基于虚拟教研室的公共卫生安全素养培育课程构建及实践

目的:探讨基于虚拟教研室的公共卫生安全素养培育课程构建及实践。方法:选取某医学院校专科护理专业学生(护生)为研究对象,将护理1班45人作为试验组,将护理2班43人作为对照组,对照组对公共卫生安全知识实施线上与线下的常规教学,试验组实施基于虚拟教研室的公共卫生安全素养培育课程。比较两组护生内容掌握情况及学习满意度。结果:试验组护生的学习成绩明显高于对照组(P<0.01),试验组护生对教学的满意度为95.6%(43/45),明显高于对照组(P<0.05)。结论:基于虚拟教研室的公共卫生安全素养培育课程构建既可以广泛促进不同专业教师进行教学研究交流,全面提高教师教书育人能力,又可以使护生在学习过程中接触不同专业、不同领域的知识与技能,注重护生主体作用,提高学习效果和学习满意度。     

The scope of computerized simulation in competency-based maxillofacial training: a systematic review

Oral and maxillofacial surgery (OMS) teaching is set to undergo a paradigm shift towards competency-based training. With increasing focus on resident skill development and patient safety, computerized simulators are likely to play a more mainstream role in OMS training. A systematic review of the available literature was conducted, in accordance with the PRISMA guidelines, to highlight the scope of computerized simulation in OMS teaching. A PubMed search was performed by two independent reviewers, and 35 articles published in English between 2010 and 2021 that reported the use of computerized simulation for teaching maxillofacial procedures were included in the analysis. Eight articles on minor oral surgery, seven on orthognathic surgery, five on maxillofacial trauma, five on cleft lip and palate surgery, three articles each on nerve block techniques, endoscopic procedures, and reconstructive surgery, and one article on fibre-optic intubation reported the use of computerized simulation that can be applied to OMS training. Ten randomized controlled trials were identified in the search. However there was marked heterogeneity among the studies. Simulator training for skill acquisition mentored by an expert OMS educator could offer holistic resident training; however more studies that test common themes of resident training such as knowledge acquisition and skill development are necessary.     

Training and teaching of vagus nerve stimulation surgery: Worldwide survey and future perspectives

ObjectiveVagus nerve stimulation (VNS) therapy has been used for more than two decades to treat drug resistant epilepsy and depression and most recently received FDA approval for stroke rehabilitation. Expanding indications will renew the interest in the technique and increase the number of surgeons to be trained. The aim of this study was to survey surgeons with substantial expertise on optimal teaching and training approaches.MethodsAnonymous forms comprising 16 questions were sent by e-mail to surgeons with substantial expertise. Statistical analyses were used to compare the answers of the most experienced surgeons (>5 years) with the less experienced ones (<5 years).ResultsFully-completed forms were collected from 57 experts from 20 countries. The placement of the helical coils was deemed to be the most difficult step by 36 (63.2%) experts, and the use of optical magnification during this step was deemed necessary by 39 (68.4%) experts. Vocal cord palsy should be largely avoidable with proper surgical technique according to 44 (77.2%) experts. The teaching tool considered the most useful was mentoring (38, 66.7%). The future of VNS surgery teaching was deemed to be in anatomical workshops (29, 50.9%) and surgical simulation (26, 45.6%). Overall, answers did not vary significantly according to experience.ConclusionsVNS surgery should be mastered by actively participating in dedicated practical training courses and by individual mentoring during actual surgery, which is still the best way to learn. This study highlights the need for a formal training course and possible specific accreditation.     

“317护”宣教平台联合肠道准备评估单在结肠镜检查前的应用

目的评价“317护”宣教平台联合肠道准备评估单在肠镜检查前的应用效果。方法选取2020年10月-2021年1月我科行结肠镜检查的住院患者120例为研究对象。根据住院时间分为观察组和对照组,各60例。观察组实施“317护”宣教平台联合肠道准备评估单进行肠道准备,对照组使用肠道准备评估单进行肠道准备。比较两组肠道清洁度、肠道清洁剂服用方法正确率、肠道准备满意度。结果观察组肠道清洁度评分、肠道清洁剂服用方法正确率及肠道准备满意度高于对照组(P<0.05)。结论应用“317护”宣教平台联合肠道准备评估单在肠镜检查前进行健康宣教后,提高了患者肠道清洁度、肠道清洁剂服用方法正确率及肠道准备满意度。     

