Unchanging dilemmas in American medical education

The author reviews "the lietmotiv of unresolved dilemmas" in American medical education: the problems of determining the premedical and medical school curricula and of selecting medical students. She offers suggestions for each area, but cautions that there are no simple answers.     

A review of medical education and medical informatics

Physicians have considerable difficulty collecting and interpreting information from patients, dealing with the uncertainties associated with diagnosing and treating their patients, communicating precisely with one another, keeping up to date, and applying recommended procedures when indicated. Some of the advances in information technology may help physicians to manage information more effectively through more accessible, validated clinical indexes, data bases of diagnostic test characteristics, computerized audits of clinical activities with feedback, expert systems, on-line access to the medical literature, and other tools of medical informatics. Medical educators can catalyze this process by facilitating the introduction of information technology into academic clinical settings so that students can learn its use first-hand and by promoting the evolution of this and other aspects of medical informatics, a new discipline dedicated to the solution of information problems in health care. The potential roles for computer-aided instruction and centralized computer laboratories in medical schools are much less clear.     

美国外科继续医学教育对我国外科继续教育的启示

<正>医学是一门需要终生学习的职业,医生需要不断学习以满足临床工作需要。继续医学教育(Continuing Medical Education,CME)旨在引导医生获取相关领域的最新知识动向,拓展业务能力。本文作者曾于美国匹兹堡大学医学中心外科、麻省总院外科做访问学者,亲身感受了美国的外科继续教育,认为其值得探讨与借鉴,现就其对我国外科继续教育的启示作用总结如下。1课程设置丰富、教育形式灵活多样     

An overview of medical informatics education in China

ObjectiveTo outline the history of medical informatics education in the People's Republic of China, systematically analyze the current status of medical informatics education at different academic levels (bachelor's, master's, and doctoral), and suggest reasonable strategies for the further development of the field in China.MethodThe development of medical informatics education was divided into three stages, defined by changes in the specialty's name. Systematic searches of websites for material related to the specialty of medical informatics were then conducted. For undergraduate education, the websites surveyed included the website of the Ministry of Education of the People's Republic of China (MOE) and those of universities or colleges identified using the baidu.com search engine. For postgraduate education, the websites included China's Graduate Admissions Information Network (CGAIN) and the websites of the universities or their schools or faculties. Specialties were selected on the basis of three criteria: (1) for undergraduate education, the name of specialty or program was medical informatics or medical information or information management and information system; for postgraduate education, medical informatics or medical information; (2) the specialty was approved and listed by the MOE; (3) the specialty was set up by a medical college or medical university, or a school of medicine of a comprehensive university. The information abstracted from the websites included the year of program approval and listing, the university/college, discipline catalog, discipline, specialty, specialty code, objectives, and main courses.Results and conclusionsA total of 55 program offerings for undergraduate education, 27 for master's-level education, and 5 for PhD-level education in medical informatics were identified and assessed in China. The results indicate that medical informatics education, a specialty rooted in medical library and information science education in China, has grown significantly in that country over the past 10 years. Frequent changes in the specialty's name and an unclear identity have hampered the visibility of this educational specialty and impeded its development. There is a noticeable imbalance in the distribution of degree programs in medical informatics in different disciplines, with the majority falling under information management. There is also an uneven distribution of the specialty settings of medical informatics at the various academic levels (bachelor's, master's, and doctoral). In addition, the objectives and curriculum design of medical informatics education differ from one university to another and also from those of foreign universities or colleges. It is recommended that China (1) treat medical informatics as a priority “must-have” discipline to build in China, (2) establish its own independent, balanced degree programs, (3) set up a specialty of “medical informatics” under the “medicine” category, (4) explore curriculum integration with international medical informatics education, and (5) establish and improve medical informatics education system.     

An analysis of lecture video utilization in undergraduate medical education: associations with performance in the courses

Background  

Increasing numbers of medical schools are providing videos of lectures to their students. This study sought to analyze utilization of lecture videos by medical students in their basic science courses and to determine if student utilization was associated with performance on exams.     

Stress management in medical education: a review of the literature.

