临床实习阶段高职护生的心理卫生现状分析及对策

目的 了解临床实习高职护生的心理卫生现状及其影响因素,为制定有针对性地防治对策提供依据。方法 采取分层整群抽样的方法随机抽取临床实习的高职护生,用症状自评量表（SCL-90）和自制调查问卷进行调查。资料用SPSS10．0统计分析。结果 高职实习护生SCL-90因子得分高于常模;16．92％的护生有轻度的心理问题．2．31％的护生有中度以上的心理问题。实习中带教老师的教育方式、人际关系以及本人的实习态度对其心理卫生状况有一定影响。结论 临床实习高职护生存在一定的心理卫生问题,实习管理工作者应尽快采取有针对性地预防对策。     

临床实习压力对医学生心理健康影响的调查

目的:调查临床实习压力对医学生心理健康的影响,为开展实习期医学生心理健康工作提供相关依据和支持。方法:采用Beck-Srivastava压力量表(BSSI)对586名处于临床实习期间医学生面临的压力源及压力强度情况进行初步检测,进一步结合症状自评量表(SCL-90)及状态-特质焦虑问卷(STAI)对其心理健康状况进行综合调查。结果:(1)临床实习期间,医学生的压力主要集中在学习压力、经济压力、临床实践和人际关系4个方面,其检出率普遍超过60%,且BSSI单因子得分均在3分以上。男生在学习压力及经济压力2个因子得分高于女生,在临床实践及人际关系2个因子得分低于女生,但差异均无统计学意义(P0.05);(2)临床实习期间医学生在SCL-90的9个因子得分均超过国内常模,且在人际关系、抑郁、焦虑及恐怖4个因子得分差异有统计学意义(t=8.5011,5.0781,27.5146,3.4907;P0.05)。男生在SCL-90的敌对性、偏执及精神病性3个因子得分高于女生,但差异均无统计学意义(P0.05);女生在SCL-90的躯体化、强迫、人际关系、抑郁、焦虑和恐怖6个因子得分高于男生,且在抑郁和焦虑2个因子得分差异有统计学意义(t=-4.2678,-3.7579;P0.05);(3)临床实习期间医学生在STAI的状态焦虑(S-AI)的得分高于标准常模,且差异有统计学意义(t=8.3293,P0.05),在STAI的特质焦虑(T-AI)的得分低于标准常模,但差异无统计学意义(P0.05);女生在S-AI及T-AI得分均高于男生,但差异均无统计学意义(t=-0.5390,-1.4026;P0.05)。结论:临床实习会对医学生造成较大的压力,进而导致一定的心理健康问题,尤其是会诱发较为严重的焦虑情绪。     

影响外科临床实习效果的因素分析与对策探讨

外科临床实习是外科实习的重要组成部分,是从学生向临床医生转型的关键时期。目前由于自身原因、社会环境、教学方式等原因影响着临床实习效果。本文分析目前外科临床实习中存在的问题,提出针对性的解决对策,促进临床外科实习教学质量的提升。     

医学留学生临床带教和实习的调查思考

目的调查医学留学生在华临床见习与临床实习现状,了解留学生临床实习的问题与障碍,探讨相应的解决方法与教学改革途径。方法采用问卷调查方式,调查了2届在我院临床见习及临床实习的留学生,同时调查了同期实习的同等学历中国医学生及临床带教医生。结果留学生对临床见习满意度90.8%,对临床实习满意度降至33.4%。留学生在实习期的积极性及纪律性明显低于见习期。在临床实习期,75.9%的留学与同行医生有交流障碍,90.7%的留学与病患存在交流障碍。获得临床实践机会情况,同期实习中国医学生明显高于留学生(管理床位数:7.6±2.5vs.0.8±0.34;书写病历数/周:18±3.6vs.0.76±0.54,P<0.05)。结论医学留学生对临床实习满意度下降的原因为失去专职教师翻译帮助。在临床实习期,最大的障碍为语言沟通困难。推进早期英汉双语教学,建立中外学生实习互助组,为可行的教学改进途径。     

90后高职护生实习现状调查及分析

目的 调查90后高职护生临床实习表现,分析存在问题,提高职临床护理教育质量。方法 2018年1月采用我院自设的《优秀实习生评选表》,调查2017~2018年度81名在我院实习的90后高职护生临床实习表现,分析不足。结果 90后护生临床实习表现总体得分（94.32±3.03）分,软技能和学习情况等条目得分稍低;男生学习情况得分高于女生,男生各项活动参与情况得分低于女生,差异均有统计学意义（P＜0.05）;3+2高职护生劳动纪律得分,学习情况得分低于非3+2高职护生,差异有统计学意义（P＜0.05）;郊区高职实习生的护士素质、工作态度、劳动纪律、学习情况,各项活动参与情况得分均低于城区高职实习生和自联大专实习生得分,差异有统计学意义（P＜0.05）。结论 90后高职护生实习表现总体良好,但软技能和理论操作技能有待提高,各层面上应注重护生软技能的培养,塑造护生良好的个性品质。不同护生特质不一,院校护理教育者应通力合作,及时沟通,积极更新教学理念,革新教育方法,针对护生不同特质采取针对教育,提高90后高职护生整体素质。     