多元化联合教学模式在超声引导下疼痛介入治疗中的应用

目的探讨多元化联合教学模式在超声引导下疼痛介入治疗教学中的应用效果。方法选择2018年1月至2020年12月在北京大学第三医院疼痛科进修的30名医师作为研究对象,将其分为对照组与观察组;对照组采用常规教学模式;观察组采用多元化联合教学模式,比较两组医师技能考核成绩、教学质量评分和满意度评分。结果观察组医师技能考核成绩优良率为93.3%,高于对照组的73.3%(P<0.05);观察组医师对基础理论知识掌握、临床思维能力的提高、学习兴趣的激发、疾病诊治能力的提高4个方面的评分均高于对照组(P<0.01)。结论多元化联合教学模式可促进超声引导下疼痛介入治疗技能的提高,有利于提高学员的综合临床能力。     

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.     

Impact of Joint Lung Cancer Screening and Cessation Interventions Under the New Recommendations of the U.S. Preventive Services Task Force

IntroductionIn 2021, the U.S. Preventive Services Task Force (USPSTF) revised its lung cancer screening recommendations expanding its eligibility. As more smokers become eligible, cessation interventions at the point of screening could enhance the benefits. Here, we evaluate the effects of joint screening and cessation interventions under the new recommendations.MethodsA validated lung cancer natural history model was used to estimate lifetime number of low-dose computed tomography screens, percentage ever screened, lung cancer deaths, lung cancer deaths averted, and life-years gained for the 1960 U.S. birth cohort aged 45 to 90 years (4.5 million individuals). Screening occurred according to the USPSTF 2013 and 2021 recommendations with varying uptake (0%, 30%, 100%), with or without a cessation intervention at the point of screening with varying effectiveness (15%, 100%).ResultsScreening 30% of the eligible population according to the 2021 criteria with no cessation intervention (USPSTF 2021, 30% uptake, without cessation intervention) was estimated to result in 6845 lung cancer deaths averted and 103,725 life-years gained. These represent 28% and 34% increases, respectively, relative to screening according to the 2013 guidelines (USPSTF 2013, 30% uptake, without cessation intervention). Adding a cessation intervention at the time of the first screen with 15% effectiveness (USPSTF 2021, 30% uptake, with cessation intervention with 15% effectiveness) was estimated to result in 2422 additional lung cancer deaths averted (9267 total, ∼73% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 322,785 life-years gained (∼318% increase). Screening 100% of the eligible according to the 2021 guidelines with no cessation intervention (USPSTF 2021, 100% uptake, without cessation intervention) was estimated to result in 23,444 lung cancer deaths averted (∼337% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 354,330 life-years gained (∼359% increase). Adding a cessation intervention with 15% effectiveness (USPSTF 2021, 100% uptake, with cessation intervention with 15% effectiveness) would result in 31,998 lung cancer deaths averted (∼497% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 1,086,840 life-years gained (∼1309% increase).ConclusionsJoint screening and cessation interventions would result in considerable lung cancer deaths averted and life-years gained. Adding a one-time cessation intervention of modest effectiveness (15%) results in comparable life-years gained as increasing screening uptake from 30% to 100% because while cessation decreases mortality from many causes, screening only reduces lung cancer mortality. This simulation indicates that incorporating cessation programs into screening practice should be a priority as it can maximize overall benefits.     

讨论式教学法在温病学中的教学设计——以温病的祛湿法为例

文章以温病的治法祛湿法为例,提出讨论式教学法的教学设计,包括建立"三人为师"规则、"发言签"规则,营造讨论气氛,角色分配包括向导、刺头、记录员、法官、汇报人,然后按照"领结模型"展开讨论,最后按照表达意愿、思维技能、学生间互动、内容知识掌握情况等进行评估,旨在培养学生温病学临床思维能力与团队协作能力。     

临床护理教师胜任力现状及与护生的评价比较

目的 调查临床护理教师胜任力水平及影响因素，为提高临床护理教学质量提供参考。方法 采用临床护理教师胜任力问卷、学习动机量表对重庆市11所三级医院的749名临床护理教师及458名实习护生进行调查。结果 临床护理教师胜任力自评均分为4.38±0.49,护生评价均分为4.12±0.65,护生评价总分及6个维度得分显著低于教师自评(均P<0.01);护龄、职务和学习动机是临床护理教师胜任力的影响因素(均P<0.01)。结论 临床护理教师胜任力处于较好水平，但护生评价低于教师自评；护理管理者可通过激发教师的学习动机进一步培养和提升临床护理教师的胜任力。