儿科医师在放射科内进行规范化培训保障体系的探索

住院医师规范化培训是医学生毕业后教育的重要组成部分,是从事临床医疗工作医师必须接受的培训.放射科作为住院医师规范化培训的公共平台科室之一,对提升住院医师医疗水平和质量至关重要.作为儿科住院医师规范化培训科室之一,放射科的培训对提升儿科住院医师诊疗水平起到积极作用.儿科住院医师作为规范化培训中重要的群体,需要全面了解和掌握临床诊疗知识,对放射科培训工作提出了更高的要求.为进一步提高儿科住院医师在放射科规范中的培训质量,通过对儿科住院医师规范化培训的调研,分析儿科住院医师在放射科规范化培训中存在的问题,建立了儿科住院医师在放射科培训的住院医师规范化培训质量保障体系,不断提高儿科住院医师的规范化培训质量.     

新形势下传染科住院总医师制实践与体会

住院总医师在医院与科室的医政管理方面发挥非常重要的作用,特别是在医院管理和科室管理中均起积极作用.依据当前发展阶段中传染病特征及住院总医师工作实际情况,严格落实住院总医师制对提高管理效率、提高医疗服务质量、保障临床医疗安全具有重要作用.     

专科医院实施住院总护师负责PICC应急处置的实践与效果

目的 探讨专科医院在实施住院总护师负责PICC应急处置中的作用及成效.方法 借鉴住院总医师的应急管理经验,制订住院总护师PICC应急处置制度,选拔临床护理骨干担任住院总护师,岗前规范化培训合格后履行岗位职责,负责全院科室PICC管路的应急处置及协调工作.结果 实施临床住院总护师负责PICC应急处置以来,为各临床科室解决PICC管路维护中疑难问题114起;参与管路评估547人次.结论 实施住院总护师负责PICC应急处置降低相关并发症的发生率,为现有护理技术力量的某些薄弱环节提供了有效的补充,提高了护理工作质量,进一步保障了护理安全.     

住院总医师培训在胸外科住院医师规范化培训中的作用

住院医师规范化培训是指临床医学专业毕业生完成高等医学院校教育之后的重要组成部分,住院总医师培训为我院住院医师规范化培训最后一年进行的培训,是基于前面培训基础的一个飞跃过程。我院自2005年就已经实行了住院医师规范化培训,为我国较早实开展培训的单位之一。我院胸外科在十年的住院医师规范化培训中,通过住院总医师培训期间进行临床导师制、教学名师言传身教以及基础导师科研思维培养,大大地提高了住院医师临床技能、教学能力和科研能力。     

规范眼科住院总医师培训提升眼科专业人才素质

结合我国眼科专业特点和住院总培训工作中的实情,探讨了眼科住院总医师的规范化培养。作者对目前我国眼科住院总培养的现状和新变化进行了分析,为进一步提高培养质量提出建议。提出应将职称晋升与住院总培训挂钩,突出临床能力的培养,严格考核制度,使培训结束后能够具有真正的独立执业能力。     

中医儿科住院医师培养模式的探讨

本文分析了中医儿科住院医师培训中存在的问题,建议制定明确的中医儿科住院医师培养目标,在加强中医基础理论学习与实践的同时,合理安排西医儿科临床各科室的轮转,培养良好的科研能力;同时,建立中医儿科住院医师的规范化考核标准,提高中医儿科住院医师的培养质量.     

充分发挥住院总医师作用 做好进修生的管理工作

住院总医师作为主任的助手。参与科室日常的医疗，教学及管理工作，进修生的管理是住院总医师工作的一项主要内容。充分发挥住院总医师的作用，做好进修医生的管理工作，对搞好全科医疗工作，减少医疗事故，提高科室管理水平起着重要作用。     

重视外科住院总医师培训,培养素质全面的外科人才

目的比较分析外科住院总医师与同年资住院医师的在医、教、研诸方面的培训情况。方法对2006-2007年度,胃肠外科、肝胆外科、骨科、泌尿外科、胸外科、神经外科及急诊外科七个专科住院总医师与同年资住院医师在临床及教学工作量、理论水平、操作技能、教学能力以及科研水平等方面的考核评分进行比较分析。结果七个专科住院总医师临床和教学工作量均明显高于同年资住院医师,理论水平和手术操作技能考核成绩均高于后者,在教学技能和科研思维方面亦明显优于后者。结论住院总医师培训是专科住院医师规范化培训的最后阶段,也是最重要的阶段,对于培养"医、教、研"素质全面的高级医疗人才具有极为重要的意义。     

重视泌尿外科住院医师专科培训

泌尿外科住院医师的专科培训是住院医师规范化培训的重要组成部分,本文通过对当前泌尿外科住院医师培养的现状分析,结合泌尿外科的专科特点,探讨如何提高泌尿外科住院医师的培养质量,培养出高素质、德才兼备的泌尿外科住院医师。     

神经内科住院总医师会诊实践和体会

住院总医师岗位是每个青年医师成长的必经之路,是提高业务水平、强化工作能力、获得锻炼的最佳机会。科外会诊是住院总医师的主要工作之一,不仅体现住院总医师的责任心,更考验临床综合分析和独立处理问题的能力。因此对担任住院总医师1年的实践体会进行了初步总结。     

