Findings from an OMFS journal club: is COVID-19 the catalyst we have needed to embrace technology?

The COVID-19 outbreak has rapidly progressed into a worldwide pandemic, and the need for social distancing has changed the way we learn and work. Our monthly OMFS journal club has been no different, and is currently meeting on the video conferencing application Microsoft Teams. The use of a virtual setting for training in medicine and dentistry is not new and, as in the case of our recent move to a virtual medium, it may be that COVID-19 has fast-tracked this digital transformation. There are of course disadvantages to online teaching that traditional face-to-face teaching overcomes. We conducted a survey to examine how trainees' attitudes and experiences have altered with this change, and to understand whether some elements of this new style of training may be advantageous in the post-pandemic world. We aimed to assess trainees’ attitudes towards online teaching, and which elements, if any, would be beneficial once face-to-face teaching becomes possible again. A survey was created for all trainees taking part in journal club meetings at Bradford Teaching Hospitals. Multiple-choice and Likert scale questions were designed to ascertain the differences in experience between online and face-to-face settings. A Wilcoxon matched pairs signed test was used to analyse the results. Responses were kept anonymous. Results showed that the majority of trainees found it easier to attend the online journal club, and also indicated that the most found Microsoft Teams easy to use, though we did not have another online application for comparison. There was no significant difference in participation comfort between the two settings, though trainees felt that the online setting considerably improved learning effectiveness. Furthermore, 79% (11/14) thought that online tutorials and meetings should replace traditional face-to-face meetings in the future. The use of internet technology such as video conferencing is not new, and although journal clubs are typically held in academic institutions, online and virtual clubs are flourishing. With an array of advantages, there is no shying away from the trend to move our teaching to a virtual medium. COVID-19 may have just provided the stimulus that has forced this transformation to accelerate.     

The effectiveness of humanoid diagram teaching strategy on care capacity and retention in novice nurses

AimTo examine the effectiveness of a Humanoid Diagram Teaching Strategy (HDTS) on care capabilities and retention of novice nurses.BackgroundGuiding novice nurses in clinical practice is a matter of concern and the use of diagrams in assisting the learning process and to promote learning efficiency has been acknowledged.DesignThis is a quasi-experimental study with asynchronous repeated measurements for the experimental and control groups.MethodsThe study was conducted in a medical centre in southern Taiwan with 24 novice nurses. The intervention, Humanoid Diagrams Teaching Strategy, contained three parts: the head and neck; trunk; and limbs. The HDTS was applied three time weekly. Each session lasted approximately 30 min and the training lasted 4 weeks. The effectiveness of HDTS was measured using Mini-CEX, CbD and retention rates in the 3rd and 6th months of novice nurses’ experience.ResultsAfter the HDTS, although increases in mini-CEX and CbD scores in the experimental group were greater than the control group, these differences were not statistically significant after considering the time interaction. But the 3rd month and 6th month novice nurses’ retention rates were statistically significantly different by comparing the differences under the time interaction effects in both groups.ConclusionsThe Humanoid Diagram Teaching Strategy is an effective tool for preceptors to use in assisting novice nurses in learning, improving their nursing care knowledge and technical skills and to increase their retention rate.     

骨肉瘤复发性因素的教学研究

目的 探讨在临床医学专业见习生带教过程中结合骨肉瘤复发性因素进行教学的效果。方法 选取陆军军医大学临床医学专业见习生102名，随机分为两组，对照组应用常规教学，研究组联合应用骨肉瘤复发性因素教学。观察比较两组见习生对不同教学模式的自身应用效果评价、满意程度评价情况、理论考核及技能考核评分情况。结果 研究组的自身应用效果评分均高于对照组，满意程度评价情况优于对照组，理论知识及实际操作能力得分均显著高于对照组，上述指标组间比较，差异均有统计学意义（P均＜0.05）。结论 对临床医学专业的见习带教生应用骨肉瘤复发性因素分析模式进行带教，让见习生从根本上了解骨肉瘤复发的影响因素，可显著提高见习生对疾病理论知识及操作技能方面的掌握程度，同时还可显著提高见习生对带教的满意度。     

