临床技能教学考核体系改革初探

临床技能的培养一直是高等中医院校临床专业类学生培养过程中的突出问题。近年来,广州中医药大学紧紧围绕创新能力培养这一核心,不断调整优化专业结构和人才培养模式,更新教学理念,改革课程体系,并建立起多学科、全方位的临床技能中心,以此培养出既有扎实中医理论基础又有熟练的中西医临床技能以及思维能力的新型中医人才.     

临床技能教学考核体系改革初探

临床技能的培养一直是高等中医院校临床专业类学生培养过程中的突出问题。近年来,广州中医药大学紧紧围绕创新能力培养这一核心,不断调整优化专业结构和人才培养模式,更新教学理念,改革课程体系,并建立起多学科、全方位的临床技能中心,以此培养出既有扎实中医理论基础又有熟练的中西医临床技能以及思维能力的新型中医人才。     

浅谈诊断学临床技能教学改革

为提高诊断学教学质量,笔者所在校区对诊断学临床技能教学进行了改革,以掌握基本理论,加强l临床技能教学,强化问诊、体格检查及临床常用穿刺技术的训练为主要内容,以培养学生实际工作能力作为改革的重点。     

儿科住院医师临床技能统考初探

探讨住院医师规范化培养和考核的学者甚多[1 3] 。为提高各级医院儿科高年住院医师的实际水平 ,北京市卫生局决定对所属医院的第 5年住院医师进行临床技能统考[4 ] 。我院作为北京市儿科住院医师临床技能考区 ,对儿科住院医师的统考命题、考试方法、评分标准等已进行 2年的探索 ,现对资料进行总结报道。一、资料来源(一 )考核对象 :为 2 0 0 0～ 2 0 0 1年度北京市卫生局所属 18家医院的 76名儿科住院医师。除一名为硕士研究生外 ,均为大学本科学历。考生的单位类别分布是三甲儿童医院占 4 9% ,三甲综合医院占2 0 % ,厂矿区县医院占 31%。(…     

临床技能教学改革的初步效果评价

对临床医学本科专业2005级学生进行临床技能学课程培训,培训结束后进行临床技能考核,并与未进行临床技能学课程培训的2003级学生的临床技能考核成绩做对比分析,以评价临床技能教学改革的初步效果.结果显示,经过技能培训后的2005级学生,其诊断学、内科学、外科学技能考核成绩及总评成绩均显著提高(均P＜0.05-0.001)...     

培训临床医生的教学技能

Ｌｅｗｒｙ Ｓ在ＢＭＪ杂志１９９３年３０６卷１２７￣１３０页上发表文章，讨论了加强对临床医师的教学技能培训问题。作者认为，一名医生能做好本专业工作不一定就能教好这门课程，因此必须对临床医师进行教学技能的培训，提高教学工作在医学领域的地位，并根据教学任务的完成情况予以适当的奖励或处罚。     

以培养学生临床实践技能为中心的影像学教学改革探讨

目的分析了解当前影像学教学在培养学生临床实践技能方面存在的问题,研究和探索培养学生临床实践技能为中心的影像学教学改革的方法和途径。方法选取某校07级医学影像系的120名同学,单盲随机将其中60名分为观察组,余者分为对照组。对照分析观察组和对照组同学正确检出率、正确诊断率、理论得分和动手能力得分。结果观察组和对照组同学正确检出率和正确诊断率对照显示,差异性显著。观察组和对照组同学理论得分和动手能力得分对照显示,差异性显著。结论新的教育模式激发学生的学习兴趣,提高理论知识及临床实践技能的掌握能力,值得推广。     

西南医院临床技能模拟培训中心

这是一所国内规模庞大、设施齐全、技术领先，以高科技模拟设备为基础，集教学、示教、操作、考核等多功能为一体的全方位培训中心，它依托医学生理及计算机技术，剑设出模拟病人和模拟临床场景，代替真实病人进行临床教学和实践，改变了传统教学及考核的方式……[编者按]     

