美国眼科住院医师的培训和继续教育

目的:本文旨在为探索适合我国国情的眼科住院医师培养模式提供借鉴和启发。方法:以美国Doheny眼科中心(Doheny Eye Institute)的眼科住院医师培训模式为主,结合约翰霍普金斯的Wilmer眼科中心(Wilmer Eye Institute)和Jules Stein眼科中心(Jules Stein Eye Institute)的培训特点,介绍美国顶尖眼科中心的住院医师培训过程,辅以对美国继续医学教育目的和要求的介绍。结果:美国有着完善和科学的临床医师培养体系,其中八年院校教育后的住院医师培训和继续医学教育(Continuing Medical Education,CME)尤为值得关注。结论:结合我国国情借鉴学习领先者的经验,是全面提高我国眼科医疗水平的重要途径。     

人文素养在眼科住院医师规范化培训中的重要性

本文简要探讨了眼科青年医师在住院医师规范化培训过程中,应该重视人文素养的培养.眼科住院医师必须三基扎实,具备敏锐的临床科研嗅觉、优秀的现代医学人文素养.在科技高速发展与医疗环境日趋复杂的今天,培养具备精湛的专业技能与高尚的医学人文精神的眼科学领袖,对于眼科的发展显得尤为重要.     

虚拟-现实手术模拟系统在眼科住院医师微创白内障手术培训中的应用效果

目的：探讨虚拟-现实手术操作训练在眼科住院医师微创白内障手术技能培训中的应用及效果。

方法：前瞻性对照研究。选取2019/2021年在南京医科大学附属眼科医院已完成3a住院医师规范化培训的20名年资相同的眼科住院医师为研究对象,通过理论考核后随机分为虚拟-现实手术操作训练(Dry-lab)组和实体动物手术操作训练(Wet-lab)组,每组各10名。Dry-lab组和Wet-lab组医师分别使用Eye SI虚拟手术模拟器和猪眼进行训练。训练结束后使用Eye SI虚拟手术模拟器和实体猪眼操作对两组住院医师的总体培训效果进行评分,使用虚拟手术模拟器对两组住院医师的模块培训效果进行评分,并采用问卷调查对两种培训方式进行客观评价。

结果：Dry-lab组医师两项操作考核总评分、模拟器考核评分、实体猪眼操作考核评分均显著高于Wet-lab组(88.03±1.34分 vs 80.35±2.87分,87.50±3.03分 vs 77.60±5.62分,88.57±1.89分 vs 83.10±3.22分,均P<0.01)。模拟器模块考核结果显示,Dry-lab组医师各模块考核评分及用时均显著优于Wet-lab组(P<0.01)。问卷调查结果显示,在培训新颖性、是否贴近真实手术体验、对显微手术技能提高的帮助程度、经过该培训是否有信心进行真实手术及手术培训的整体满意度方面,Dry-lab组医师对于培训方式的效果评价均优于Wet-lab组(P<0.05)。

结论：将虚拟-现实手术操作训练应用于眼科住院医师白内障手术技能培训可以显著提升住院医师的白内障显微手术操作技能,提高培训整体满意度,帮助住院医师在执业初期提升真实手术时的信心、心理素质、决策及处理能力,为建立眼科住院医师正式、规范化的白内障手术培训体系提供了新的标准和模式。     

眼科专科医院住院医师规范化培训实践与思考

眼科住院医师规范化培训(以下简称“规培”)是培养眼科医师的必要环节。我国规培模式日臻成熟,但眼科规培过程管理中仍存在诸多问题,包括专科医院和综合医院的规培协调问题、师资激励、规培学员类型多样、研究生和规培“双轨制”、如何开展显微手术技能培训等,很多具体方案和措施仍在摸索中。眼科专科医院学科体系建设相对完善,配备更充足的教学资源,有一定的规培经验,是眼科规培的主力军。汕头国际眼科中心结合国家要求创建了一套规培模式,注重规范化、标准化和个性化相结合,并通过借鉴香港及海外住院医师培训经验,丰富理论培训形式,优化操作培训环境,突出外语和科研能力训练,强调系统性临床思维。本文基于汕头国际眼科中心五年来开展眼科规培的实践经验与思考,总结当前眼科专科医院规培现状,并提出对策和建议。     

