医学专业本科生导师制度的实践与思考

随着我国高等教育改革工作的不断发展与深化,本科生导师制的培养模式在各大高校如火如荼地进行,对于提高本科生培养水平具有良好的推动作用。本文通过对医学院校本科生导师制的开展状况及发展现状的观察,简要分析医学专业本科生导师制的开展内涵与目的,随后阐述了在开展医学生本科生导师制的过程中所遇到的3个问题：导师队伍匮乏、考核机制模糊、培养模式单一。建议分别从构建优秀导师队伍、明晰权责奖励机制、创立互动式培养模式进行实践反思与改革创新,科学推进医学本科生导师制,助力学生全面成长,为培养高层次、高素质的临床科研人才打下坚实基础,以期有效提升高校教育教学质量。     

综合性大学中医专业本科生导师制带教实践与思考

分析了在综合性大学中医专业本科生中施行导师制的重要性,阐述带教的具体实施方法和体会,同时针对该模式实施的过程中存在的问题进行探讨和思考。     

双导师制在临床实习教学中的应用与思考

目的探索本科生导师制在临床实习教学中的应用效果。方法遴选聘任本科生导师,并与2012级临床医学专业实习生进行"1+1"师生配对,实习结束时发放自行设计的导师和学生调查问卷,评价本科生导师制实施效果。结果全程导师全年人均指导学生17.3次,所有导师均对导师制实施价值表示肯定。81.7%的学生对全程导师指导培养表示满意,91.5%的学生认为带教导师在技能培训方面称职,76.0%的学生认可导师制对学习质量提高有价值。结论临床教学本科生导师制对提高临床教学和学生培养质量有积极意义。     

对高等医学院校本科生实施导师制的探讨

本科生导师制（tutorial system）的发展是我国高等教育发展的必然趋势。本文结合导师制的渊源，分析了导师制在大学教育中的作用，提出了在医学院校实行本科生导师制的设想及实施方法。     

双导师制带教模式应用于实习生带教管理中对学生专业技能的影响

目的:探究双导师制带教模式应用于实习生带教管理中对学生专业技能的影响.方法:选取2015年9月至2016年6月在我院实习的40名护理本科生参与研究,将50名实习生分成两组,每组各20人,一组实施常规带教模式(对照组),另一组实施双导师制带教模式(观察组).比较两组实习生在期中、期末时专业能力考核分数.结果:对照组实习生的考核成绩均低于观察组学生,且差异具有统计学意义(P<0.05).结论:双导师制带教模式能够全面提高护理本科生的专业能力、自我发展能力,促进科研能力和护理能力提升,给学生学习带来较大的帮助,值得广泛推荐和应用.     

医学院校实行本科生导师制探讨

导师制是教书育人的一条重要途径。本文从目前国内外形式以及学分制改革因素影响下，探讨高校教育改革的模式，提出了在医学院校实行本科生导师制的设想，并初步提出了在医学院校实行本科生导师制的具体实施方法。为医学院校适应新形势要求，加大教学改革力度提供了选择。     

完善本科生导师制,培养高素质的医学人才

本科生导师制是提升学生的综合素质的有效途径,文章阐述了医学院校实行本科生导师制的重要性和必要性,分析了医学院校实行导师制所面临的具体问题,对如何实行导师制提出了建议和对策。     

军医大学本科生导师制的优化

军医大学实行本科学员导师制,可与学员队管理模式相互补充,相得益彰,本文从优化本科生导师的遴选范围与方法,探索学员选择导师的最佳途径、接受辅导的最佳方式,明确学员的辅导需求,并量化分析导师指导的实际效果等方面,探讨了军医大学本科生导师制进一步优化完善的对策与建议。     

浅论中医院校本科生科研素质培养

中医院校本科生同样也需要较高的科研素质来适应现代医学科技的发展,但目前普遍地存在缺乏基本科研素质的现状。中医院校本科生的科研素质教育不同于临床医学技能教育,不能要求掌握太多的学习内容,而应该在基本科研思维、基本科研技能和基本科学态度上加强"三基"教育,通过课堂教学、第二课堂或实施本科生导师制等方法来逐步提高中医本科生的科研素质,使之具备未来从事科研的可能性,从而逐步提高中医科研水平。     