我国医学临床技能教学现状及其策略分析

社会的进步、科技的发展、知识经济的来临、医学模式的转变．对高等医学教育提出了更新更高的要求。临床医学课程教学必须与时俱进．才能培养全面发展的医学人才。临床技能是医学生专业素质的核心内容．加强临床技能教学是高等医学教育发展的客观需要．也是世界各国高等医学教育教学改革的共识。     

基于临床技能培训中心平台的临床技能实践教学体系构建

临床技能实践教学是医学高等教育体系中的重要组成部分,是培养实用型新型医学专业人才的关键阶段.该文总结分析某医院建设临床技能培训中心平台的实践经验,探讨临床技能实践教学体系的构建问题,通过建设完善的临床技能中心平台,构建全院临床技能实践教学体系,建立全面的临床技能实践质量监控体系,有效促进了对医学学员的临床实践教学,使医院的临床实践技能教学质量持续提升.     

Making continuous quality improvement a reality: innovation skills

Creativity and innovation, according to Grudin, "lie near the heart of humanity." If CQI is to be the force that will transform healthcare organizations into more systems-conscious and customer-driven endeavors, creativity and innovation must be encouraged and practiced. Given that they have a responsibility to introduce new products and services to their organization, materiel management professionals are particularly well-suited to practice and encourage creativity and innovation.     

Difficulties in clinical skills evaluation

A case-specific method of evaluating clinical skills is presented. The instrument is described together with its evaluation based on results from ninety-two medical students. The method involves direct observation, by pairs of teachers, of student encounters with simulated patients. The purpose of this paper is to explore the methodology of assessing clinical competence. Three aspects of this are addressed: reliability between teachers acting as observers, and the relationship of both observations of process measures and self-assessments with the students' understanding of the patient. Three aspects of clinical skills were evaluated; interviewing, problem orientation and physical examination. The results showed the observers to be highly reliable in observing physical examination but to have a wide range of reliability across cases in their observations of the other aspects of clinical skill. There was no correlation between both teachers' observations and the students' self-assessments with the students' understanding of the patient. This is a worrying finding. The implications of this study are that evaluation of the process of clinical skills is difficult methodologically and, added to which, it is not clear what relevance these observations have to clinical competence. Rather than effort being devoted to refining instruments to measure the process of clinical skills it would seem preferable to devote energy to assessing students' abilities in diagnosis and management, at least until we understand what observations of clinical skills are measuring.     

Assessment of clinical skills in medical practice

The introduction of a clinical skills examination (CSE) to Step 2 of the U.S. Medical Licensing Examination (USMLE) has focused attention on the design and delivery of large-scale standardized tests of clinical skills and raised the question of the appropriateness of evaluation of these competencies across the span of a physician's career. This initiative coincides with growing pressure to periodically assess the continued competence of physicians in practice. The USMLE CSE is designed to certify that candidates have the basic clinical skills required for the safe and effective practice of medicine in the supervised environment of postgraduate training. These include history taking, physical examination, effective communication with patients and other members of the health care team, and clear and accurate documentation of diagnostic impressions and plans for further assessment. The USMLE CSE does not assess procedural skills. As physicians progress through training and enter practice, both knowledge base and requisite technical skills become more diverse. A variety of indirect and direct measures are available for evaluating physicians, but, at present, no single method permits high-stake inferences about clinical skills. Systematic and standardized assessments make a contribution to comprehensive evaluations, but they retain an element of assessing capacity rather than authentic performance in practice. Much work is needed to identify the optimal combination of methods to be employed in support of programs to ensure maintenance of competence of practicing physicians.     

Evaluation of clinical skills for nutrition counseling

This report describes the procedures for and feasibility of an evaluation program that provides a direct assessment of the use of specific clinical skills during an interview with a simulated patient. The specific aims of this evaluation were to assess untrained graduate students in nutrition on their application of a set of 31 specific clinical skills for resolving dietary adherence problems. Each student conducted two interviews with each of two different simulated patients with hyperlipidemia presenting typical problems following a diet low in saturated fat and cholestrol. The evaluation program provided analyses that identified the strengths and deficits of each student and the performance of the entire group. It is suggested that the evaluation program offers a practical, objective method for examining the entry-level clinical skills of students in training and may be useful in other educational programs (eg, in-service, continuing education workshops).