眼科医师规范化培训期间科研能力现况调查

目的：了解眼科住院医师在规范化培训期间的科研培训现状及需求，为今后开展住院医师科研能力相关课程提供科学依据。方法：采用横断面调查的方式，在2021年7月间对北京大学第三医院眼科中心42名住院医师进行问卷调查，对结果进行数据分析。从科研现状、科研能力及科研需求3个方面来进行分析，其中科研能力通过常规科研技能掌握程度和软件的使用情况来评分，最后将各项得分汇总得到的分数为科研能力得分。对科研现状及可能能力得分进行了相关分析，其他数据按数据类型选择对应的分析方法。结果：共42名北京大学第三医院住院医师参与了问卷调查，其中男20名，女22名，平均年龄25岁。有90.5%的住院医师参与过科研工作，而科研内容主要来自及导师布置(90.5%)。只有14.3%的住院医师具备良好的科研能力(科研能力得分在18分及以上)。此外，有92.9%的住院医师认为临床研究有助于临床技能的理解，97.6%的参与者认为非常有必要进行临床研究方法的继续教育培训。结论：眼科住院医师科研能力普遍偏低，目前的规范化培训不能满足住院医师科研能力培养的需求，在课程设计及内容安排上需要更广泛更具实际意义的拓展。     

曹安民教授传略

曹安民教授现任美国约翰霍普金斯大学医学院眼科及病理学科教授、北京大学医学部名誉教授、北京大学眼科中心主任、香港眼科医师学院顾问 ,前任院长、亚太眼科学会委员 ,名誉信托人、世界眼科学院第十一讲座教授 ,世界眼科理事会副主席。曹教授于 196 1年至 196 7年在美国波士顿大学医院任外科实习医师和眼科住院医师。完成眼科住院医师培训后 ,于 196 9年进入美国军队总医院病理学院任眼科医师和病理研究员 ,完成两年病理学专科培训后兼任美国佐治亚华盛顿大学医学中心眼科学临床助理教授 ,研究副教授。于 1976年到 1994年 ,任美国伊利诺州…     

眼科学住院医师规范化培训的体会与思考

眼科住院医师规范化培训(住培)是眼科后备医疗人才培养中极其重要的环节，但反观目前我国眼科住培体系，尚存诸多不足。笔者以所在眼科住培专业基地运行为例，拟评估住院医师临床带教内容、带教模式和带教效果，以及加强规培学员思政教育及对带教老师授课能力的培训等方面进行较为全面的改革，并对此项改革所取得的成效进行报告，以期对我国眼科住院医师规范化培训模式的探索和完善提供帮助，提高我国眼科规培基地质量，为眼科发展培养更多优秀的后备人才。     

眼科显微手术技能培训模式探讨

目的：探索一种眼科专科医师显微手术技能培训模式,使年轻的眼科医生了解并掌握眼科显微手术的基本特征、基本知识和基本技能, 以适应眼科临床工作的需要。 方法：对尚未熟练掌握眼科显微手术的本院眼科医生、进修医生和实习研究生进行眼科显微手术基础理论和操作技能培训,并建立起严格的培训制度。 结果：培训者46名基本显微手术操作比较准确和熟练,能在带教老师指导下应用手术显微镜完成翼状胬肉切除、白内障囊外摘出+人工晶状体植入术、青光眼小梁切除等手术操作。 结论：利用眼科显微手术培训平台进行显微手术技能培训,并将理论与实践相结合的这种培训模式,能达到掌握眼科显微手术操作的目的。     

将眼科住院医师规范化培训教育落到实处

住院医师规范化培训(简称“住培”)是我国新医改的一项重要举措，旨在通过住培来使我国临床整体医疗水平同质化提高，解决民众日益增长的医疗需求和各地医疗发展不平衡之间的矛盾。我国眼科住培改革经历十余年，在追求同质化的实践中发现一些值得重视的问题，如教学师资的选拔和培训、临床操作类教学的落实、教学师资待遇的提升以及包括人文在内的住院医师诊疗能力全面培养等。本文探讨了这些问题的根源和解决方法，希望通过改革将住培这一临床医学基础工程更好的落到实处。     