“一对一”亲情导师制模式在新员工医患沟通能力提升中的重要性研究

目的:通过“一对一”亲情导师制带教模式的引入和实施,探索新入职医护人员医患沟通能力的培养与管理方法?方法:采用自身对照?对照组对照的方法,比较实行“一对一”亲情导师制带教模式前后新入职医护人员在医患沟通能力方面的效果?结果:实施“一对一”亲情导师制带教模式后,新入职医护人员在人际交往和沟通能力等方面有了明显提高,减少了因沟通不良导致的医疗纠纷的发生,提升了患者满意度?结论:“一对一”亲情导师制带教模式,有利于增加师生的互动交流?通过开展医患沟通课程,增强了新员工的沟通意识和沟通技能,切实提高临床工作中医?患?护三方满意度,降低护患纠纷的发生率,提高了新入职医护人员的职业认同感?     

Modeling the Problem-based Learning Preferences of McMaster University Undergraduate Medical Students Using a Discrete Choice Conjoint Experiment

Objectives: To use methods from the field of marketing research to involve students in the redesign of McMaster University’s small group, problem-based undergraduate medical education program. Methods: We used themes from a focus group conducted in an electronic decision support lab to compose 14 four-level educational attributes. Undergraduate medical students completed a discrete choice experiment composed of 15 web-administered, partial-profile, conjoint-choice tasks. Results: Latent class analysis revealed two segments with different preferences. Segment 1, (86% of students), preferred a problem-based approach with more small group tutorial sessions led by expert tutors who facilitated the tutorial process without teaching didactically. Segment 2, (14% of students), preferred more large group lectures, explicit learning objectives, expert tutors who taught didactically, and streaming options based on learning preferences. Although Segment 1 preferred smaller tutorial groups, simulations predicted these students would trade increases in tutorial group size for a conceptually integrated program that included tutorial problems based on core curriculum concepts, greater integration of the content of clinical skills training sessions and the tutorial curriculum, and a link between clerkship patient selection and the program’s curriculum. A majority of both segments would accept a more conceptually integrated program if the savings associated with increases in tutorial group size was reinvested in web-enhanced tutorial processes and computer-simulated health care problems. Conclusions: Most students preferred a small group, web-supported, problem-based learning approach led by content experts who facilitated group process. Students favored a program in which tutorial group problems, clinical skills training sessions and the patients selected for clerkship activities were more closely linked to core curriculum concepts.     

Computer-Assisted Instruction Improves Clinical Reasoning Skills of Dietetics Students

Objective The effects of a computer-assisted instruction (CAI) tutorial program on learning clinical reasoning skills were compared in undergraduate dietetics students.Design A drill-and-practice program to control for time on task, a tutorial program, and a simulation program, as the test vehicle, were developed. The tutorial and simulation programs presented data on a patient with cardiovascular disease.Setting Subjects were tested in 30 undergraduate dietetics programs.Subjects Participants were 413 undergraduate diet therapy students enrolled in a coordinated program in dietetics (CPD) or a didactic program in dietetics (DPD).Intervention After completion of lectures on cardiovascular disease, subjects were given the drill-and-practice program plus a simulation test (group 1), the tutorial plus a simulation test (group 2), or the simulation test only (group 3).Main outcome measures Scores on the simulation test were compared. Variables included type of CAI, dietetics program, year in school, computer experience, and experience using a medical chart. Mastery of objectives related to lower- and higher-level clinical reasoning skills introduced in the tutorial program was compared.Statistical analysis One-way analysis of variance and Student-Newman Keuls tests were conducted to determine any differences among the three groups. Reliability was determined using the Kuder-Richardson Formula 20.Results The reliability coefficient of the simulation test was 0.93. Group 2 scored higher on the simulation test than group 1 or group 3. As a group, the CPD students scored higher than the DPD students. When CPD and DPD students were divided into the three experimental groups, there was no significant difference between the CPD and DPD student simulation scores. Group 2 mastered all objectives for lower-level reasoning skills and the higher-level decision-making objective better than groups 1 and 3.Applications/conclusions A computer tutorial program enhanced clinical reasoning skills in undergraduate dietetics students. This type of program could be used to supplement many topics taught in diet therapy and provide DPD students with experiential learning before their clinical intern practicums. J Am Diet Assoc. 1995; 95:868–873.     

