军队基层卫生技术干部继续医学教育的问题与对策

本文从适应未来高技术条件下局部战争卫勤保障,现代医学科学突飞猛进发展以及现代医疗体制、医疗模式转变三方面入手,讨论了继续医学教育在基层部队卫生工作中所具有的重要作用。并针对实际情况,对在基层部队继续医学教育工作中存在的问题进行了剖析。进而提出并阐述了加强军队基层继续医学教育的实施策略——转变观念．深化做好基层继续医学教育工作的意识;进一步加强毕业后临床规范化培训;引进全科医学概念,结合军队基层卫生工作特点,制订军队基层继续医学教育培训大纲;调整基层卫生人才培训的经费投入;拓宽基层继续医学教育的途径;建立军队基层继续医学教育工作评估体系。从而使继续医学教育能更好地为基层部队卫生工作建设服务。     

四川省农村卫生人员继续医学教育需求调查

目的 了解四川省农村卫生人员继续医学教育的需求,为制定适合农村的继续医学教育学习方案提供依据.方法 采用文献调研、专家咨询、问卷调查和小组访谈等方法 ,对四川省射洪县和仪陇县的12个乡镇卫生院163名卫技人员和224个村卫生站的240名乡村医生进行调查.结果 被调查对象的学历、职称、收入均偏低;认为最适合的继续医学教育活动方式分别为单位组织自学、临床病例讨论和参加学术会议;最喜欢的继续医学教育内容是学习新技术、新知识和新进展、新业务、基础医学理论和人际沟通;最需要的继续医学教育保障条件是解决学习培训经费;85.7%的乡卫技人员和96.1%的乡村医生都认为建立继续医学教育效果的定期评价制度可行.结论 四川省农村卫生人员素质偏低,应加强继续医学教育工作;农村继续医学教育要注重学习方式的可及性和学习内容的实用性;应加大国家对农村继续医学教育的投入;尽快建立科学的继续医学教育考评制度和指标体系.     

继续医学教育学分制的实践与思考

本文叙述了该院实施继续医学教育学分制的做法以及开展多种形式的继续医学教育活动,并认为做好继续医学教育工作要做到:1.纳入领导干部任期目标管理;2.真正体现“四新”,做到“三结合”、“三统一”;3.充分发挥学术团体的作用;4.倡导以业余学习和自学为主;5.给予必要的经费支持,更新教学设备和手段;6.完善组织实施、考核、任用等运行机制。     

继续医学教育是提高卫技人员能力素质的重要途径和手段

去年卫生部对我国2002～2004年继续医学教育工作进行了检查，认为．我国继续医学教育体系较为完善，具有中国标志的继续医学教育制度也基本建立。但同时还要看到：继续医学教育工作发展不平衡．继续医学教育资源不足和利用效率不高．其形式和内容还不能完全适应卫生技术人员的需求。回顾3年来我们疾病预防控制中心，在国家卫生部，省卫生厅和市卫生局的领导下。中心按照年初制定的目标，有计划、有步骤推行继续医学教育工作，使各项工作落到实处。通过检查我们深深体会到。继续医学教育是提高卫技人员能力素质的重要途径和手段。只有卫技人员能力得到进一步的提高．才能更好的服务于卫生防病事业。2003年的“非典”．2004年的禽流感．疾控人用所学的重大传染病防治知识，打胜了这场没有硝烟的战斗。充分证明疾控人对重大传染病具有极其强大的应急能力。如何面对今后可能出现的传染病．我们必须不断的学习，提高业务素质，只有这样才能拉的出打的响。下面就将2002～2004年继续医学教育工作进行一下简单的总结。     

美国继续医学教育的认证制度

对美国继续医学教育的认证组织、继续医学教育认证的主要政策依据、对继续医学教育举办单位和州医学会的认证程序以及认证管理做了简要介绍,为我国继续医学教育的认证工作提供了借鉴.     

加快推进继续医学教育工作 为卫生事业发展奠定基础

探讨继续医学教育工作。结合我国继续医学教育工作的实际，应在以下方面加快推进继续医学教育工作：进一步提高认识，切实加强对继续医学教育工作的领导；进一步完善继续医学教育相关制度，加强和规范继续医学教育的监督管理；加大对农村和基层继续医学教育工作的支持力度；突出重点，加快推进医学继续教育工作：加强继续医学教育管理干部队伍建设。     

南京地区医务人员继续医学教育情况调查分析

对南京地区省市、区县、社区20家医疗单位发放问卷1800份。结果南京地区医务人员认为继续医学教育是有必要的,但对目前继续医学教育情况满意率不高。工作忙、经费缺乏是影响参加继续医学教育的主要因素。     

预防医学会在继续医学教育工作中发挥的作用

继续医学教育是集科技、教育、人才培养于一体的事业。随着大连市医学信息“高速公路”的建立和大连市国际远程医疗系统的开通，继续深入开展继续医学教育，对提高整体卫生医疗水平和服务质量，跟踪国际、国内医学科学技术发展前沿具有重要意义。预防医学会在继续医学教育工作中，应当发挥什么作用？鉴于以往继续医学教育工作的成效和经验，笔认为学会应从以下四个方面发挥应有的作用。     

