建立具有中国特色的继续医学教育模式：谈开展我国继续医学教育存在的问题

开展继续医学教育，适应新形势的发展建立具有中国特色的继续医学教育模式，是当前医学教育改革中一个重大课题。就甸目前继续医学教育中存在的问题，分析和总结了国外开展继续医学教育的经验，提出开展我国继续医学教育的对策；更新观念、制定政策、分级管理、形式多样。     

深入开展继续医学教育之己见

目前我国继续医学教育存在的主要问题是：继续医学教育缺乏激励机制；片面强调国外对继续医学教育的定义会对我国继续医学教育的发展产生不利的影响；对继续医学教育管理队伍缺乏适当的支持；对全国性的学术交流活动缺乏管理；教学手段落后，现代化的教学手段没有得到很好的利用。对此提出，认识统一、措施得力、制度健全、政策配套是保证继续医学教育深入开展的关键所在；在开展继续医学教育的过程中，要汲取国外的先进经验，更要结合国情，建立有中国特色的继续医学教育制度。     

谈继续医学教育

谈继续医学教育孟群作者单位：１００７２５卫生部科技教育司成人教育处继续医学教育工作虽然在全国得到了普遍开展，但仍有相当一部分卫生技术人员，包括一些管理人员，对继续医学教育的意义、涵义、对象及有关规定不清楚，因而影响了继续医学教育的深入开展。一、开展继...     

深入开展继续医学教育之已见

目前我国继续医学教育存在的主要问题是：继续医学教育缺乏激励机制；片面强调国外对继续医学教育的定义会对我国继续医学教育的发展产生不利的影响；对继续医学教育管理队伍缺乏适当的支持；对全国性的学术交流活动缺乏管理；教学手段落后，现代化的教学手段没有得到很好的利用。对此提出，认识统一、措施得力、制度健全、政策配套是保证继续医学教育深入开展的关键所在；在开展继续医学教育的过程中，要汲取国外的先进经验，更要结     

医学会开展继续医学教育的做法与体会

提出了继续医学教育项目的选题，阐述了开展继续医学教育项目各期的重点工作，列举了医学会开展继续医学教育的优势，指出通过开展继续医学教育，为广大医务人员提供学习、交流的机会和平台，为我国的医学事业作贡献。     

继续医学教育管理系统的优点及展望

继续医学教育上世纪50年代起源于美国，70年代引进我国，卫生部于1991年颁布《继续医学教育暂行规定》，并在全国范围内进行继续医学教育规范化和制度化的探索和实践。广东省卫生厅于1999年发出《关于进一步开展继续医学教育工作的通知》，要求全省医疗卫生系统开展继续医学教育工作。几年来，我院继续医学教育工作都是人工处理。     

开展继续医学教育工作中需要明确的几个问题

开展继续医学教育工作中需要明确的几个问题中华人民共和国卫生部科技教育司成人教育处（北京１００７２５）孟群我国开展继续医学教育研究和实践已有二十几年历史。从７０年代末、８０年代初继续医学教育概念引入我国，国内医学教育管理部门和学术界对继续医学教育的含义...     

我国开展远程继续医学教育评估的初步探讨

我国远程继续医学教育经过几年的探索，取得了一定的成绩。适时利用评估这一有力杠杆，对于规范远程医学教育机构办学行为、保证教学质量、加强科学化管理、促进我国远程继续医学教育健康发展，是极为必要的。本文就开展远程继续医学教育评估的有关问题进行了初步探讨，希望能对我国远程医学继续医学教育评估工作的开展有所帮助。     

常州市医务人员继续医学教育现状分析

继续医学教育在我国越来越受到重视。常州市从１９９０年始，对县（市）、区以上医疗卫生单位现职卫技人员开展了继续医学教育工作。笔者对该市临床医护人员继续医学教育现状进行分析，以期说明取得的效益和存在的问题；     

做好继续医学教育的建议

本文提出现阶段我国继续医学教育仍然存在一些问题,如继续医学教育发展不平衡、继续医学教育重视不够、考核体制有待完善、少数项目质量不高等。解决对策是：创造条件,为基层卫生技术人员提供有效的继续医学教育;建立健全继续医学教育制度,完善配套政策,实施全员性在职教育：利用网络平台,使继续医学教育形式灵活多样,内容丰富多彩：加强继续医学教育信息交流,积极开展国际间交流与合作。     

Accreditation of general practices: challenges and lessons

To flourish, practice accreditation must meet challenges. It needs to manage uncertainty over its effectiveness and cost effectiveness, to address concerns that it erodes professional autonomy, and to promote and elucidate the conditions under which it is appropriate. Lessons from Australia and New Zealand help to focus these challenges. The lessons include the need to reward quality practices, loosen professional control over accreditation, trade some consistency of standards for validity, develop standards that acknowledge cultural diversity, and be transparent. Another lesson is to separate quality control from quality improvement within a coordinated systems based framework, with practices being helped to pay for accreditation and quality improvement. Such assistance is important because, in the presence of unintended variations in practice service delivery, all practices should have to show that they meet or exceed minimum standards while aiming for excellence.     