中国医师协会眼科医师分会2008年会议在沈阳召开

2008年10月10日至12日中国医师协会眼科医师分会2008年会议在沈阳召开。本次大会除了研讨一些眼病的诊疗指南、操作规范和最新学术进展外，重点对加强关于医师自律维权、医疗质量控制、行医规范和专科医师培训等方面的内容进行了研讨。在开幕式上，中国医师协会常务副会长杨镜强调，中国医师协会的宗旨是“服务、协调、自律、维权、监督、管理”，眼科医师分会应在此基础上建设好眼科医师之家，加强行业自律属于管理，制定行规，树立行风，协助卫生部及中国医师协会做好相应工作，将重身份管理转变为重行为管理。     

Adoption of newer teaching methods to overcome challenges of training in ophthalmology residency during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic has disrupted training programs across all specialties. Surgical specialties, such as ophthalmology, that need continued microsurgical training are affected the most. The pandemic has resulted in ophthalmology residents being taken off their regular duties in ophthalmology and inducted into COVID duties. The focus on COVID care has de-emphasized training in ophthalmology. We highlight the challenges that teachers face in continuing the training programs of theory, clinical skill, and surgical skill transfer. Embracing technology is the need of the hour. We discuss the multiple options available to enable continued training programs and emphasize the need for all training institutes to include technology as an additional component of their training curricula.     

Trabeculectomy versus ExPRESS shunt surgery in residency training

The core curriculum for an ophthalmology residency training program should include surgical procedures relevant to a comprehensive ophthalmologist. Considerations include outcomes (success and complications), technical skill required, applicability to a wide range of disease, and cost. Using these metrics, trabeculectomy should be favored over ExPRESS shunt surgery.     

Motivations and future trends: a survey of Canadian ophthalmology residents

BACKGROUND: There has been little investigation into the attitudes and aspirations of current ophthalmology residents. The object of this study was to investigate the factors influencing career choice and to identify the future plans of Canadian ophthalmology residents. METHODS: All ophthalmology residents in English Canadian ophthalmology residency training programs were invited to complete an anonymous survey in June 2006. Data were categorized by demographic variables and basic statistics; chi2 comparative analyses were performed. RESULTS: Of 128 residents surveyed, 49 (38%) responded to the survey. Having the ability to combine medicine and surgery was the most common factor influencing the decision to pursue ophthalmology (98% of respondents), with intellectual stimulation (76%) and mentorship (50%) also emerging as important factors. The majority of residents (62%) plan on pursuing fellowship training, with medical retina, anterior segment/cataract, and cornea being the most popular choices (36%, 34%, and 32%, respectively). Most residents expressed plans of pursuing fellowships abroad, and only 22% planned on training within Canada. Fourteen percent indicated an interest in performing laser refractive surgery, female residents being significantly less likely than males to express such an interest (0% vs. 21%; p < 0.02). Most residents (71%) expressed the wish to practice in an urban or suburban setting, with only 6% intending to work in a rural community. INTERPRETATION: The appeal of the dual medical and surgical nature of ophthalmology is the most common motivating factor for pursuing an ophthalmology residency. The trends identified, including the high level of interest in subspecialty training and the desire to work in an urban setting, have important implications for the future of ophthalmology in Canada.     

Attrition from ophthalmology residency programs

PURPOSE: To investigate the incidence of and reasons for voluntary resident attrition from ophthalmology training programs. DESIGN: Retrospective survey. METHODS: A survey was mailed to residency program directors of the 121 Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs asking them to report the number of residents who withdrew from training during 2001 to 2002 and the reasons for withdrawal. RESULTS: Of 102 responding programs, 13 (12.7%) had one resident withdraw from training in the academic year 2001 to 2002. These 13 residents represented 1.1% of all ophthalmology residents in training at the responding institutions during that academic year. The most frequent reason for withdrawing was to enter another medical specialty. CONCLUSIONS: Voluntary resident attrition from ophthalmology training programs is uncommon. The 1.1% attrition rate in this study is the lowest among published reports of attrition from other specialties.     

