“卓越”究竟意味着什么：关于卓越医学人才培养的几点思考

“卓越医生教育培养计划”是由教育部、卫生部共同组织实施的医学人才培养重大改革项目,其目的就是要解决医学人才培养中存在的突出问题, 遵循教育规律,接轨医学教育全球标准和最基本要求,培养合格的临床医生。“卓越”的内涵也不是追求高、精、尖,而是要根据医疗卫生事业不同岗位的要求,通过精英教育的途径和方式,不断推进医学人才培养模式改革,努力提高人才培养质量,以适应卫生事业发展和医疗卫生体制改革与发展的需要。     

医学生考试违纪的分析与思考

本文通过对我校1993～1997年考试违纪的回顾,较系统地分析了违纪的类型、特点、成因、预防措施及处理原则,以期提高教育质量,促进教学改革。     

Disability, identity and the "expressivist objection"

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed "the expressivist objection". In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an "identity claim" to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling.     

Sinning against nature: the theory of background conditions

Debates about the moral and political acceptability of particular sexual practices and new technologies often include appeals to a supposed imperative to follow nature. If nature is understood as the totality of all phenomena or as those things that are not artificial, there is little prospect of developing a successful argument to impugn interference with it or sinning against it. At the same time, there are serious difficulties with approaches that seek to identify "proper" human functioning. An alternative approach is to understand interference with nature as acting in a manner that threatens basic background conditions to human choice. Arguably, the theory of background conditions helps explain much of the hostility to practices and technologies that allegedly sin against nature. The theory does not, however, entail that appeals to nature are relevant or rational. Such appeals should be subjected to sceptical scrutiny. Indeed, the theory suggests that arguments against practices and technologies that can be seen as contrary to nature sometimes exercise a psychological attraction that is disproportional to their actual cogency.     

基于关键成功要素的医院绩效考核指标体系探索

随着医疗市场的竞争不断加剧,国内各医院开始纷纷转向内涵式的发展模式,战略管理和绩效管理的思想被逐渐引进广大医院的管理实践中。在目前国内缺乏统一标准的医院绩效考核体系的前提下,如何建立基于关键成功要素的绩效考核指标体系成为关键所在。分析T医院对绩效考核指标体系的探索,期望能够为国内同类医院提供借鉴和参考。     

论民族传统体育文化与大学生人文素质教育

笔者通过对文献资料的综合研究，从人文社会学的视角结合民族传统体育的本质特点，联系自身从事高校体育教育工作的实践，论述了中华民族传统体育中蕴含的丰富文化和人文资源内涵。民族传统体育的丰富文化和内涵是高校实施人文素质教育的重要资源，在当今日益强调人文素质教育的背景下，民族传统体育确实不失为高校实施人文素质教育的一种有效模式和重要途径。     

新时代临床医学本科教育“课程思政、专业思政”的对策研究

立德树人是高校教育的根本任务,医学教育更应如此。近年来,医德问题常成为公众关注的焦点。医疗不良事件的发生不仅使公众对医务人员的职业信任度降低,也给临床医学专业学生带来职业迷茫与困惑。重庆医科大学从2018年开始探索如何在临床医学专业本科人才培养中落实"课程思政""专业思政"。本文通过部分实例,探讨了如何将"思政"融入理论教学的教材、教学大纲及课程设计,如何在临床示教、技能培训、入科教育、教学查房等实践教学活动中加强医学职业道德、职业态度和职业价值观的培育,以及如何在学生管理、教学团队建设及师生考核标准中强化"思政",形成与理论教学、实践教学互相补充、互相促进的临床医学专业"课程思政、专业思政"育人体系,希望能为其他医学院校提供参考。     

Are the recommendations being met in the general practice year of vocational training? Trainees' views in the West Midlands region

Vocational trainees in the West Midlands who were in their general practice year were sent a postal questionnaire to find out whether there were important differences between the criteria for training of the 1986 West Midland postgraduate education committee (based on national recommendations) and the perceptions of the trainees of their current trainers and practices. The response rate was 86.2% (75 out of 87). Sixty four per cent (48) of trainees reported that they received on average less than the recommended minimum of three hours of teaching time a week. They felt that experience was inadequate in paediatric surveillance (62.7%) and preventive medical care (37.3%). Most trainers gave topic teaching (90.7%), and few used role play (5%). Most of the trainees (52%) had not signed a contract, a third did not get help with recommended allowances, and 37% thought that their progress had not been reviewed. Several trainees commented on the excellence of their training practices, and most of the practices appeared to be keeping to the spirit of the recommendations. There are, however, discrepancies between what some trainees feel they receive and what is recommended.     