临床麻醉学实习教学特点

临床实习主要目的是让学生全面参加专业临床实践。学会理论知识和实践技能的有机结合,从而实现能力的质的提高,为毕业后独立从事专业工作打下基础,麻醉学理论知识涉及     

护生面对临床实习的心理分析及对策

经过二年的基础理论学习，除短暂的见习外，护生对医院及临床护理工作了解甚少，而临床实习是护生从学校进入临床，迈向社会的第一步，他们常会感到困惑，希望得到更多的帮助和指导。结合临床护理带教及临床实习前的教学工作，笔者认为可针对性地开展临床实习教育，使护生能尽快适应临床护理工作，顺利完成实习任务。     

医学生在外科实习中存在的问题及对策

外科学是一门实践性很强的学科，学生除了要掌握基本知识与基本理论外，还要掌握较多的基本技能，是外科教学的一个重要环节。随着医疗体制改革步伐的不断加快，作为医学教育关键环节的临床实习教学也进行了深入的改革，但实习效果仍令人担忧。本文就医学生在外科实习中存在的问题进行了认真分析，并总结出一些经验。     

临床医学生视角下的医学人文素养现状调查

目的了解临床医学生对医疗实践中医学人文素养现状的认知并提出改进建议。方法对已参与临床实践的临床医学本科生、研究生和博士生采用问卷调查的方法收集信息(共回收184份问卷)。结果 1)医患沟通以及医际沟通过程中医务人员存在人文素养不足;2)目前医学院校对临床医学生人文教育投入不足;3)大多数医学生愿意并且希望通过多途径进一步提高自身人文素质。结论医学生对临床医学人文素养的诸多问题有相当清楚的认识,增设人文相关课程、定期举办讲座、提高薪资待遇、增大考核力度具有必要性和可行性。     

临床医学八年制本科生多阶段心理状况调查及分析

目的通过调查不同学年八年制医学本科生的心理健康状况,分析其影响因素,以便提出改善学生心理健康的对策,提高学生的心理健康水平。方法采用问卷方法对我校五至七年级本科医学生进行心理健康现况调查,并按照不同年级分组,分析组间差异。应用卡方检验、Fisher精确检验的统计学方法进行数据分析。结果问卷回收率96.5%,合格问卷164份。14例学生(8.5%)有抑郁情绪,28例(17%)有焦虑问题。57例(34.76%)需要心理自评问卷的协助,110例(67.07%)需要抑郁及焦虑情绪疏导的帮助。六年级医学生对抑郁/焦虑情绪疏导的需求比例与五年级(82%vs 50%;P<0.05)、七年级(82%vs 57%;P<0.05)学生相比显著增高。86.67%的七年级学生曾进行心理问卷自评,高于五年级组(64.29%,P<0.05),较六年级组无显著差异。结论不同学习阶段的八年制医学生的心理健康状态存在差异,不同程度存在情绪调试障碍。需要多方面采用有效措施进行心理学支持及干预。     

Perception of medical students towards the clinical relevance of anatomy

Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.     

Interpretation of acupoint location in traditional Chinese medicine teaching: Implications for acupuncture in research and clinical practice

Acupuncture is a therapeutic intervention of traditional Chinese medicine, characterized by the insertion of a fine metal needle through the human body's skin at an acupuncture point (acupoint). Acupuncture has become from cultural curiosity to fast-growing complementary and alternative medicine therapy worldwide, including in the United States. The ability to locate acupoints on the body surface precisely is critical for the acupuncture treatment. However, the location of acupoints varies frequently among practitioners. Therefore, in the present study, the author will address the application of acupoint in traditional Chinese medicine (including the anatomical location of acupoint) to draw attention to the issues about the acupoint location in acupuncture research and clinical practice. Moreover, further studies are needed to determine whether acupoint location with specificity could be validated by employing reliable tools. In the future, the incongruity among acupuncturists regarding acupoint location should be resolved, and the acupoint location methods with more accuracy should be developed.     

