国际互联网在医学检验教育中的综合应用初探

国际互联网（因特网）在医学领域中的应用,近年来国内已有报道［１～３］。我校于１９９７年上半年建成了以光纤为主干的校园网,并通过ＣＥＲＮＥＴ与国际互联网相通。为提高国际互联网在医学检验教育中的综合应用水平,结合我校的实际,我们在医学检验教学、科研、考试及日常管理等多方面对国际互联网进行了初步应用,现报告如下：１　材料与方法１－１　医学检验教学计算机多媒体课件制作将医学检验教学过程中所需投影片、幻灯片、图片及声像资料,通过文字、图片处理软件或扫描仪输入计算机。用ＶＢ语言（ＶｉｓｕａｌＢａｓｉｃ）制成…     

生物芯片技术在医学检验中的应用

生物芯片 (ＢｉｏｌｏｇｉｃａｌＣｈｉｐ)技术是一种大规模平行检测生物分子的有效手段 ,兴起于 90年代初。由于其快速、微量、准确的应用优点 ,正在成为新一代的自动化医学检验工具。本综述着重介绍生物芯片技术的种类、检测原理、应用举例。1　生物芯片的概念传统的医学检验主要是对临床标本进行定性及半定量的分析 ,以获得病原体进行诊断或判断病人的病情。随着分子生物学的发展及人们对疾病过程的认识加深 ,传统的医学检验技术已不能完全适应微量、快速、准确、全面的要求。生物芯片技术由于在科研中的成功应用正由实验室扩展到临床应…     

探索形成性评价在医学检验教学中的应用

通过研究形成性评价体系在检验教学过程中的应用方法,深入分析形成性评价体系的优缺点,探讨形成性评价体系在检验教学体系中运用的成效,促进检验教学体系适应新课标理念,推动检验教育教学、课程考试改革顺利实施。     

医学检验在海洋环境战创伤救治中的作用

海战及登陆作战战伤部位与陆战相似。除炸伤、枪弹伤、烧伤外,水下冲击波、燃烧毒气和爆炸强闪光、低温海水浸泡等也是重要的致伤、致死原因。特别是伤员经过海水浸泡,会使全身、损伤局部产生一系列病理生理改变,增加战创伤救治难度。因此,早期检验诊断对快速救治尤为重要。     

浅析新形势下循证检验医学的现实意义

20世纪90年代以来，循证医学（Evidence-Based Medicine）的新概念逐渐引入医学领域，不断发展，日趋成熟，成为一种医学实践的新模式，是一门新兴临床学科，是医学界关注的热点。循证检验医学是循证医学在检验医学中的一个重要应用。循证检验医学和循证医学对于现代检验医学的发展起着重要作用。本文结合有关文献对发展循证检验医学的现实意义作一简要叙述。     

检验医学人员对循证医学应用及认知能力的初步调查

循证医学(evidence-based medicine,EBM)是近10年来现代医学实践中迅速发展起来的一个新兴学科,带动了医学领域各个分支学科的发展。检验医学在其影响下,也将跨入一个新的境界—循证检验医学(evidence-based laboratorymedicine,EBLM)。“以当前最好的证据为基础”的原则,用临床流行病学的方法学规范检验医学的研究设计和文献评价;用当前最好的检验技术和质量控制体系对检验结果进行严格的质量控制和评价,其任务是向临床医师提供反映患者真实情况的证据。因此,循证医学对于现代检验医学的发展和临床工作的质量有着极其重要的作用。但是,…     

互联网医学资源利用与研究

现代信息通讯技术的蓬勃发展 ,推动了临床医学的交流 ,尤其是互联网络的功能与传输速度的日益完善 ,为广大医务人员带来了便利 ,使医学用户能方便、快捷地查找和利用Internet网上的生物医学信息资源。本文论述了如何充分利用互联网的医学资源以及我馆在这方面的具体作法。1　网络生物医学信息资源的开发与利用生物信息资源是医院图书馆开展信息服务的基础和根本保障。Internet上信息极其丰富 ,为人们共享信息提供了有利条件。但是 ,由于十分活跃的综合网站和专业网站、电子图书、电子期刊以及电子报纸等存在着组织上的松散、数据类型各异、…     

医学检验分析前后的质量保证

随着医学科学技术的发展和进步 ,在临床诊断和治疗疾病中 ,实验室检查越来越显得重要。为此关于“医学检验全程质量管理”的概念近年来在检验界倍受重视。然而在临床医生、护士、检验员中有的对此还比较模糊 ,在具体实施上还存在一定问题。所以让临床医生和护士了解和掌握实验前后许多因素可对实验结果有重大影响 ,会给疾病的诊断和疗效观察带来错误判断 ,有重要意义。1　分析前的质量保证1 .1　临床医生正确选择检验项目　目前检验项目繁多 ,每一种试验都有其不同的临床意义 ,因此根据病人病情需要正确选择检验项目是保证质量的第一步。首…     

医学检验专业教学内容改革的思路

如何培养适应医学检验技术发展需要的高素质人才，是医学教育面临的重要任务。本文就医学检验专业教学内容的改革作以初浅探讨。１立足专业需要，打牢三个基础１１科学文化基础作为医学检验专业，现在开设的文化基础课程一般为外语、高等数学、计算机等，就其教学内容，...     