Conditions for research in general practice. Can the Dutch and British experiences be applied to other countries, for example Spain?

The aim of this study is to identify conditions for research as part of professional development in general practice. Based on the work of Andrew Abbott, who studied the dynamics of professional development, five conditions were identified. These are: the creation of associations among professionals; control of work; the establishment of specialised education; the development of professional knowledge; and the creation of organised structures for professional work. Two countries with a well-established research tradition in general practice (the UK and the Netherlands) and one country where GP research development is still limited (Spain) were evaluated on the basis of these conditions. The conditions identified as favourable were as follows: the existence of a scientific association; a peer-reviewed journal; a defined population resulting in a population denominator for practices; a gatekeeping system; chairs and departments of general practice at universities; the integration of education centres and research centres; GPs working in group practices or health centres; a certain degree of independence from the Ministry of Health; and financial support for practicing GPs to conduct research activities. We showed that most conditions for the successful scientific progress of general practice in Spain are present. However there is still a gap between academia and general practice and a lack of research organisation and support.     

Promoting professional knowledge, experiential learning and critical thinking for medical students

It has been recognized internationally that undergraduate medical education must adapt to changing needs, as illustrated by the Tomorrow's Doctors recommendations from the General Medical Council. This paper aims to relate contemporary educational theory to under-graduate medical educational requirements, specifically highlighting conditions (e.g. experiential learning) for: professional knowledge acquisition; critical thinking, problem-solving and clinical problem-solving; and lifelong professional learning. Furthermore, problem-based learning (PBL) is highlighted as potentially providing such conditions. There are lessons from contemporary educational theory for the reform of undergraduate medical education. These include valuing prior knowledge and experience; promoting learner responsibility through facilitating rather than directing learning; encouraging learners to test out and apply new knowledge, and using small-group work to foster explicitly the elusive skills of critical thinking and reflection. Contemporary educational theory contributes valuable insights, but cannot dictate the ultimate 'mix'; at best it provides some principles for reflective analysis of the learning experiences created for tomorrow's doctors.     

Conditions for successful interprofessional collaboration in integrated care – Lessons from a primary care setting in Denmark

IntroductionIncreasing demand for interprofessional collaboration in health care settings has led to a greater focus on how conditions influence the success of interprofessional collaboration, but little is known about the magnitude of the interactions between different conditions. This paper aims to examine the relationships of intervention conditions and context conditions at the professional and organisational level and examine how they influence the staff’s perceived success of the interprofessional collaboration.MethodsThe study was conducted as a multilevel cross-sectional survey in March of 2019 in the second largest municipality in Denmark, Aarhus. The study population was all frontline-staff members and managers in nursing homes, home care units and health care units. The final sample consisted of 498 staff members and 27 managers. Confirmatory path analysis was used to analyse the data.ResultsThe results indicate that context conditions greatly influence intervention conditions at the professional and organisational level and that the professional and organisational levels moderately co-variate. Professional level context conditions have the biggest influence on staff’s perceived success, partly because its influence is confounded by intervention conditions.ConclusionPractice and research in health care settings should re-focus their attention from a broad understanding of context as unchangeable and inconsequential, to understanding context as an important condition type for interprofessional collaboration that needs to be further understood and researched.     

Die Rolle der Pflege im Gesundheitswesen

As a result of recent demographic developments, there has been an increased demand for high-quality health care. Among the various health professions, caregiving represents the largest professional group, numbering approximately 820,000 caregivers. Despite its size, this group is failing to meet basic conditions in line with international standards that secure adequate care. This failing is primarily due to the special path that Germany took regarding healthcare at the end of the nineteenth century and on which it continues to this day. It manifests itself in a heteronomy to which the professional group is permanently subjected by lobbies and policies that view health care from a perspective whose primary aim is to reduce unemployment. The present lack of organization of caregivers has frustrated their political assertiveness; and not least because of this, many caregivers leave the profession early. The profession itself is grappling with its professional identity. The development of expert standards, research into care, ethical reflections, as well as the struggle for common professional training are positive signs in this ongoing debate and are reflected in the positive feedback received from patients. The interdisciplinary dialogue between caregivers and physicians is in need of improvement. The first signs of progress are evident within the framework of health care ethics committees. This dialogue would certainly benefit both the professional group as well as the patients.     

