如何培养合格的国际化外科医师

对照国外外科发展漫长的历史，可了解到我国外科医师培训制度是否已达到与国际接轨的水平。1外科医师培训制度的发展1．1师徒制是自然产生的制度，是通过代代相传把知识技能传承下去。这种制度限制很多，发展慢，知识和技能容易流失。古代医师没有分科，什么病都治。当时医学知识掌握在教会手中，但1123年教皇禁止神父行医，阻碍医学发展。直到14世纪时，医学开始发展为内科和外科。大不列颠帝国是世界上最早成立外科学术团体和外科医师培训制度的国家。当时的内科医师地位崇高，身穿长袍，     

卷首语：不忘初心 牢记使命

莺歌燕舞春添喜,豕去鼠来景换新,《中华危重症医学杂志(电子版)》已迎来全新的一卷。我谨代表编辑部全体工作人员对一直以来支持本刊的各位编委、学者致以最衷心的感谢!对关注本刊的各位作者、读者致以最诚挚的祝福!2019年,我们用汗水浇灌收获,以实干笃定前行。这一年,我们在民族复兴的道路上砥砺前行,喜迎祖国70华诞,彰显了不同凡响的中国风采、中国力量!本刊也在各位编委、作者与读者的共同努力下,继续入选《中国学术期刊影响因子年报》统计源期刊、中国科技核心期刊(中国科技论文统计源期刊)、中国科学引文数据库(CSCD)来源期刊、浙江省评审卫生高级专业技术资格医学卫生刊物名录一级期刊和浙江大学专业技术职务评聘一级期刊.     

如何培养合格的整形外科医师

整形外科医生的培养，不仅仅是医术的提高，也是审美水平、行为素养的提高。本文就如何提高培养整形外科医师水平进行总结与探讨。     

疫情下的思考：发展全科医学，不忘初心、任重道远

<正>2019年12月,新型冠状病毒的疫情在武汉暴发,并逐渐蔓延至全国各个省市,疫情防控成为我国卫生工作的中心。此次新型冠状病毒肺炎(以下简称新冠肺炎)疫情,是新中国成立以来传播速度最快、感染范围最广、防控难度最大的一次突发公共卫生事件~([1])。目前,随着确诊患者和疑似病例的逐渐减少,全国疫情防控已经进入常态化阶段。半年来的防疫过程中,在党中央、国务院集中统一领导下,400万基层医疗卫生机构医务人员临危受命,在最平凡的岗位上,编织了一条牢固的基层防疫战线。而全科医师作为专业技术人员,在其中发     

浅谈如何培养合格的外科学生

每年都有一批年轻的外科学生跨进医院的大门,胸怀悬壶济世的理想,实则对这个职业却只有模糊不清的了解。如何培养合格的外科学生,而不是简单的开刀匠人,便成为我们这些医学教育工作者的当务之急。随着医学科学的迅猛发展,外科医生的培养,准确地说外科     

外科临床研究生教育与专科医师培养

我国的医学研究生教育始于20世纪50年代，医学院本科生毕业后经过考试进入研究生培养阶段，该阶段的教育主要着重于研究能力的培养。直至“文革”前，这种研究生培养体制为我国培养了大批优秀人才，目前的许多资深院士都是这种体制培养的研究生。“文革”期间，这种研究生培养体制遭到严重破坏。文革结束后的80年代初，我国在恢复高考后很快恢复了研究生培养体制。但从80年代起，国外的医学研究进展迅速，出现专业明显细化，医疗技术和水平明显提高，这些变化对医学教育提出了更高的要求。80年代中期，为解决我国医学研究生的临床技能培养问题，出现了以临床技能培养为主要目标的临床研究生，其中包括临床硕士和临床博士研究生。经过近20年的教育实践，临床研究生培养制度的设立为我国培养了一大批具备一定临床基础和能力的医师。但近10多年通过与欧美国家医学教育界的交流，使我国医学教育界感到，国内的医学教育仍有不小的差距，尤其是始于60年代末的美国专科医师培养体制，国内此方面的差距更为明显。该体制着重于专科医师实际能力的培养，联邦政府不但投入大量的资金，也制定了相应的法律支持该体制充分发挥作用，医学院校的毕业生经过5～7年的专科培养，即成为有着丰富经验的主治医师。     