Application of the case method in medical student radiology education

RATIONALE AND OBJECTIVES: Our goal is to design, implement, and evaluate a rich educational activity to engage medical students in learning the importance of providing clinical histories when ordering radiological examinations. We adapted the format of the case method commonly used in business schools. MATERIALS AND METHODS: In the setting of a 1-week required radiology course offered during the third year of medical school, we created an unknown case assignment consisting of two chest radiographs and a concise history for three- to four-person study teams. Unknown to students, each team received the same images, but different patient histories. After turning in their written analyses, students had a classroom opportunity to discuss their conclusions. A written evaluation of the entire experience using both Likert items and unstructured response items was conducted at the end of each session. RESULTS: The evaluation was conducted during a 17-month period, and 141 evaluations were received from students. The response rate was 100%. Most teams met several times and worked on the assignment for 2 or 3 hours. Students agreed that the learning experience was worthwhile (95%), content was appropriate (93%), and the activity should be continued for subsequent classes (94%). Unstructured responses indicated that students learned the importance of clinical histories in the interpretation of radiological studies. CONCLUSION: An educational activity based on the case method was well received by students and met its educational objectives. Activities of this type have potential for widespread application in radiology education.     

Computer-assisted mammography feedback program (CAMFP) an electronic tool for continuing medical education

RATIONALE AND OBJECTIVES: Our goal was to develop and evaluate software to support a computer assisted mammography feedback program (CAMFP) to be used for continuing medical education (CME). MATERIALS AND METHODS: Thirty-five radiologists from our region signed consent to participate in an institutional review board-approved film-reading study. The radiologists primarily assessed digitized mammograms and received feedback in five film interpretation sessions. A bivariate analysis was used to evaluate the joint effects of the training on sensitivity and specificity, and the effects of image quality on reading performance were explored. RESULTS: Interpretation was influenced by the CAMFP intervention: Sensitivity increased (Delta sensitivity = 0.086, P < .001) and specificity decreased (Delta specificity = -0.057, P = .04). Variability in interpretation among radiologists also decreased after the training sessions (P = .035). CONCLUSION: The CAMFP intervention improved sensitivity and decreased variability among radiologist's interpretations. Although this improvement was partially offset by decreased specificity, the program is potentially useful as a component of continuing medical education of radiologists. Dissemination via the web may be possible using digital mammography.     

用超文本标记语言开发外军卫生工作体制查询系统

为适应我军卫勤研究工作的需要，充分利用Ｉｎｔｅｒｎｅｔ军事医学信息资源，我们应用超文本标记语言开发了外军卫生工作体制查询系统。该系统的为１５个子系统，主要数据源自外军卫生工作体制手册，部分数据是可链接的外军军事医学机构的Ｉｎｔｅｒｎｅｔ节点。所有文字、图像和超文本标记语言（ＨＴＭＬ）进行显示标记和链接标记，锭接方向有纵向链接、向链接和外向链接，链接形式是文字、图像、声音三种信息媒体之间的链接。查询     

网上免费医学信息的应用

目的了解Internet上免费的医学信息资源。方法利用搜索引擎通过搜索关键词,对Internet上和医学信息有关的网站（页）进行考察。结果网络上的医学信息资源分布丰富,它包括了与医药相关的背景信息和研究信息。结论利用搜索引擎对免费医学信息的检索,是目前医务工作者获取信息的有效方法。     

Changes in graduate medical education: A view from radiation oncology

The accreditation process of graduate medical education is changing. This change presents new challenges to teachers of radiation oncology. With the help of the ACR and other institutions, radiation oncology is well positioned to meet this challenge.     