An update on the novel approaches towards skills assessment of ophthalmology residents in the Indian scenario

An essential part of the teaching-learning paradigm is assessment. It is one of the ways to achieve feedback for the various methods that have been used to impart a particular skill. This is true of ophthalmology training, where various clinical and surgical skills are learned as part of the residency program. In preparation for residents to become proficient ophthalmologists, both formative and summative assessments are of paramount importance. At present, assessment is primarily summative in the form of a university examination, including theory and practical examinations that are conducted at the end of the three years of residency. A formative assessment can make course corrections early on, allowing for an improved understanding of the subject and the acquisition of clinical and surgical skills. Formative assessments also allow us to customize the teaching methodology considering individual residents’ learning capabilities. In addition, formative assessments have the advantage of alleviating the stress of a “final” examination, which could sometimes result in a less-than-optimum performance by the residents. The COVID-19 pandemic has forced us to adopt new teaching methods, which has led to the adoption of changes in assessment. In this regard, we discuss the different assessment tools available, their pros and cons, and how best these tools can be made applicable in the setting of an ophthalmology residency program.     

Assessment of ophthalmology residents' contact lens training.

PURPOSE: To characterize the nature and duration of contact lens training in ophthalmology residency training programs and to ascertain the comfort level of residents in fitting various types of contact lenses and in dealing with common contact lens-related complications. METHODS: Surveys were mailed to 126 ophthalmology residency program directors/coordinators and requested to be distributed to 1,381 ophthalmology residents. The questionnaire addressed issues related to contact lens training, hours of clinical and didactic training, comfort with fitting a variety of different types of contact lenses and dealing with common contact lens-related complications, and plans for incorporation of contact lens dispensing into future practice. RESULTS: Two hundred and forty-nine residents (18%) responded from 84 programs (67%). Most programs (87%) have some form of supervised contact lens training, frequently conducted by an optometrist (61% of programs), that consists of 20 hours or less of clinical experience and 20 hours or less of didactic training. A majority of the responding graduating residents (66%) feel comfortable fitting spherical soft contact lenses, while less than half of all residents feel comfortable fitting any other type of contact lens. In addition, most residents (65%) feel comfortable diagnosing and treating common contact lens-related complications. CONCLUSIONS: Most ophthalmology residency programs offer some form of supervised contact lens training which allows a majority of residents to feel comfortable fitting only spherical soft contact lenses, while also dealing comfortably with most contact lens-related problems. A comparison with previous data suggests increasing comfort with fitting most types of contact lenses over the last decade.     

Burnout during ophthalmology residency training: A national survey in Saudi Arabia

PurposeThe aim of this study is to identify burnout prevalence among ophthalmology residents and the predisposing factors associated with higher levels of burnout.MethodsA cross-sectional study was conducted on all ophthalmology residents in Saudi Arabia using Maslach Burnout Inventory in January 2018. Associations between Emotional Exhaustion scores and other continuous variables were evaluated using Spearman’s correlation coefficients. Logistic regression model was constructed, and results were reported as odds ratios with 95% confidence intervals. The significance level was set at p < 0.05.ResultsA total of 117 residents responded to the survey with a 70% response rate. The response rate was above 65% for each training programs by region. 41% of ophthalmology residents scored a positive burnout result on the common subscales (Emotional Exhaustion and/or Depersonalization). Further sub-analysis of data showed positive Spearman’s correlation with number of call days per month and EE subscale (r 0.195). Multivariate logistic regression of the sample yielded significant results with satisfaction with work/life balance and choosing medicine again as a graduate level major p ≤ 0.05. The regression model also showed the Southern program had significantly higher burnout on the common subscales p ≤ 0.05.ConclusionsPrevalence of burnout among ophthalmology residents was lower when compared to plastic surgery and otolaryngology residents in Saudi Arabia. Work hours and on call days were associated with higher burnout. Actions must be taken to ensure that all training programs implement work hour limitations. Special attention should be given to the Southern region program due to its significantly higher levels of burnout.     

贵州省眼科住院医师规范化培训现状调查

目的:通过描述贵州地区眼科住院医师规范化培训概况,以遵义医学院附属医院眼科为例具体分析评价培训内容及效果。方法:统计该地区眼科规陪学员的专业能力、就业情况、存在问题等现状,提出贵州省住院医师规范化培训保障机制的对策及建议。结果:自2006/2011年该地区共计培训学员16名,顺利毕业仅1名。结论:该地区眼科规培学员临床能力大幅提高,但保障政策是学员放弃培训的主要原因。建议医学本科生尽早考研,缩短教育成本。