首席医学专家下社区为居民服务的实践与思考

目的寻找合适的方法,让有限的资源在一、二级医院间共享,使社区居民得到更好、更便捷的医疗服务。为解决＂看病贵、看病难＂的问题探索出路。方法通过上海市奉贤区中心医院近年来向社区派驻首席医学专家,发挥他们的桥梁纽带作用,从传技术、帮管理、带培训等各方面提高基层医疗机构的服务水平,同时缓解二级医院的压力。结果调整社区医疗服务重点,找到一、二级医院的既合理分工又紧密合作的契合点,充分发挥各自作用。结论首席专家下社区活动充分体现医疗服务行业应该贴近社会,贴近患者的整体方针,也更好地为＂看病难,看病贵＂的社会问题提供了可行性的解决方案。对保证社区卫生服务事业健康有序的发展具有重要意义。     

A management skills workshop for chief residents

A needs assessment was used to plan a national workshop on management skills for chief residents. Of replies from 1,256 residency programs, 50 percent of the respondents reported a high likelihood of attending such a workshop. The three skills that the respondents considered should be given high priority in such a workshop were giving feedback, delegating duties, and building teamwork. Based on these responses, the author designed and conducted a two-day workshop in June 1987 that was attended by 180 chief residents from 138 programs in 21 specialties from 36 states. Each skill was taught by presenting a lecture and a small-group exercise to apply the skill; these small groups were led by trained faculty members. The participants rated the workshop as 4.21 (on a 5-point scale in which 5 = very helpful). The workshop will be offered annually.     

期望值管理对心脏外科患者术后满意度干预效果研究

目的:探讨期望值管理对心脏外科患者术后满意度干预效果.方法:选择首都医科大学附属北京安贞医院心脏外科单一病房201 8年1～12月行心脏外科手术患者382人,按照诊疗组医生在患者术前是否对其及家属进行期望值管理分为干预组和对照组.对照组患者术前由手术组医生常规签署《知情同意书》,干预组进行期望值管理.结果:术后1年门诊...     

The psychiatry chief resident as information manager

In all medical specialties, the chief resident position is considered an honor that is the culmination of a resident's hard work and clinical acumen. However, the position requires managerial skills that residents have had little exposure to during medical school and postgraduate medical training. In the paper presented here, the author describes a model involving a medical school department of psychiatry and affiliated residency programs and discusses how various components of the structure are organized (affiliated hospitals, groups of individuals, and administrative hierarchy) and how the movement of information is influenced by organizational structure and interpersonal relationships within the model. The author also describes how information management is a major administrative function for the chief resident and how various predicaments that a chief resident faces stem from his mishandling information and from a misinterpretation of his power and influence. Training issues that could maximize the chief resident's theoretical and practical administrative experience are discussed.     

北京大学医学部内科总住院医师培训现状分析

总住院医师培训是由住院医师成长为主治医师的重要阶段,总住院医师承担着医疗、教学和管理职责。随着内科专业化的不断增强、专科医师规范化培训的逐步开展,内科总住院医师培训受到一定的影响。本文通过调研北京大学医学部在培内科总住院医师和临床指导教师,了解了内科总住院医师的培训现状,发现了存在的问题,并提出了改进建议。     

住院总医师在创伤骨科临床八年制实习带教中的作用

结合南方医科大学南方医院创伤骨科特点,介绍了在培养八年制医学生方面,如何发挥住院总医师作用的一些做法。包括：八年制实习医师跟随住院总医师参与急会诊以及急症处理、参与临床值班查房、参与急诊手术以及临床操作,同时住院总医师以自己的实际行动加强对实习医师的医德教育,将病例书写与临床思维、临床操作相结合,帮助他们完成一名医学生到医师的转变。     

Teaching the resident in internal medicine. Present practices and suggestions for the future

There appears to be a trend to move clinical teaching from bedside to conference room. While much emphasis is placed on conducting teaching rounds, no one asks how they are conducted. To evaluate how teaching is done, questionnaires on composition of teaching services and management of rounds including resident, patient care, attending, and teaching rounds were sent to 463 medicine residency programs. Responses were solicited from the program directors and chief residents. Two hundred twenty-one responded, but only for 123 programs did both the program director and the chief resident respond; these 123 programs formed the basis of our study. Fifteen percent of teaching rounds were held only in conference rooms, while 77% were made both at bedside and in conference rooms. The figures for attending rounds were 7% and 74%, respectively. Our data indicate a trend away from bedside teaching to the conference room.     

骨科总住院医师在进修医生教学和管理工作中的作用

目的 探讨总住院医师在进修医生的带教和管理工作中的作用.方法 分析第二军医大学附属长征医院骨科总住院医师作为科事主任的助手,参与科室日常的医疗、教学及管理工作,特别是在进修医生带教和管理工作中的组织实施和管理方法 .结果 总住院医师切实做好科室和进修生的协调工作,可以促进进修医生素质的提高,对教学医院科室管理工作和长远发展有着积极的影响.结论 总住院医师在进修医生教学及其管理工作中起着重要作用.     

Using ILIAD system shell to create an expert system for differential diagnosis of renal masses

Differential diagnosis of renal masses is an important and difficult process. A renal mass diagnostic system (RMDS) developed by using the ILIAD expert system shell has been created for diagnostic consultations and patient simulations. Seventy-two cases of renal mass have been tested on this system and the diagnostic accuracy was compared to that of residents. The overall diagnostic accuracy (75%) for renal masses is significantly better than second-year urological residents (60%) and not worse than urological chief residents (71%). The expert system also displays the cost of the diagnostic procedures so that the user can choose the most cost-effective diagnostic process. We conclude that this powerful renal mass diagnosis system developed by using ILIAD system shell can be used as a teaching, self-training and clinical tool for urological residents.