加强实习生学习教育，培养合格人才

21世纪教育目标的一个重要方面为学习教育,即培养学生“爱学”、“会学”、“学会”。“爱学”教育：培养同学爱学的习惯,即培养同学主动汲取新知识的能力,增强社会适应能力。“会学”教育：掌握好的临床学习方法,达到学会的目的。“学会”教育：掌握临床专业理论知识和技能操作。通过学习教育,让同学在临床实习过程中,养成自觉学习的习惯,运用较好的学习方法,掌握护理的基本技能、基本理论和知识,并不断汲取新知识,成为合格的护理人才。     

加强实习医生管理，培养合格医学人才

作为医学院的教学医院，近年来，随着高等医学教育规模不断扩大，我院接受的临床实习医生逐年增多，如何加强对实习医生的管理，培养合格的医学人才，在实践工作中我们总结了以下几方面的体会。     

消除护士焦虑情绪，培养合格护理人才

护理工作是医疗卫生事业的重要组成部分，担负着“保存生命，减轻病痛，促进康复”的崇高职责。当今护理事业已由以往的附属专业正向独立学科发展，护理临床实习是护生将理论知识与临床实践相结合的过程，带好实习护士．培养优秀护理人才是我们临床护理人员义不容辞的责任。     

Revisiting our roots: caring in nursing curriculum design

It is widely accepted that a caring curriculum is integral to nursing education. Caring as a concept is extensively cited in the literature as a core value in nursing education and nursing practice. What is not evident is the curricular designs used by nurse educators to enable students to internalize caring behaviors. The literature supports the internalization of affective learning through hierarchically structured learning objectives, and the movement from emotional to reflexive responses through critical reflection. Krathwohl, Bloom, and Masia’s (1964) taxonomy of affective objectives and concepts from Mezirow’s (2000) transformational learning theory were used to synthesize the integration of caring affective objectives into the design of the nursing curricula. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students’ caring behaviors that are consistent with the ideals of the profession. Examples of hierarchically leveled caring objectives are provided.     

Evidence-based mental health nursing in Australia: our history and our future

This paper will develop a discussion related to evidence-based knowledge for mental health nursing, arguing for a historical component to be included in the comprehensive degree programme that will offer significant insights into mental health nursing knowledge from historical information and constructing implications for contemporary practice. Our understanding of the present is clearer by this looking back and forth and by adding meaning (and what the meanings mean) to what historically preceded. It allows the history of psychiatry to be a much more productive, useful, and a continual source of wisdom for the here and now. This blending of past knowledge with contemporary inquiry can offer depth in mental health nursing practices by forming a context for practice for the beginning nurse practitioner.     

不忘初心送瘟神—中国共产党领导下的血吸虫病防治历程

血吸虫病严重危害我国人民生命健康,阻碍社会经济发展。 中国共产党带领全社会,动员群众,积极开展血吸虫病防治。 经过70余年的艰苦努力,有效控制了血吸虫病流行,基本消除了血吸虫病危害。 中国共产党将继续引领血吸虫病防治工作,以中国血防经验助力人类卫生健康共同体。     

Revisiting the impact of job satisfaction and organizational commitment on nurse turnover intention: an individual differences analysis

Background

Nurse turnover is an important contributing factor to the worldwide nursing shortage. Many studies have examined the antecedents of nurse turnover to gain a better understanding of the problem and help hospitals reduce their turnover rates. However, an important shortcoming of this research stream is its exclusive focus on explaining turnover behavior of the “average nurse”, thereby disregarding individual differences between nurses and groups of nurses.

Objectives

To examine individual differences in the relationships between two crucial turnover antecedents – job satisfaction and organizational commitment – and nurse turnover intention.

Participants

A sample of 287 nurses working for a variety of Belgian hospitals participated in the study.

Methods

A survey method was used to collect quantitative data, which were analyzed through standard multiple linear regression, mixture regression models and t-tests.

Results

In the total sample of hospital nurses, both job satisfaction and organizational commitment significantly predicted nurse turnover intention. However, subsequent individual differences analyses revealed the existence of two subgroups of nurses. In the satisfaction focused group, only job satisfaction was found to predict nurse turnover intention, whereas in the satisfaction and commitment focused group both job satisfaction and organizational commitment were related to turnover intention. Furthermore, nurses in the latter group displayed stronger turnover intention, were significantly younger and had less job tenure and organizational tenure than nurses in the satisfaction focused group.

Conclusions

The debate on the antecedents of nurse turnover still continues, as the existing models fail to fully grasp nurse turnover. The present study identifies individual differences in nurse turnover antecedents among groups of nurses as a possible reason for the absence of one comprehensive turnover model that holds for the general nursing population. Further studies are needed in order to capture the total impact of the underlying individual differences in nurse turnover antecedents.