PURPOSE: To review systematically clinical studies providing empirical data on stress-management programs in medical training. METHOD: The authors searched Medline and PSYCHINFO from 1966 to 1999. Studies were included if they evaluated stress-management programs for medical trainees (medical students, interns, or residents); reported empirical data; and had been conducted at allopathic medical schools. RESULTS: Although the search yielded over 600 articles discussing the importance of addressing the stress of medical education, only 24 studies reported intervention programs, and only six of those used rigorous scientific method. Results revealed that medical trainees participating in stress-management programs demonstrated (1) improved immunologic functioning, (2) decreases in depression and anxiety, (3) increased spirituality and empathy, (4) enhanced knowledge of alternative therapies for future referrals, (5) improved knowledge of the effects of stress, (6) greater use of positive coping skills, and (7) the ability to resolve role conflicts. Despite these promising results, the studies had many limitations. CONCLUSION: The following considerations should be incorporated into future research: (1) rigorous study design, including randomization and control (comparison) groups, (2) measurement of moderator variables to determine which intervention works best for whom, (3) specificity of outcome measures, and (4) follow-up assessment, including effectiveness of future patient care.     

约束关联规则挖掘在医疗数据分析中的应用

目的 探讨关联规则挖掘在医疗数据分析中的应用研究.方法 通过分析医疗数据的特点,将约束应用到医疗数据的关联规则挖掘中,提出了一种有效挖掘医疗数据关联规则的约束关联规则挖掘算法CAMD,并采用该算法对冠心病病例进行关联分析.结果 以冠心病诊断的数据集为例,设置最小支持度和最小置信度分别为20%和60%,病例数为303例,得到关联规则8条.这些规则揭示了年龄、性别、心电图结果等因素与冠心病的发生和诊断之间的关联关系.结论 CAMD算法不产生候选项集,扫描数据库的次数较少,能够大大减少产生无用规则的数量,快速发现有趣的医疗关联规则.     

近5年医学教育研究热点分析

目的 探索医学教育研究的热点主题,为医学教育的科学发展提供参考.方法 采用文献计量学方法确定医学教育高频主题词,并对其进行聚类分析.结果 课程改革、教学模式、教育管理与标准、医学生临床能力与评价和医学生职业素养是目前医学教育研究人员较为关注的内容.结论 为了促进医学教育,教育者需要重视教育质量的提高以及理念与方法的创新.     

Role-playing in medical education: An experience from public role-players

ObjectiveWe aim to explore the lived experiences of public role-players from the aspects of benefits, barriers, and enablers of role-playing in a medical school in Malaysia.MethodsA mixed-method study was performed involving 15 community dwellers who been engaged as role-players with Newcastle University Medicine in Malaysia. Participants answered a brief questionnaire followed by taking part in semi-structured interview. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic approach.Results86.7% of the participants strongly agreed that they had better medical knowledge after participating. Seven themes emerged under the three categories of perceived benefits, challenges, and recommendations: understanding and medical knowledge, and practical application, other benefits of role-playing, emotional upheaval, understanding medical jargons, improving the role-playing quality, and translating the experience gained into the community setting.ConclusionThe public role-players acknowledged their role positively and recognized refinement in their interpretation of medical knowledge and health. The public role-players were enthusiastic in using their knowledge acquired by upskilling themselves for community health programs and initiatives.     

加强病例讨论，努力搞好素质教育

病理生理学是一门与临床医学关系密切的桥梁性学科 ,其主要任务是研究疾病发生的原因和条件 ,疾病过程的机能、代谢的动态变化以及这些变化的发生机制 ,揭示疾病发生、发展和转归的规律。因此 ,病理生理学不仅要求学生学习前人已总结出的理论知识 ,而且更应培养学生用所学的理论知识对疾病 (包括复制的动物疾病模型和临床实际病例 )进行综合分析的能力。医学教育的目的是培养促进全体人民健康的医生 ,因此 ,它要求受教育者必须掌握作为医生所应具备的基本理论、基本知识和基本技能 ,即解决问题的能力 ,为社会培养具有创新精神的人才。本文旨…     

Global health competencies and approaches in medical education: a literature review

Background  

Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training.     

Factors influencing patient education in shared medical appointments: Integrative literature review

ObjectiveThis integrative literature review investigates the factors influencing patient education in Shared Medical Appointments.MethodsFollowing template analysis method, we used key concepts of the Social Cognitive Theory (SCT) and Social Constructivism as a priori themes. After detailed analysis of the included studies, we deduced subthemes, forming a final template. Based on this final template, we analysed our data again as a final check.ResultsWe included 22 studies. We found that the factors feeling of bonding, humour, feeling of safety, access to information, time, relationship participants-staff, modelling and self-regulation influence the education of SMA participants. Furthermore, we found that health care providers function both as leaders and peers.ConclusionWe found eight factors that influence the education of SMA participants. Health care providers exert influence on these factors, but in turn, they are also influenced by them in their transfer of knowledge.Practice implicationsIn order to create a climate of learning and to promote transfer of knowledge, these eight factors should be considered. Health care providers should be aware of their roles and they might need some extra skills for their leadership roles. This can also lead to practical implications for the curriculum in medical schools.