selected chronic pain syndromes (chronic back pain, fibromyalgia syndrome (FMS), phantom limb pain, and complex regional pain syndrome (CRPS)), and commonalities and peculiarities of imaging correlates across different types of chronic pain are discussed. We conclude this chapter with implications for treatments, with focus on behavioral interventions, sensory and motor trainings, and mirror and motor imagery trainings.     

Confessions of a New York rupture researcher: An insider’s guide and critique

Objective: The study of alliance rupture has become quite prevalent since 1990 and especially in the past 10 years where we have seen a noticeable surge in empirical publications on the subject. This honorary paper attempts to provide a critical review of this literature from the perspective of someone who has contributed to it in his collaborative work on a research program designed to investigate ruptures and to develop intervention and training models to resolve them. Method: This paper is organized into three topics or sections: (1) alliance rupture, (2) rupture resolution, and (3) alliance training; and it addresses definitions, findings, questions, and lessons with regard to each topic. Results/Conclusions: It suggests some clinical conceptualizations (concerning agency and communion as well as mutual recognition), training implications (regarding emotion regulation and deliberate practice), and methodological considerations (promoting pluralism and contextualism), along with future directions.     

Disparity between recent graduates’ and experienced surgeons' assessment of time to operative independence

Background

In cardiothoracic surgery, little data exist on the transition to operative independence. We aimed to compare current perceptions of operative autonomy of junior cardiothoracic surgeons and senior colleagues who oversee transitional years.

住院医师规范化培训中引入Mini-CEX的实践

目的　观察对住院医师规范化培训部分学员使用Mini-CEX进行临床教学的效果。方法选取我院2015级住培学员40名，随机分为对照组和实验组，每组20人。2015年10月至2018年4月，对照组采用传统教学；实验组在传统教学基础上结合Mini-CEX活动，实验组每人在每个轮转科室至少进行2次Mini-CEX。毕业时应用改良的Mini-CEX评分量表、病例答辩和OSCE三种考核方法对两组学员进行测评。针对实施过Mini-CEX的教师和学员分别发放问卷，进行满意度调查。采用SPSS 18.0对数据进行统计分析，组间比较采用独立样本t检验，组内前后比较采用配对样本t检验。结果 Mini-CEX测评显示，两组学员各项临床能力毕业成绩均高于入学成绩，实验组学员毕业成绩优于对照组，实验组学员成绩提高分数大于对照组提高分数，差异均有统计学意义（P＜0.05）。病例答辩显示，实验组学员平均成绩为（81.16±3.75）分，优于对照组的（70.13±3.88）分，差异有统计学意义（t= -9.140，P=0.000）。OSCE考核显示，实验组平均总分为（96.300±4.681），优于对照组的（91.775±3.227）分，差异有统计学意义（t=-3.559，P=0.001）。共发放调查问卷80份，其中教师40份、学员40份，结果显示教师满意率达95.0%、学员满意率达92.5%。结论　Mini-CEX应用于住院医师规范化培训临床带教中，有利于提高学员的临床思维、医患沟通和人文关怀能力。     

住院医师规范化培训中科研能力的同质化培养

住院医师规范化培训是提高我国临床医师队伍整体素质和水平的重要举措。培训内容和培训方式也需要与时俱进才能培养出真正适应快速发展的医学事业人才。当前住院医师的培养多局限于理论知识灌输及临床操作技能的训练,忽视了科研能力的提高。特别是社会学员的科研能力训练往往被忽视,不符合目前住院医师规范化培训对同质化的要求。本文结合既往研究和自身从事规培管理工作的实践,从多角度对规培中针对科研能力培养存在的问题进行梳理,主要包括:带教教师的科研培训、学生自身提高、考核标准完善和基地配套保障四个方面。先提出各方面存在问题,再深入分析出现上述问题的原因,最后结合既往研究及自身实践,对上述各问题的解决方法进行分析和讨论,最后得出相应的具有可行性的解决方案。     

情境模拟案例教学法在护士规范化培训中的应用效果

目的研究情境模拟案例教学法在护士规范化培训中的应用效果。方法选择2017年8月-2018年7月在医院外科系统进行规范化培训的护士60名作为对照组,接受常规模式的规范化培训;而选择2018年8月-2019年7月进行规范化培训的护士60名作为研究组,在规培期间引入情境模拟案例教学法。规培结束后,考核并比较两组规培护士的理论知识和临床护理操作,测评规培护士的评判性思维能力,调查规培护士对规培模式的满意度。结果对照组的理论知识和临床护理操作的得分分别是(86.7±7.5)分、(82.8±8.7)分,而研究组的得分则分别是(91.3±8.4)分、(87.5±8.1)分;与对照组相比,研究组护士对理论知识的掌握和临床护理操作技能更强(P<0.05)。与对照组相比,研究组规培护士具有更强的批判性思维能力(P<0.05)。而且,研究组护士对情境模拟案例教学模式的满意度要优于对照组(P<0.05)。结论情境模拟案例教学法在护士规范化培训中效果较好,可显著提高规培护士的理论及实践操作的综合能力以及评判性思维能力。