规范管理推动继续医学教育健康发展

分析了知识经济时代继续医学教育面临的挑战,阐述了继续医学教育存在的一些问题,指出了推动继续医学教育健康发展,必须加强对继续医学教育工作的规划、组织和管理,注重向农村基层倾斜,将现代远程教育手段运用于继续医学教育工作中。     

某三甲专科医院继续医学教育现状与需求分析

目的 调查医院继续医学教育现状及需求,提出合理的建议,为做好继续医学教育工作提供依据.方法 采用自行设计的调查问卷对某三甲专科医院的医务人员进行调查.结果 医务人员参加继续医学教育的主要形式为科室业务学习(89.04％),影响其对继续医学教育满意度的主要因素是时间安排不合理.同时,医务人员对继续医学教育的需求程度较高(...     

The uncertain future of continuing medical education: commercialism and shifts in funding

To preserve a professionally responsible system for continuing medical education (CME), medicine must recognize and address two powerful economic forces: commercial interests and societal resource limitations. Commercial support to accredited CME providers is now more than 50% of total CME income. The cumulative influence is increasingly biasing CME development, presentation, and participation toward topics that benefit commercial interests. Options to address this cumulative bias are proposed. Limitations on societal resources for health care have reduced funding from medical schools and hospitals for the infrastructure of CME. Financial pressures are likely to increase, potentially leading to controls on drug costs and significant reductions in commercial support of CME. Financial pressures on physicians' incomes may limit the extent to which registration fees could offset these reductions. Physicians and their professional organizations should recognize these threats to the objectivity, funding, and infrastructure of the CME system and they should work to ensure a viable CME system in the future.     

Congress 2000: a continuing medical education summit with implications for the future

The expectations of attendees, the evaluations of themes, and the implications for continuing medical education (CME) identified by "Congress 2000: A Continuing Medical Education Summit on the Practices, Opportunities and Priorities for the New Millennium" are reviewed. A vision was identified with significant opportunities for CME to become a more valuable partner in and contributor to quality health care. The vision suggests that CME should be linked more closely to physician learning at the point of care and that technology might be used more successfully to address physician-learner needs by helping them to manage volumes of evidence for treating patients more effectively. At the same time, health care outcome data to analyze the need for and measure the effectiveness of educational interventions should become integrated into standards of practice for CME providers. Continuous improvement based on research about effective learning processes and outcomes should become an essential construct of the CME culture. Implications are summarized for the profession, organizational CME providers, individual CME professionals, and CME research from this new vision of CME crafted at Congress 2000.     

淮安市卫生技术人员继续医学教育认知情况调查

目的调查淮安市卫生技术人员对医疗卫生机构继续医学教育情况的了解程度以及对继续医学教育的认知情况。方法采用分层和单纯随机抽样相结合的方法,对淮安市乡镇及以上卫生机构在职卫技人员开展继续医学教育自填式问卷调查。结果卫技人员所在单位继续医学教育管理情况中除了网络医学教育的实施情况较差外（24.0%）,其余情况尚可;教育经费的支付方式以单位部分支付为主,占46.4%;单位负责继续医学教育学分管理的机构主要是医务/科教科,占59.9%。卫技人员继续医学教育认知程度得分平均为63.75分,认知情况受性别、学历、现从事专业、技术职称、所在单位级别的影响。结论全市医疗卫生机构继续医学教育管理情况在总体上还存在很多缺陷,卫技人员对继续医学教育的重要性认识不够,各级卫生机构应继续加强继续医学教育的宣传力度,为卫技人员提供各种培训方式和机会,提高全市卫技人员整体医技水平。     

Marketing issues in continuing medical education.

Marketing is an important component of continuing medical education (CME). However, marketing is more than the identification of methods to recover costs of delivering programming. It focuses on meeting the needs and desires of physician participants, identifying an appropriate location, satisfying the goals of a sponsoring institution, and making an effect on the quality of care given by receivers and deliverers of CME. This paper discusses these issues as well as describes results of a survey designed to gather opinions on CME activities from alumni of training programs of a large, referral-based, multispecialty group practice. The data suggest that CME programs should be targeted to certain specialty groups as determined by field of training rather than practice specialty. Physicians' preferences for CME activities held at resort settings should be considered. Finally, participation in CME may itself be a marketing tool for a sponsoring institution to increase referrals.     

Continuing medical education, professional development, and requirements for medical licensure: a white paper of the Conjoint Committee on Continuing Medical Education

To provide the best care to patients, a physician must commit to lifelong learning, but continuing education and evaluation systems in the United States typically require little more than records of attendance for professional association memberships, hospital staff privileges, or reregistration of a medical license. While 61 of 68 medical and osteopathic licensing boards mandate that physicians participate in certain numbers of hours of continuing medical education (CME), 17 of them require physicians to participate in legislatively mandated topics that may have little to do with the types of patients seen by the applicant physician.Required CME should evolve from counting hours of CME participation to recognizing physician achievement in knowledge, competence, and performance. State medical boards should require valid and reliable assessment of physicians' learning needs and collaborate with physician and CME communities to assure that legislatively mandated CME achieves maximal benefit for physicians and patients. To assure the discovery and use of best practices for continuing professional development and for maintenance of competence, research in CME and physician assessment should be raised as a national priority.     

