重视骨科基本功训练-规范临床物理检查

骨科临床物理检查是骨科医师必须掌握的基础技能之一,是骨科教学的重点内容。临床物理检查在骨科疾病的诊断过程中发挥非常重要的作用,骨科医生在进行临床工作时需要而且必须首先对患者进行系统全面的物理检查以获得诊断的重要信息。规范并加强骨科临床教学中物理检查技能的训练,提高物理检查结果准确性具有重要的科学和临床意义。     

Smoking assessment and cessation skills in the inpatient medicine clerkship

Effective disease prevention skills are essential for practicing physicians. One specific area of disease prevention skills underutilized by physicians is smoking assessment and cessation. A study of medical students’ ability to perform and opportunity to practice these skills during a core medicine clerkship was conducted to determine how well the program prepared students to practice these skills. An analysis of 61 patient medical writeups completed by 23 third‐year medicine clerks in a required, 3‐month, inpatient medicine clerkship was conducted. Although smoking history was noted in 74% of the charts, patient exposure was quantified in only 26% of the appropriate writeups. None of the writeups from the 9 currently smoking patients detailed an assessment of the patient's addiction, willingness to quit, or included smoking cessation in the therapeutic plan. We concluded that students’ smoking assessment and cessation skills are not well developed and that there is little opportunity to practice these skills in the inpatient setting.     

Student perceptions of skills acquisition during the surgical clerkship: Differences across academic quarters and deviations from faculty expectation

Background: Individual and experiential factors, as well as the timing of the surgical clerkship, may influence knowledge and/or skills acquisition.

Purpose: To examine differences across academic quarters in student perceptions of skills acquisition; differences between student perceptions and faculty expectations; and the association between perceptions and grades, student evaluations of the program, and their own career interests.

Methods: Each of 61 students evaluated postclerkship acquisition of 33 procedural and 12 clinical skills. Each of 14 faculty surgeons indicated expectations for skills acquisition.

Results: Faculty expectations were significantly higher (p < .01) than first quarter (Q1) student perceptions for most skills. Ql student perceptions were significantly lower than those of third quarter (Q3) students for most skills. Perceptions of skills acquisition were associated with preclinical desire for a surgical career, number of procedures performed, number of workups completed, and clinical grade.

Conclusion: Student perceptions of skills acquisition vary with the timing of the clerkship and reflect an interaction between individual and experiential factors, suggesting a need for increased standardization.     

Teaching information literacy skills: an evaluation

This paper describes an evaluation of a curriculum-integrated information literacy programme in an undergraduate nursing course. The aim of the programme was to provide students with an awareness of the discipline's literature and the skills to locate and retrieve the literature. A multidimensional process for determining nursing students' development was utilised in the evaluation of the programme. Pre- and post-programme questionnaires were distributed to a cohort of students who undertook the programme. A cohort of more senior students who had not undertaken the information literacy programme was utilised as a comparison group. Questionnaire results were analysed using a range of inferential statistics. This paper will focus on two main findings related to objective measures of information literacy skills. These include pre-programme/post-programme change in student performance and differences in student performance between those who undertook the programme and those who did not. The programme demonstrated its effectiveness in developing information literacy skills, however the challenge remains for both academics and students to ensure that these skills are consolidated and extended for effective life-long learning.     

临床技能强化培训对提高医学生临床技能和实习效果的影响

目的评价强化技能培训对医学生临床技能提高和实习效果的影响。方法在首都医科大学附属北京友谊医院的2007级七年制学生本科阶段临床实习初期,利用业余时间进行临床技能强化培训,并对培训效果和满意度进行评估。结果受强化培训的学生总共有34名,在首都医科大学组织的临床医学专业学生临床技能考核中,获得一等奖5名,二等奖8名,三等奖12名。两名同学代表获得华北地区医学院校临床技能大赛团体总分第2名和全国医学院校临床技能大赛一等奖。参与强化培训的学生实习期间的工作量与前一批未全面强化培训的实习生工作量比较,实习期间书写大病历数、非手术操作次数、作为助手上台手术次数往届比较没有显著性差异(P0.05)。受培训学生对培训老师满意者占89.7%,对培训时间满意者65.5%,对培训科目满意者93.1%,认为对实习有帮助者75.9%,认为对技能提高有帮助者96.6%,对培训总体满意度评价69.0%。同期临床科室实习老师对强化培训了解情况者占84.6%,对所带教学生工作量完成情况满意者为61.5%,认为对该批学生临床技能以往学生有提高者占86.2%,认为培训对实习总体有帮助的占78.5%。结论利用业余时间对医学生实行强化培训有助于临床技能的提高,有助于提升实习效果。采取临床技能强化培训方式可作为医学生临床实习初期提高临床技能水平的途径之一。     

客观结构化临床考核在护理学基础技能考核中的应用

目的探索客观结构化临床考核(objective structured clinical examination,OSCE)在护理学基础技能考核中的应用效果。方法以北京某高校护理学院2013级全体本科生为研究对象,实施护理学基础技能OSCE考核,并进行效果分析与评价。结果 1本次考核,考生操作总得分平均分为(90.23±3.65)分。2考核总难度系数为0.9,总体区分度为0.62,内部一致性系数为0.73,平均内容效度比为0.93;与理论考试成绩的校标关联系数为0.51。388%的考生同意本次OSCE考核全面合理,65%的考生愿意再次参加。结论将OSCE应用于护理学基础技能考核中,能够科学、客观地评价考生护理学基础技能水平,有助于考生临床运用能力的提高,考生对此新型考核模式较为认可。     

Development of a musculoskeletal examination skills course for a physical medicine and rehabilitation residency program

This article describes the development of a musculoskeletal physical examination skills course for a physical medicine and rehabilitation residency training program. Course objectives, structure, and modification over time based on experience and resident feedback are discussed. The current course design is adaptable to meet the needs and resources of most residency programs.     

Automated video-based assessment of surgical skills for training and evaluation in medical schools

Purpose

Routine evaluation of basic surgical skills in medical schools requires considerable time and effort from supervising faculty. For each surgical trainee, a supervisor has to observe the trainees in person. Alternatively, supervisors may use training videos, which reduces some of the logistical overhead. All these approaches however are still incredibly time consuming and involve human bias. In this paper, we present an automated system for surgical skills assessment by analyzing video data of surgical activities.

Method

We compare different techniques for video-based surgical skill evaluation. We use techniques that capture the motion information at a coarser granularity using symbols or words, extract motion dynamics using textural patterns in a frame kernel matrix, and analyze fine-grained motion information using frequency analysis.

Results

We were successfully able to classify surgeons into different skill levels with high accuracy. Our results indicate that fine-grained analysis of motion dynamics via frequency analysis is most effective in capturing the skill relevant information in surgical videos.

Conclusion

Our evaluations show that frequency features perform better than motion texture features, which in-turn perform better than symbol-/word-based features. Put succinctly, skill classification accuracy is positively correlated with motion granularity as demonstrated by our results on two challenging video datasets.