Gender representations and morality in the nursing profession

This text is part of a dialogue between the authorserlating to two research projects: one on "The professional ambiguities, work conditions and the citizenship of nurses--a comparative study in the Federal District and S?o Paulo" and the other on "The impact of work conditions on the nurses in the Hospital S?o Paulo as to sexual and reproductive life". Nursing occupies a singular place in the health professions. Is is differentiated by numeric importance as well as by a professional practice which is almost exclusively feminine. Culturally, to care is attributed as a woman's task (nurse, mother teacher, social worker, etc.); to treat is a man's task (doctor, father, provider, etc.) The dichotomy between caring and treating denies other conflicts, relations of power, and of hierarchies established in the professional practice of nursing. These conflicts may be associated with: a) the founding myth of the origin of nursing, generator of a morality and a competence which condition htis professional practice; b) feminity, mothering, the administration of intimacy and body care, that is, the social representations of nursing with respect to gender; c) the androcentric character of power relations and those of sexuality which subsume the professional space of nursing.     

What can musicians’ claims data reveal about their musculoskeletal conditions?

Abstract

Musculoskeletal (MSK) symptoms are common amongst professional musicians. No study has reported on workers’ compensation claims (WCCs) of musicians to determine the proportion of claims and costs attributed to MSK conditions. We analyzed Australian WCCs for professional musicians 2004/2005–2015/2016. MSK conditions accounted for 69.78% of claims; 50.46% of which were for upper limb conditions. MSK conditions also accounted for 77.76% of costs for musicians’ WCC. The most common reported mechanism for MSK claims was body stressing (72.48%), and the most common agency was “other non-powered equipment” (including musical instruments; 39.71%), which also accounted for 51.27% of upper limb claims specifically. For the first time, we showed that MSK conditions account for the majority of musicians’ WCC, and the majority of the cost of claims, making them the biggest health issue for professional musicians.     

Altenpflegekräfte länger im Beruf halten

Retaining geriatric nurses in their line of work could be an important strategy to prevent the shortage of skilled staff in the future. A prerequisite for this is detailed knowledge of the length and structure of professional careers. The IWAK ( Institut für Wirtschaft, Arbeit und Kultur) evaluated data from the German Social Insurance and carried out a structural analysis of the professional careers of geriatric nurses. Results showed that the average duration of professional careers is 20 years, of which 11.7 years constitute the period of employment and 7.8 years account for periods of inactivity. According to these findings, there is a considerable potential in extending professional careers and reducing the periods of inactivity to make better use of the existing skilled staff and to reduce staff shortage in this area. Concrete measures could involve improvement of working conditions (with the aim of avoiding long periods of inactivity and illness-related premature career endings as well as of increasing job satisfaction), creating better conditions for a good balance between work and family life, as well as setting up individual strategies to expand weekly working hours. Key players are businesses but also local authorities and politicians.     

医院管理人员职业化研究概述

通过对我国医院管理人员职业化的范围、概念、标准和考评体系进行了科学界定，对我国医院管理人员职业化的现状和必要性进行客观描述，对我国医院管理人员职业化的可行性进行“以时间、教育为纵、横轴线立体展开的‘三段两块式’方案”的设计，对我国医院管理人员职业化的教育现状及发展趋势进行了系统研究，提出了培育我国医院管理人员“职业化意识”的理念，对我国医院管理人员职业化的市场运行，医生能否成为职业化管理者和我国医院院长由“官员化”向“职业化”转向的利弊过程进行了深入探讨，并对我国医院管理人员职业化的管理、教育、准入、市场立法等重大问题进行了深入研究，提出了建议。     

Der Pflegeberuf im Spiegel der Öffentlichkeit

The following article represents the main results of studies in Germany treating the situation of nurses in hospitals and in long term care units focussing the image of nursing work—on the one hand from the public’s and on the other hand from the nurses’ perspectives. The article enters into the question what the general public and the nurses thinks about the nursing work, the nursing work conditions and trust in professional caring. As a result, it can be stated that the rating of nursing work and nursing work conditions in public differs. Nursing work is higher rated in public than the nursing work conditions and the quality of professional caring. In the nursing community a high identification with the nursing profession and nursing work can be determined. But there is lower job satisfaction and esteem for nursing work visible.