南京鼓楼医院基于能力进阶和里程碑的住院医师规范化培训的实践探索

基于能力的医学教育在美国等发达国家被广泛运用于住院医师规范化培训.南京鼓楼医院成立Johns Hop-kins—鼓楼医院住院医师合作项目后,逐步实践基于能力进阶和里程碑的住院医师规范化培训,围绕岗位胜任力,力争培养高质量的具人文素养和独立临床实践能力的住院医师.     

基于岗位胜任力的住院医师规范化培训分年度递进式培养的探索与实践

培育岗位胜任力是住院医师规范化培训的核心任务。南京医科大学第一附属医院针对培训内容缺乏递进性、住培管理部门参与相对不足、医学人文教育相对缺乏、急救知识与技能相对薄弱等问题,结合岗位胜任力的要求,设计了住培管理部门可统一实施的分年度递进式培养方案,主要是第一年度的基础操作技能训练和急救技能培训,第二年度的医疗文书规范书写与专科操作技能培训,第三年度的临床诊疗能力培训和生命支持培训,是对临床轮转实践的有效补充。     

住院医师规范化培训应注重综合能力培养

住院医师规范化培训是医学教育的重要环节之一,直接关系到医院专业人才的培养.未来医学人才不仅要有扎实的专业知识,还应具有高尚的职业道德,丰富的人文和社会科学知识,良好的社会交往能力,精湛的临床技能和超强的创新思维.因此,不仅要注重临床技能的培养,还应从多方面加强对住院医师综合能力的培养.     

基于职业胜任力的临床医学研究生培养及相关问题分析

临床医学研究生教育是我国培养合格医师的重要途径,随着住院医师规范化培训的深入,目前正步入以胜任力培养为核心的阶段.本文从提升临床医学研究生职业胜任力的角度,系统分析研究生临床培训过程中存在的非规范培训、师资准入制度缺失、对医学人文教育认识不够和课程体系较为陈旧等问题及其原因,探讨并提出解决问题的对策.     

住院医师规范化培训人文素养教育的必要性

住院医师的规范化培训是医学生毕业后医学教育的重要组成部分,在当前的形式下,医务人员的压力大,思想政治工作的有效开展对于提高住院医师人文素养和医患沟通能力,增强其岗位胜任力有着重要意义,能够促使医疗质量的不断提高,更好地为人民的健康服务。     

主院医师规范化培训应注重综合能力培养

住院医师规范化培训是医学教育的重要环节之一．直接关系到医院专业人才的培养。未来医学人才不仅要有扎实的专业知识,还应具有高尚的职业道德．丰富的人文和社会科学知识,良好的社会交往能力,精湛的临床技能和超强的创新思维。因此,不仅要注重临床技能的培养,还应从多方面加强对住院医师综合能力的培养。     

住院医师人文医学执业技能核心课程培训需求分析

目的 分析上海某大学附属三级医院在住院医师规范化培训阶段的住院医师对人文医学核心课程培训的需求,为后续规划与开展有效的人文医学执业技能培训提供参考.方法 自行设计调查问卷进行调查,问卷内容主要为一般情况,核心课程设置情况以及培训考核方式等内容,对调查结果进行统计分析.结果 人文医学执业技能培训得到了住院医师较高程度的认可与重视,初步确立了培训核心课程等要素,并对人文医学培训的实施、考核、反馈等方面提出了一些意见与建议.结论 人文医学核心课程的培训应尽快纳入住院医师规范化培训体系中,开展人文医学核心课程培训有利于提升住院医师人文医学素养,有利于完善和提高住院医师规范化培训内涵.     

对12所医院住院医师规范化培训质量调查

从医学终身教育体系看,住院医师培训属于毕业后医学教育范畴,是医学教育连续统一体的重要组成部分。医学生完成学校基本医学教育毕业后接受某一学科系统化、规范化的专业培训,使其掌握从事该专科医疗活动所具有的诊疗知识和技能,对培养高层次专门化人才起着承上启下的作用。这一制度自德国于19世纪末实行以来,经各国实践证明,它是适应医学科学技术迅速发展的新形势和培养高层次医学人才的重要途径[1]。卫生部于1993年在总结部分部属院校住院医师培训试点工作经验的基础上,相继颁布了住院医师培训试行办法和培训大纲,使我国住院医师培训工作…     

情景模拟教学在临床技能培训中的作用

情景模拟是对真实人类决策行为情景的模拟和仿真,十分适合临床技能培训课程的教学,而提高住院医师规范化培训阶段临床医生的岗位胜任力,是目前毕业后医学教育培训探索的重点。文章以急诊腹痛的处理模拟实践课程为契机,选定3个情景模拟环境,然后进行情景模拟和角色扮演,模拟接诊、病情分析诊断、模拟腹腔镜手术场景,达到了预期的教学目的,初步探索了医学情景模拟教育在培训中起到的积极作用。     

神经内科住院医师规范化培训的探索

临床医学是实践性、技能性很强的学科,临床医师的成长不仅要有广博的知识,而且要有扎实熟练的临床技能。住院医师规范化培训是培养医药卫生人才的重要措施,也是完善毕业后继续医学教育的重要组成部分[1]。住院医师培训制度是指住院医师在上级医师的指导下进行临床实践,通过规范化的要求和严格的考核,从而学习到某一医学专科中的合格医师所需要的知识、技能和态度[2-4]。     

医学人文实践能力培养路径探索

医学人文实践能力是在实践中应用人文知识的能力及人文素养的展现,是医学生临床实践能力极为重要的组成部分.加强医学生人文实践能力,提高医学生整体素养是当前医学教育面临的重要任务.在分析医学人文实践能力的内涵和现状的基础上,探讨加强医学人文实践能力的有效途径:明确医学人文素养的培养目标,构建合理的医学人文课程体系,多途径、全...     