Evaluation of an Interactive Case-based Online Network (ICON) in a Problem Based Learning Environment

Purpose: This study sought to assess the introduction of a web-based innovation in medical education that complements traditional problem-based learning curricula. Utilizing the case method as its fundamental educational approach, the Interactive Case-based Online Network (ICON) allows students to interact with each other, faculty and a virtual patient in difficult neurological cases. Given the paucity of available metrics to benchmark online systems, we complement user perceptions with data on system utilization. Methods: We describe a case study of distinct, small group tutorials over 2 years as part of the Human Nervous System and Behavior (HNSB) course at the Harvard Medical School. Participating students and faculty were interviewed following completion of the course and their utilization of the system was recorded and examined. Results: Students each spent 3.2±1.3 h (mean±SD) through 8.6±2.8 accessions per week using ICON outside of required tutorial time. Faculty each spent 4.8±3.4 h through 16.6±8.9 accessions per week on ICON. Students identified real-time engagement, stronger relationships with faculty, increased accountability to the tutorial group and self-selected pace as the most beneficial characteristics of the ICON-based tutorial in comparison to traditional problem based learning (PBL) tutorials. Faculty identified enhanced collaboration with students and more realistic student experiences as the most beneficial characteristics. Both students and faculty reported that limitations of ICON included increased time investment for faculty and increased reliance on good faculty mentorship. Conclusion: This is the first study of the ICON learning system in undergraduate medical education, a platform designed to facilitate collaboration outside of the classroom. Data on user perceptions and system utilization suggest that both faculty and students chose to adopt this online learning system as a means for collaboration. The study also outlines future avenues for research in assessing novel online technologies.     

Use of commercial ''authoring systems'' for medical education

A recent development in computer-assisted medical instruction has been the introduction of 'authoring systems'. Authoring systems are computer programs which can allow an instructor to prepare computer-based medical instructional materials without the need to know programming languages or have more than minimal familiarity with the computer hardware. This report documents the use of a commercially available authoring system that was used to prepare a tutorial for medical student instruction. This lesson presented information about paediatric developmental disabilities in both a text and question-and-answer format. Significant improvement in knowledge was demonstrated by the pre- and post-test results of the study group compared to the control group. The control group consisted of students who did not view the tutorial but had been assigned to a paediatric developmental disabilities clinic. The medical students who viewed the tutorial generally had very favourable comments about the use of such a system for the presentation of new information.     

Can medical students contribute to quality assurance programmes in day surgery?

CONTEXT AND OBJECTIVES: Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to QA processes as part of an undergraduate day surgery educational programme. SUBJECTS AND METHODS: Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to the QA processes as part of an undergraduate day surgery educational programme. SUBJECTS AND METHODS: Fifty-nine final year medical students followed allocated patients with common surgical conditions through all phases of the day surgery process. Students kept records about each case in a log book and also presented their cases at weekly Problem Based Learning tutorials. An audit of student log books and review of tutorial records was conducted for the 1996 and 1997 academic years, in order to evaluate student contribution to QA. RESULTS: Students followed 621 cases, representing a sampling of 14. 1% day surgery cases. Categories of problems highlighted by students included inappropriate patient and procedure selection, inadequate pain management, discharge, communication and resource issues. Students made a number of recommendations including the development of multilingual videotapes and patient information sheets for non-English speaking patients, avoidance of bilateral surgical procedures and improved links with local medical officers. They also developed new guidelines and protocols. CONCLUSIONS: Our study confirms that students are able to identify QA issues and propose solutions. We recommend that students have a formally recognized place in day surgery QA programmes, to close the QA loop and to adequately prepare them for medical practice in the 21st century.     