临床医疗和临床科研中的知情同意问题

知情同意概念含有丰富的伦理内涵。该讲介绍了知情同意的伦理学基础,讨论了在临床医疗活动及研究工作中应如何理解知情同意,以及知情同意与保护性医疗制度的关系等问题。     

精准医学模式下医学生临床与科研能力并重培养的思考

精准医学作为一种新的医疗模式,是生命医学发展的方向。目前临床医生普遍对其认识不足,需正确认识精准医学,并加强学习及应用。通过分析精准医学对医学生的要求,可以发现一个能胜任岗位的医学生必须具备以下特质:临床与科研能力并重、注重团队及合作精神、积极创新、拥有人文精神。对带教医师的培训、多学科协作联合教学查房、引入导师制和联合导师制等措施,可以让医学生既锻炼了临床能力,又学习和掌握了科研思维与相关的研究方法。     

Enhancing reflective practice through online learning: impact on clinical practice

Purpose

Traditionally, radiographers and radiation therapists function in a workplace environment that is protocol-driven with limited functional autonomy. The workplace promotes a culture of conformity and discourages practitioners from reflective and critical thinking, essential attributes for continuing learning and advancing workplace practices. As part of the first author’s doctoral study, a continuing professional development (CPD) educational framework was used to design and implement an online module for radiation therapists’ CPD activities. The study aimed to determine if it is possible to enhance healthcare practitioners’ reflective practice via online learning and to establish the impact of reflective learning on clinical practice.

Materials and methods

The objectives of the online module were to increase radiation therapists’ knowledge in planning for radiation therapy for the breast by assisting them engage in reflective practice. The cyclical process of action research was used to pilot the module twice with two groups of volunteer radiation therapists (twenty-six participants) from Australia, New Zealand and Canada.

Results

The online module was evaluated using Kirkpatrick’s four-level evaluation model. Evidence indicated that participants were empowered as a result of participation in the module. They began reflecting in the workplace while assuming a more proactive role and increased clinical responsibilities, engaged colleagues in collaborative reflections and adopted evidence-based approaches in advancing clinical practices.

Conclusion

The study shows that it is possible to assist practitioners engage in reflective practice using an online CPD educational framework. Participants were able to apply the reflective learning they had developed in their workplace. As a result of their learning, they felt empowered to continue to effect changes in their workplace beyond the cessation of the online module.     

北京市医用高分子材料在医疗器械产业发展中的现状调研

目的深入调研北京市医疗器械用高分子材料的开发及产业化情况,探寻本领域发展所面临的机遇与挑战。方法 2014~2016年,北京理工大学材料学院师生结合专业学习,与中关村医疗器械产业联盟合作,对北京市与医用材料产业化相关的企业、科研院所、专家学者及行业协会,通过问卷调查、参观、生产实习、座谈等形式进行调研,并对调研结果进行深入的分析。结果梳理了北京市医疗器械用高分子材料的开发及产业化过程中,在新型高分子材料的研发及应用、技术开发及创新、人才培养等方面所存在的问题及解决的措施,为加速实现医用高分子材料的产业化提出了有针对性的意见和建议。结论本研究对促进北京市医疗器械用高分子材料的开发及产业化具有一定的指导意义。     

医学生临床见习教学的伦理困境及其解决

临床见习是医学生从理论学习到临床实践的重要转折,全面而系统的临床实习是医学生接受实践检验、巩固和加强所学理论知识,培养独立工作能力的一个十分重要的阶段。本文根据临床见习教学特点,分析当前临床教学和医学生临床见习中存在的伦理学难题,并就如何解决进行探讨。     

Comparisons between the attitudes of medical and dental students toward the clinical importance of gross anatomy and physiology

Marked changes are occurring within both the medical and dental curricula and new ways of teaching the basic sciences have been devised and traditional methods (e.g., dissection for gross anatomy and of bench‐based animal preparations for physiology) are increasingly no longer the norm. Although there is much anecdotal evidence that students are not in favor of such changes, there is little evidence for this based on quantitative analyses of students' attitudes. Using Thurstone and Chave attitude analyses, we assessed the attitudes of first year medical and dental students at Cardiff University toward gross anatomy and physiology in terms of their perceived clinical importance. In addition, we investigated the appropriateness (“fitness for purpose”) of teaching methodologies used for anatomy and physiology. The hypotheses tested recognized the possibility that medical and dental students differed in their opinions, but that they had a preference to being taught gross anatomy through the use of dissection and had no preference for physiology teaching. It was found that both medical and dental students displayed positive attitudes toward the clinical relevance of gross anatomy and that they preferred to be taught by means of dissection. Although both medical and dental students displayed positives attitudes toward the clinical relevance of physiology, this was greater for the medical students. Both medical and dental students showed a preference for being taught physiology through didactic teaching in small groups but the medical students also appreciated being taught by means of practicals. Overall, this study highlights the expectations that students have for the basic science foundation teaching within their professional training and signals a preference for being taught experientially/practically. Differences were discerned between medical and dental students that might reflect the direct association between systems physiology and pathophysiology and the application of this knowledge within the medical field in comparison to the dental field, which is heavily skill‐based. Clin. Anat. 27:976–987, 2014. © 2014 Wiley Periodicals, Inc.