应用临床情景式教学模式培养医学生职业素质的初步探讨

目的对医学生进行临床情景式教学的系统培训,采用结构化医师职业素质评价体系,对医学生职业素质进行整体考核评估,探索适用于提高医学生职业素质的临床情景式教学模式。方法选择北京大学2008级八年制临床医学专业63名学生为研究对象,将其随机分为实验组和对照组。实验组学生采用多种形式的临床情景式教学案例,全面开展临床情景式教学。建立结构化医师职业素质评价体系,采用此评价体系对实验组和对照组学生进行职业素质的整体评估考核,对考核成绩进行统计分析。结果①是否接受大课教学对医学生职业素质测评结果没有影响。②结合多种形式的临床情景式案例的临床情景式教学模式可以全面显著提高医学生的职业素质。结论采用临床情景式教学模式可以全面提高医学生的职业素质。     

以提高医学生职业素质为目标的临床情景式教学模式的建立与实施

目的 建立系统的适用于提高医学生职业素质的临床情景式教学模式,探讨其具体实施方法和实际教学效果.方法 情景式教学模式的实施包括5个主要环节：第1环节分析案例确定教学点,这一步是核心其他环节都要围绕着教学点进行;第2环节根据教学点设计情景脚本;第3环节课堂展现情景;第4环节情景的再现和反馈,这一步是情景式教学最重要的一步;第5环节是总结与记录教学点.结果 通过临床情景式教学模式的教育实践可以看出：①随着临床见习、实习的进行,医学生的职业素质逐步提升.②是否接受大课教学对医学生职业素质测评结果没有影响.③临床情景式教学模式可以全面提升医学生的职业素质.结论 临床情景式教学模式遵循了科学的教育教学方法,采用了现代化的教学手段,充分发挥了医学生主动学习的热情,实现了全面提升医学生的职业素质的预期效果.     

Nursing students' learning of managing cross-infections--scenario-based simulation training versus study groups

Up to 33% of all health care-associated infections are preventable [Alexander, M., 2006. Nursing Practice. Hospital and Home. Elsevier, Churchill Livingstone]. Nurses must consider how they can address infection prevention, control and management within health care settings. An outbreak of any infectious disease can occasionally occur, even when protocols have been followed. A well-coordinated, multidiscipline response will minimize the impact of the outbreak by controlling and managing the impact and ongoing risks. In this study nursing students were challenged to manage cross-infections based on two hypothetical cases, MRSA and Norovirus. The purpose of the study was to determine the most efficient teaching strategies for managing cross-infections and determining the teachers' role by comparing three different teaching methods; scenario-based study groups with and without teacher and simulation training. A class of 141 2nd year nursing students participated as part of their learning programme on infection control. Out of these 21 students were randomly selected to take part in three focus groups assigned to evaluate the program. Overall, the findings indicated that scenario-based simulation training made the students more aware of how complex each scenario was. Events occurred that they had not expected, and this lead to a better recollection of details. By asking appropriate questions, giving feedback and hypothetical examples, the teacher's role was crucial in both teaching strategies.     

“6W”理论联合情景模拟教学应用于心血管专科疾病临床教学的效果评价

目的：探讨临床教学中应用6W（what、where、when、who、why、how）理论联合情景模拟教学对于心血管专科操作并发症诊断和处理的效果。方法：将58名学生随机分为2组,每组29人,分别实施6W理论联合情景模拟教学法和传统教学法带教,教学完成时及3个月后对2组学生进行成绩考核,评估对不同专科操作并发症的诊断与处理能力,以比较2种教学方法的效果。结果：6W联合情景模拟教学组教学结束后理论考核成绩为（90.2±2.1）分,高于传统授课组（82.3±2.3）分;操作技能考核成绩为（98.2±4.2 ）分,高于传统授课组（92.6±3.3）分,2组间的考核成绩差异均有统计学意义（P<0.05）。3个月后对2组对象再次测试,6W联合模拟教学组理论考核成绩为（84.4±3.2）分,高于传统授课组（74.1±2.3）分;操作技能考核成绩为（95.5±3.2 ）分,高于传统授课组（88.6±5.4）分,2组间的考核成绩差异均有统计学意义（P<0.05）。结论：通过6W理论联合情景模拟教学对心血管专科新职工进行带教,可有效提升其对心血管专科操作并发症的诊断及实际处理能力,近期和远期教学效果均好于传统教学组。     

情境教学在妇产科临床技能培训中的应用

妇产科临床技能培训可采用情境教学,通过模拟临床工作实景,有效增加医学实习生的实践机会。在专科检查教学中,由教师和仿真模型共同模拟患者,可帮助医学生提高检查技巧并及时反馈错误：在危急重症教学中,通过引入真实病例,采用仿真模型、相关仪器设备、多专业合作等方式,可训练医学生的临床处置能力;在医患沟通教学中,通过场景资料库的建立,由教师引导．可训练医学生掌握医患沟通技巧：在技能考试中,通过整合多种临床技能考核内容与形式,可更加准确地反映医学生临床实践效果。情境教学要求准备大量的情景培训材料,同时也要求教师具备高素质并能够有力地掌控整个教学过程。     

Scenario-based design: a method for connecting information system design with public health operations and emergency management

Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Methods: Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Results: Interview analysis identified 25 information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create 25 scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. Conclusion: The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design.