Students' views of reflective learning techniques: an efficacy study at a UK medical school

OBJECTIVE: To describe the effects of a voluntary intervention using reflective learning techniques on students' learning. DESIGN: An interventional study with reflective learning techniques offered to medical students. SETTING: Year 3 of undergraduate medicine at Cardiff University where the curriculum is integrated with early clinical contact. PARTICIPANTS: All 232 Year 3 students were invited to participate. A total of 65 attended an introductory lecture. After the lecture 35 students agreed to take part; 15 of these subsequently dropped out (some before attending tutorial groups, others after taking part for some weeks). INTERVENTIONS: Participants kept learning journals for 2 terms and attended fortnightly, facilitated tutorial groups where they discussed their reflective journal entries. Main outcome measures were qualitative interviews and examination results. RESULTS: Interviews were carried out with 19 full participants, 4 initial participants and 7 non-participants. Participants perceived that they gained a greater ability to identify learning objectives and to integrate learning. The tutorial groups encouraged students to compare progress with their peers. Some students did not take part because they thought that the large factual content of the curriculum would make reflective learning less useful. There were no differences between the groups in examination results. CONCLUSIONS: Students among the small, self-selected group of participants were better able to identify what they needed to learn although there was no improvement in examination results. Students appear unlikely to take up voluntary reflective learning if they do not think it relates to the curriculum and assessments. Student culture exerts a potent effect on willingness to attend extra tutorial groups.     

Providing access to blacks and Hispanics in dietetics education

To increase the number of blacks and Hispanics in dietetics and three other health professions, the Health Sciences Recruitment and Retention Program was developed and implemented in 1985 by the College of Health at Florida International University in Miami. The coordinated undergraduate program assisted in a federal grant to accomplish the objectives of recruiting and retaining minority students. High school and community college students were recruited using a slide/tape presentation featuring black and Hispanic professionals. In addition, the college offered a summer course entitled "Perspectives of the Health Sciences Professions" to students entering their senior year in high school. In this course, students learned how dietitians, medical laboratory scientists, and physical and occupational therapists treat various disease states. Field trips and site visits provided additional exposure to the professions. A summer orientation and tutorial program was established to retain minority students enrolled in the coordinated undergraduate program. We recommend that this program be considered as a model for dietetics educators to use in developing other programs to increase the number of minorities in the profession.     

Evaluation of procedural skills training in an undergraduate curriculum

CONTEXT: A substantial proportion of medical students enter their intern year without any basic skills experience. Lack of experience is a significant source of stress for many junior doctors. OBJECTIVES: To evaluate the effect of a basic procedural skills tutorial for Year 3 medical students on their competence in relevant skills at Year 5. SUBJECTS: The control group consisted of 93 medical students who completed Year 3 in 1996. The intervention group consisted of 92 medical students who completed Year 3 in 1997. The intervention group received a practical skills tutorial in Year 3; the control group did not. Both groups were assessed on their practical skills competence during Year 5. METHODS: A 3-hour practical tutorial on injection and suturing techniques was delivered to the intervention group. The effectiveness of the intervention was assessed by self-reported experience of giving injections, inserting sutures and sustaining needlestick injuries, and by teacher-rated competency in four basic procedural skills. RESULTS: Students who received the Year 3 tutorial were significantly more likely to record a satisfactory assessment for their performance in all four basic skills compared with students who did not receive the tutorial. They were less likely than controls to refuse invitations to give injections, but not invitations to insert a suture, during Years 4 and 5. CONCLUSIONS: A single session of formalised teaching in procedural skills in the early stages of a medical degree can have long-term effectiveness in basic skills competence and may increase students' confidence to practise their skills.