Is current medical education adequately preparing future physicians to manage concussion: an initial evaluation

Objectives: In 2010, there were 2.5 million hospitalizations, emergency room visits, or deaths associated with concussions in the United States.[1] Knowledge deficits exist among physicians regarding concussion management, which can lead to severe repercussions, including poor patient outcomes, poor patient satisfaction, and potential medical-legal issues. While concussion is a prevalent condition evaluated in the medical field, medical students continue to have a knowledge deficit regarding concussion diagnosis, prognosis, medical management, and return to play guidelines. Methods: Medical students from a mid-western medical school completed a survey on concussion diagnosis, prognosis, medical management, and return to play guidelines. Results: The response rate was 40%. The data suggests that the vast majority of medical students are able to define concussion; however, most reported never having a lecture dedicated to concussion during medical school and also lacked clinical experience with acute concussion and post-concussive syndrome. There are clear areas of deficiency as noted by the inability of students to correctly identify symptoms and appropriate management of concussion. Conclusion: The current study indicates that at an individual, mid-western, top 50 medical school, current medical trainees may not be adequately educated to identify and manage concussion. Future research is warranted to determine the optimal guidelines to educate future physicians as it pertains to concussion diagnosis, management, prognosis, and return to play guidelines.     

Audience response systems in medical student education benefit learners and presenters

RATIONALE AND OBJECTIVES: We sought to assess how the use of an audience response system (ARS) in medical student radiology instruction affects the self-confidence, ability to gauge mastery, and insights for future preparation in students when they participate as audience members and when they give peer teaching presentations. MATERIALS AND METHODS: Twenty-seven medical students discussed radiology case files in groups and used an ARS to present their assigned cases to peers. Students' views of interactive audience response versus traditional pedagogy were surveyed using a 5-point Likert scale (1, strongly agree; 2, agree; 3, neither agree nor disagree; 4, disagree; 5, strongly disagree). RESULTS: Students reported that instruction with interactive ARS lectures gave them more confidence to verbally answer questions in subsequent lectures when compared to instruction with standard didactic lectures, where a presenter asks questions and a single student responds (2.35 versus 3.14, p < .024). Students found it easier to gauge their level of mastery of material by answering ARS questions than by hearing classmates' verbal responses to questions posed in lecture (1.77 versus 2.68, p < .002). When giving peer teaching presentations, students reported that the ARS lecture format helped them to gauge their audience's level of understanding (1.55, 95% CI [1.27-1.82], p < .001). CONCLUSION: Radiology instruction utilizing an ARS can help build students' confidence, knowledge of self-mastery, and insights for future studying. Similarly, student presenters using an ARS improve their confidence, better gauge their audience, and develop helpful insights for future teaching presentations.     

深化医学教学改革,加强介入放射学后备力量培养——医学生调查引起的反思

近年来介入放射学在疾病诊疗中的应用得到了广泛普及和认可,然而介入放射学科却面临着患者流失、人员缺乏等诸多挑战。本文着重从医学院校介入放射学教学现状和学生对本学科的认识上剖析其原因,以探求缓解供求矛盾的方法。     

Internet网站在远程放射学的应用

目的 建立Ｉｎｔｅｒｎｅｔ医学影像网站用于远程教学和会诊。方法 搜集各系统病理证实和和符合诊断标准的病例,图像以数码相机,扫描仪等方式数字化。网站制作使用的制作 软件为Ｆｒｏｎｔｐａｇｅ ９８,Ｈｏｍｅｓｉｔｅ２．５,文本编辑器等。结果 资料内容丰富,每周更新。网站界面简洁,导航,使用非常方便。     

Redefining radiology education for first-year medical students: shifting from a passive to an active case-based approach

RATIONALE AND OBJECTIVES: The aim of the study is to design and implement an elective course in which first-year medical students learn about radiology by actively integrating imaging with hospital records and radiology reports, rather than passively observing radiologists or images. MATERIALS AND METHODS: Twenty students enrolled in an elective entitled "Introduction to Clinical Radiology." Students were divided into groups of two or three and given a case file describing the hospital visit of a patient with a common computed tomographic (CT) diagnosis. Files contained a PowerPoint presentation with all images from the patient's CT examination (allowing students to scroll through the images as if viewed on a picture archive and communication system workstation), as well as emergency department records, admission and discharge summaries, surgical notes, pathology reports, and radiology reports. Group discussion was facilitated by radiology staff acting as consultants, rather than instructors. As a final project, each group presented its case to the students and faculty. RESULTS: Compared with before the course, students' understanding of the role of radiologists in the clinical management of patients significantly increased, but interest in radiology as a specialty was unchanged. Students significantly preferred scrolling through images on their own, rather than being shown static images in a didactic format. Students significantly agreed that they would recommend the course to a classmate. CONCLUSION: Case-based instruction in radiology, in which first-year medical students are actively engaged in the integration of clinical and imaging information, can affect students' views on the role of radiologists and their clinical management of patients.