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41.
教学评价是教学过程中不可或缺的,行之有效的教学评价是促进教学方法改革,增强教学效果的指挥棒。与传统的教学方法相比较在混合式医学教学课堂中,教学评价也应进行相应的改革,从教师、自身、同行三个维度研究混合式医学教学中的教学评价方法的改革。同时强调完善教学评价的反馈机制。通过学生反馈、专家反馈、同行反馈、自身反馈,建立完整的混合式教学+医学教育的教学评价体系。 相似文献
42.
目的:系统评价针刺结合医用臭氧注射治疗膝骨性关节炎的临床疗效和安全性。方法:依据荟萃分析要求,全面检索CBM、CNKI、VIP、PubMed、Embase及TheCochraneLibrary等数据库,纳入以针刺结合医用臭氧注射为干预措施治疗膝骨性关节炎且为随机对照试验或临床对照试验的研究文献,文献的检索年限均为建库至2019年4月。由两名经过培训的研究人员独立进行检索并提取资料,如果遇到分歧,找第三方(老师或者专家)协助解决。采用Cochrane协作网提供的ReviewManager5.3软件进行数据的荟萃分析。结果:最终纳入15篇RCT或CCT,受试者共1244例,10篇文献报道总有效率,总有效率异质性检验:[Chi2=5.07,P=0.83,I2=0%,OR=4.00,95%CI(2.72,5.89),Z=7.03,P<0.00001]。10篇文献报道了VAS评分,异质性检验,[MD=-1.72,95%CI(-2.39,-1.06),Z=5.10,(P<0.00001)]。2篇文献报道了WOMAC指数,异质性检验,[Chi2=0.01,P=0.91,I2=0%,MD=-6.84,95%CI(-9.23,-4.45),Z=5.61,P<0.00001]。2篇文献报道了Lysholm膝关节功能评分,异质性检验,[Chi2=0.84,P=0.36,I2=0%,MD=7.97,95%CI(5.60,10.34),Z=6.60,P<0.00001]。仅有1篇文献报道不良反应的发生。结论:针刺结合医用臭氧注射治疗膝骨性关节炎疗效显著,易于推广,但其结论的验证还需要大样本高质量临床试验进一步验证。 相似文献
43.
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。 相似文献
44.
Objective
It is useful for reviewers of economic evaluations to assess quality in a manner that is consistent and comprehensive. Checklists can allow this, but there are concerns about their reliability and how they are used in practice. We aimed to describe how checklists have been used in systematic reviews of health economic evaluations.Methods
Meta-review with snowball sampling. We compiled a list of checklists for health economic evaluations and searched for the checklists’ use in systematic reviews from January 2010 to February 2018. We extracted data regarding checklists used, stated checklist function, subject area, number of reviewers, and issues expressed about checklists.Results
We found 346 systematic reviews since 2010 that used checklists to assess economic evaluations. The most common checklist in use was developed in 1996 by Drummond and Jefferson, and the most common stated use of a checklist was quality assessment. Checklists and their use varied within subject areas; 223 reviews had more than one reviewer who used the checklist.Conclusions
Use of checklists is inconsistent. Eighteen individual checklists have been used since 2010, many of which have been used in ways different from those originally intended, often without justification. Different systematic reviews in the same subject areas would benefit from using one checklist exclusively, using checklists as intended, and having 2 reviewers complete the checklist. This would increase the likelihood that results are transparent and comparable over time. 相似文献45.
Young Hyo Choi Min Yong Kang Hyun Hwan Sung Hwang Gyun Jeon Byong Chang Jeong Seong Il Seo Seong Soo Jeon Chan Kyo Kim Byung Kwan Park Hyun Moo Lee 《Clinical genitourinary cancer》2019,17(1):e19-e25
Background
The purpose of the study was to compare cancer detection rates between 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and multiparametric magnetic resonance imaging (mpMRI)-guided target prostate biopsy (MRI-TBx) according to prostate-specific antigen (PSA) level in biopsy-naive patients.Patients and Methods
A retrospective study was conducted in 2009 biopsy-naive patients with suspected prostate cancer (PSA ≤20 ng/mL). Patients underwent TRUS-Bx (n = 1786) or MRI-guided target prostate biopsy (MRI-TBx; n = 223) from September 2013 to March 2017 and were stratified according to each of 4 PSA cutoffs. MRI-TBx was performed on lesions with Prostate Imaging Reporting and Data System (PI-RADS) scores of 3 to 5 on mpMRI. Clinically significant prostate cancer (csPCa) was defined as Gleason ≥7. Propensity score matching was performed using the prebiopsy variables, which included age, PSA, prostate volume, and PSA density.Results
Propensity score matching resulted in 222 patients in each group. There were significant differences between the TRUS-Bx and MRI-TBx groups in the overall detection rates of prostate cancer (41.4% vs. 55.4%; P = .003) and csPCa (30.1% vs. 42.8%; P = .005). However, across PSA cutoffs, MRI-TBx detected more prostate cancer than TRUS-Bx at PSA levels of 2.5 to <4 (29.5% vs. 56.6%; P < .001). The csPCa detection rates of TRUS-Bx and MRI-TBx did not differ significantly within the PSA cutoffs. There was a significantly higher detection rate of prostate cancer and csPCa in lesions with PI-RADS scores 4 and 5 than in those with a score of 3.Conclusion
Prebiopsy mpMRI and subsequent targeted biopsy had a higher detection rate than TRUS-Bx in patients with prostate cancer and csPCa. 相似文献46.
目的:探讨脑心健康管理师对脑卒中病人实施全程管理的应用效果。方法:选取入住医院的136例脑卒中病人为研究对象,按随机数字表法分为试验组和对照组各68例。对照组给予传统管理,试验组在前者基础上实施脑心健康管理师全程管理。在干预前和干预后5个月,分别采用自行设计的脑卒中病人随访服务记录表、生活质量综合评定量表(GQOL-74)、病人对脑心健康管理工作满意度调查表对病人进行评估。结果:试验组病人服药和日常生活行为依从性高于对照组(P<0.05);试验组病人的满意度高于对照组(P<0.05)。结论:脑心健康管理师能明显提高对脑卒中病人实施全程管理的效果。 相似文献
47.
Emilie Dromer Lyes Kheloufi Philippe Azouvi 《Annals of physical and rehabilitation medicine》2021,64(5):101468
BackgroundImpaired self-awareness (ISA) has frequently been found to be both frequent and deleterious in patients with moderate to severe traumatic brain injury (TBI).ObjectivesThe present paper is the first of a two-part systematic review of ISA after traumatic brain injury (TBI), focusing on assessment methods, clinical aspects and recovery.MethodsFollowing the PRISMA guidelines, 95 articles meeting the inclusion criteria were included.ResultsISA occurs in 30% to 50% of patients with moderate to severe TBI, although it tends to improve with time. There is no one single gold-standard measure of ISA. Self-proxy discrepancy scores, with scales such as the Patient Competency Rating Scale or the Awareness Questionnaire, or a structured interview such as the Self Awareness of Deficits Interview, are the most frequently used assessment methods, with adequate psychometric properties. Scores on these different scales correlate only moderately with each other, which suggests that they may address different aspects of self-awareness. ISA mainly concerns cognitive and behavioral problems rather than physical or sensory impairments and may concern different areas of functioning, such as anticipatory, emergent or meta-cognitive awareness.ConclusionISA is a complex and multifaceted issue that should be systematically assessed in rehabilitation settings using a range of relatively well-validated tools. The consequences and predictors of ISA after TBI will be addressed in a companion paper. 相似文献
48.
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