Evidence of improved knowledge and skills after an elective rotation in a hospice and palliative care program for internal medicine residents

There is compelling evidence that residents training in primary care need education in palliative care. Evidence for effective curricula is needed. The objective of this study was to test whether a clinical elective improves measures of knowledge and skill. Residents from three categorical training programs in internal medicine were recruited to an elective including clinical experiences in an acute hospital palliative care consultation service, on an acute hospice and palliative care unit, and in-home hospice care. A 25-question pre- and post-test and a videotaped interview with a standardized patient were used to assess communication skills and measure outcomes. Residents demonstrated a 10 percent improvement in knowledge after the four-week elective (p < 0.05). All residents demonstrated basic competency in communication skills at the end of the rotation. These results indicate that clinical rotation shows promise as an educational intervention to improve palliative care knowledge and skills in primary care residents. An important limitation of the study is that it is an elective; further studies with a required rotation and/or a control group are needed to confirm the findings.     

医学研究生的人文素质教育探析

医学研究生是高级专业人才,在当今社会,其人文素质的重要性不亚于专业素质。本文着重分析了医学研究生人文素质教育的必要性、存在的问题和加强医学研究生人文素质教育的途径,以便我国医药院校更好地培养医学研究生的人文素质,提高其综合素质,以适应社会的发展。     

Teaching evidence-based medicine more effectively

Evidence-based Medicine (EBM) is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT) were 170 members of the medical faculty who were divided into two groups of 86 (intervention) and 84 (control). Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI) was defined and computed. Results: The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84). Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conclusions: Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.     

新入职医护人才培养管理策略

以OGSM为模型制定新入职医护人才培养管理策略。以培养高素质的医疗界精英为目的,以具备一定知识水平、临床技能及人文素质为目标,以巩固知识、提高临床及培养人文精神为策略,以知识考核、技能考核及文人素质考核为测量,全方位对新入职医护人员的培养进行规划,以期待新入职医护人才尽早投入到临床工作中,造福患者及社会。     

Professional competencies in health sciences education: from multiple intelligences to the clinic floor

Nontechnical competencies identified as essential to the health professional’s success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding “professional success” is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and “bedside” or “cageside” manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.     

我国医生执业能力自评情况及影响因素分析

目的:了解我国医生执业能力现状并对其影响因素进行分析,为有效提高我国医生的执业水平提供循证依据。方法:参考国际成熟评价框架制定我国医生执业能力评价量表。2018年6—12月,采用分层抽样方法,依托医联体平台,随机选取全国13个省(自治区、直辖市)的39家医院,共2 156名医生参与调查。对其执业能力6个维度(医学知识、...     

A study on the goals and achievements of postgraduate medical education

In order to evaluate postgraduate medical education (PGME) in Japan, residents and supervisors of all the postgraduate teaching hospitals (128 university hospitals and 216 non-university hospitals designated by the Ministry of Health and Welfare) were surveyed. The purposes of this study were, 1) to compare the goals of PGME set by residents and the achievements of PGME by residents in university hospitals and non-university hospitals, 2) to compare the goals of PGME between residents and supervisors, 3) to identify how clinical skills and knowledge related to the behavioral sciences and social medicine are stressed on PGME. Residents and supervisors received a newly developed questionnaire consisting of 41 items concerning clinical skills and knowledge. The items were divided into four categories: 17 basic areas, 9 allied areas, 12 areas related to the behavioral sciences and social medicine, and 3 areas related to clinical research. The response rate was 52.3% for university hospitals and 75.5% for non-university hospitals. The results are 1) residents in non-university hospitals scored at higher levels than residents in university hospitals for 14 items concerning goals and 11 items of achievements, mainly basic clinical skills and knowledge, 2) there was an incongruence between residents and supervisors for 23 items concerning goals, 3) clinical skills and knowledge related to the behavioral sciences and social medicine were not as highly stressed as other areas of clinical skills and knowledge. This study suggests that more effort is needed to create or improve the system of PGME, especially in university hospitals.     

北京市朝阳区城乡居民应对突发公共卫生事件知识与技能影响因素分析

目的 了解北京市朝阳区居民应对突发公共卫生事件知识与技能的影响因素,为制定有效的干预策略提供依据.方法 采用多阶段系统抽样的方法,选取北京市朝阳区城乡居民2000人进行问卷调查,对突发公共卫生事件应对知识与技能的影响因素进行多元线性回归分析.结果 82.7％的调查对象经历过突发公共卫生事件,朝阳区居民在伤寒、放射性事故方面知识与技能的知晓率相对较低,分别为19.9％和22.8％.多元线性回归分析显示,城市居民应对突发公共卫生事件知识与技能得分高于农村;越年轻者,应对突发公共卫生事件知识与技能得分越少;文化程度越低,应对突发公共卫生事件知识与技能得分越少.结论 北京市朝阳区居民应对突发公共卫生事件知识与技能水平有待提高,应加强对伤寒、放射性事故等方面的健康教育,并采取有效的措施开展农村地区、年轻人、低文化程度居民的防灾减灾宣传教育工作.