Joint-preserving treatment for type 3 sequelae following fracture of the proximal humerus with small head fragments

BackgroundAlthough nonunions of the proximal humerus are rare, they cause significant disability to patients. Surgical reconstruction is challenging, especially with small and excavated head fragments. A promising surgical option is open reduction and stabilization using the Humerusblock device along with tension wires. The aim of this retrospective investigation was to evaluate the clinical and radiological results of this procedure.Materials and methodsFifteen patients with symptomatic surgical neck nonunions were treated with open reduction and internal fixation using the Humerusblock device without bone grafting. All patients showed a loss of bone stock, leading to excavated head fragments. The mean interval from injury to the described treatment was 6.2 months (range, 3.4–10.7). At a mean follow-up of 40.5 months, the Constant-Murley score was documented, pain and patient satisfaction were evaluated using a visual analogue scale, and x-rays were taken in two planes.ResultsThe patients’ mean age was 69.7 years (range, 52–83). The mean Constant-Murley score improved from 24 points before surgery to 62 points at follow-up, which was an average of 80.8% of the score obtained for the contralateral arm. Radiological examination confirmed bony healing in 14 patients. All but one patient felt satisfied with the results. Three patients required revision surgery because of a hematoma, and early metal removal was performed in one patient because of infection.ConclusionNonunions of humeral surgical neck fractures can be successfully treated by fixation using the Humerusblock device along with tension wires without the need for additional bone grafting. Especially in patients with flat, concave head fragments, this procedure remains a promising reconstructive option to arthroplasty.Level of EvidenceLevel IV; Therapeutic retrospective case series.     

腹腔镜模拟培训在微创外科研究生临床教学中的应用

目的探讨腹腔镜模拟培训在微创外科专业学位研究生临床教学中的应用效果。 方法采用腹腔镜模拟训练结合临床教学模式对我科24名微创外科专业学位研究生进行临床教学，教学结束时考核教学效果，调查教学满意度，比较考核前后的成绩。 结果培训后学生出科平均成绩、合格率、优秀率、主观对自己基本操作熟练程度评分、满意度评分等均高于培训前，且差异有统计学意义（P<0.001）。 结论微创外科研究生临床教学理论与腹腔镜模拟培训相结合，可有效提高微创外科研究生对腹腔镜基本操作及视觉能力，提高腹腔镜操作者的基本技能，取得良好的教学效果，但考核标准仍需要完善。     

多种教学方法在全科住院医师眼科规培中的应用

本文针对眼科常见病临床表现多样、学科专业性强、多种全身性疾病有眼部表现的问题,通过充分调动全科规培医师的学习积极性,运用多种教学方法,在教学大纲规定的学习时间内,培训眼科临床上常规的基础检查和基本操作技能,弥补大学阶段“眼科学是考查课”的思想误区,降低全科医师在基层临床工作中漏诊、误诊情况的发生。经过3年的全科住院医师规范化培训,特别是通过眼科学的轮转学习,在眼科常见疾病方面完美的由理论学习向临床实践过度,培养出合格的面向基层的全科医师。在全面推进分级诊疗的医改行动中,在基层的全科医师能够做到眼科疾病早发现、早诊断,把需要转诊到上级医院的患者“转上去”,把经过上级医院诊治后处于康复阶段的患者“转回来”,保障首诊于基层医院的常见眼病患者可以得到及时的诊治。因此,通过应用多种教学方法,从而加强全科规培医师眼科轮转学习非常重要。     

微课在胸腔外科临床教学中的应用及效果

传统的胸腔外科教学存在课堂教学课时分配有限、病种较多而课堂教学难以全面覆盖、实践教学水平参差不齐、"大教材"更新难以同步等诸多问题。空军军医大学第二附属医院胸腔外科将微课教学逐渐应用于胸外科教学工作的各个层面当中，如本科生辅助课堂教学及临床技能培训、基层及进修医生培训、研究生教育等，取得了良好的教学效果。