Continuing medical education in the United States: why it needs reform and how we propose to accomplish it

As the continuing medical education (CME) enterprise evolved over the last half century, a variety of rules, national and state regulations, and reporting requirements developed, with a resultant substantial variation in what is required of a physician. That CME needs fundamental reform is not news to those who read the literature. Yet many of the physicians who are served by the current CME system are comfortable with it. Following an initial report of the Council of Medical Specialty Societies, representatives of major stakeholders in CME met voluntarily over 3 years to explore, agree on, and finally propose changes to the present CME system. Their belief in the need for change and their recommendations achieved a collegial outcome; fundamental systemwide changes must occur in CME. This involves educational methods and physician performance, particularly in self-assessment. It also involves the leadership of organized medicine in accreditation, certification, credentialing, licensure, and credit recording, reporting, and funding. The multiple parties involved who control various aspects of CME agreed to focus on the physician end user and to create a revised CME system that would allow simplified and identical reporting of the CME experience and credits for individual physicians. The system also would offer a simplified and more rational approach to credit. Recommendations and action plans to accomplish the objectives were agreed on and have been assigned to organizations according to commitment and relevant historical interest.     

Continuing medical education in a district general hospital: a snapshot

BACKGROUND: "Consultants' continuing medical education (CME) activity is variable." Is this true? What part do prompts and constraints play? OBJECTIVE: To identify the CME activity of 80 district general hospital consultants from 27 specialties and all nine Royal Colleges. What do they do and why? What constrains them? What are their views on CME as a basis for revalidation?METHOD: A cross-sectional survey using a structured questionnaire derived from a content validity exercise, a pilot study and structured interviews. RESULTS: Of the 74 consultants who replied (92.5%) most claim to be spending sufficient time (defined by their College) undertaking a variety of internal and external CME. They do so through methods such as reading, discussion with colleagues, and teaching, which are not universally recognized by their Colleges. The majority declared most CME activity to be in their subspecialty rather than in their wider clinical or non-clinical roles. Least popular was non-clinical professional development. The majority knew how much CME they should be undertaking and all but one claimed to be doing so. Prompts were personal rather than organizational or external, while constraints centred on finding time. CME activity as a basis for re-certification was accepted and rejected by almost equal numbers. CONCLUSIONS: CME is being undertaken on the basis of personal choice. The focus is on subspecialty topics without considering needs. The guidance from the Colleges exerts little influence as a prompt. The methods chosen are personal choices and ignore what the Colleges recognize as valid CME.     

Maximizing the use of a Web-based teaching skills curriculum for community-based volunteer faculty

BACKGROUND: The University of Kansas School of Medicine in Wichita created an Internet-based faculty development curriculum for community-based faculty. Because relatively few physicians use Internet-based continuing medical education (CME), the most cost-effective methods of encouraging use need to be identified. METHOD: Five interventions intended to increase use of the curriculum were assessed. The number of times the CME curriculum Webpages were accessed was correlated with the interventions. RESULTS: Demonstrating the Website to faculty at a semiannual meeting elicited the most Website "hits." Electronic mail and flyers also appeared to be effective in stimulating interest in the Website. Only four community-based faculty applied for CME credit for completing the curricular modules. FINDINGS: Multiple modalities should be used in advertising and stimulating interest in an Internet-based faculty development curriculum. Demonstrating the Website to faculty at a meeting appeared to achieve the greatest return. Offering CME credit was not helpful in stimulating interest.     

中外医学期刊继续医学教育模式调查分析

【目的】 探索医学期刊开展继续医学教育(Continuing Medical Education, CME)的模式,以提升医学期刊服务行业发展的能力。【方法】 通过期刊网站调查分析国外3种(Annals of Internal Medicine、JAMA、BMJ)和国内9种医学期刊(包括《中华医学杂志》《中华外科杂志》《中华儿科杂志》等)的CME模式,调查内容包括CME课程素材、主题、内容、结构及形式等。【结果】 3种国外期刊均在网站上创建了完善的CME平台/版块,包括多种主题和形式的CME课程,课程素材不仅局限于期刊文章;课程主题多样,包括医学专业知识和技能、医学伦理规范和医患沟通技巧等;均采用图文、音频和视频等多种媒体形式;测试内容兼顾实践能力评估,学分申领过程简便。相比之下,国内医学期刊网站缺乏完善的CME平台/版块,课程主题相对局限;素材仅来自期刊少数栏目的文章;形式相对单一,以纯文本为主;测试内容仅重视专业知识,且学分申领过程相对繁琐。【结论】 国内医学期刊应从课程素材、内容、形式及测试环节等方面改进以提高CME质量,从而推动医学知识向临床实践转化。