多学科视角下的高考作弊现象分析

高考作弊的现象已是一件不争的事实,全国各地各级管理部门实施了很多监督和惩罚措施依然不能杜绝。经济学认为,高考作弊是一场风险与收益的博弈;社会学认为,高考作弊是社会扭曲的价值观所致;教育学认为,高考作弊是教育本质异化的使然。采用不同学科的分析视角来诠释高考作弊,目的是找到更好的办法维护高考的公正性。     

对目前体育课程与教学改革的反思

针对当前基础教育阶段体育与健康课程改革实践过程中出现的一些问题进行剖析，认为造成这些现象的主要原因是教师未能深入的理解和学习新课程标准的内容，未能领会新课程的精神实质、改革目的等，体育课程改革应在继承和创新中发展完善。     

PDS线环行加"8"字内固定治疗髌骨骨折

目的一种治疗髌骨骨折的内固定方法.方法PDS线环行加"8"字内固定治疗髌骨骨折30例.结果随访12～18个月,平均15个月,优23例,良4例,可3例.优良率90%.结论pDS线环行加"8"字内固定是治疗髌骨骨折的有效方法,无需二期手术取出内固定.     

The use of patients in health care education: the need for ethical justification.

This paper addresses ethical concerns emanating from the practice of using patients for health care education. It shows how some of the ways that patients are used in educational strategies to bridge theory-practice gaps can cause harm to patients and patient-practitioner relationships, thus failing to meet acceptable standards of professional practice. This will continue unless there is increased awareness of the need for protection of human rights in teaching situations. Unnecessary exposure of patients, failing to obtain explicit consent, causing harm to vulnerable or disadvantaged groups and inappropriate use of information, though normally regarded as unacceptable professional practices, may go unrecognised in meeting educational needs, widening rather than narrowing theory-practice gaps.     

对高师体育院系足球普修课教学的思考

随着教育改革的不断深入，高校体育教学的内涵已经在本质上发生了重大变革，运动参与、运动技能、身体健康、心理健康与社会适应5个学习领域的教育理念应得到充分的体现和强化，因此根据体育院系足球普修课实际情况，体育教学、训练原理和足球运动的规律，运用系统化、程序化的教学模式和手段，在有限的授课时间内，充分利用科学的教学措施、发挥教师的主导作用和培养学生能力，以及建立健全考核制度等，提高足球普修课教学质量。     

老年骨折患者治疗管理中“动”与“静”的辩证思考

在人口老龄化的大趋势下,针对老年骨折患者这一群体的特殊性,结合现代骨折治疗进展,重点回顾分析了“动静平衡”理念在老年骨折患者治疗管理中的应用和注意点,探讨在老年骨折患者治疗过程中如何动态把握动与静的辩证统一关系,认识其内在规律,为老年骨折治疗管理提供指导和帮助。     

Implementing description-logic rules for SNOMED-CT attributes through a table-driven approach

Maintaining a large controlled biomedical vocabulary requires ensuring the content''s internal consistency. This is done through rules, specified by the vocabulary''s curators, which denote how the vocabulary''s concepts should be defined. When individual organizations deploy such vocabularies, local concepts are typically added and linked to concepts in the main vocabulary: the process of maintaining and linking local content should follow the same rules. The operation of content-maintenance software can be facilitated by maintaining such rules in computable form. In this paper, we demonstrate how to implement computable rules for attribute usage in SNOMED CT using a table-driven approach where a given rule is expressed as one or more rows in a table and is consulted by generic code. This approach, which is tailored to database implementations, is computationally efficient and allows new attribute-definition rules to be created as data while needing minimal or no code modification.     

地方医学院校学生作弊的原因分析

大学生考试作弊现象一直是困扰高校教育管理者的一个难题,也是影响学风校风建设的一个重要因素。通过对医学生作弊现象的调查分析,发现考试作弊现象的症结所在,以期找到相应的解决方法和对策,减少考试作弊的发生率。     

论防御性医疗行为

防御性医疗行为既是医学问题，也是道德和法律研究的范畴。从防御性医疗行为的概念和历史沿革谈起，深入分析其产生的主要原因并结合医学伦理学、法学的基本原则进行深入的思考。从医事立法、强化医生的职业道德、建立健医院内部监督机制三个角度。对立法机关、医院、政府提出了减少防御性医疗行为的相应对策建议。     

Who is my brother's keeper?

Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might be expected to use their energy and scholarship to explore and endorse the universalisability of ethics rather than to develop ad hoc arguments that would allow exceptions and variations from accepted moral standards. To this purpose, issue will be taken with arguments in three fields: medical and pharmaceutical practices, research strategies, and local application of research results.     

医学教育的质量保证

本文指出医学教育面临挑战和改革的要求,医学人才培养质量受到关注。为了做好质量保证工作,建立一套标准是重要的。简要介绍了全球医学教育标准。认证是外部质量保证机制,建立认证制度和相应的机构是必要的。对与内部质量保证有关的领导责任、教师作用和学生参与作了讨论。     

回归大学本位扎实推进地方综合大学卓越医学教育

为贯彻落实教育规划纲要,服务医疗卫生体制改革,国家制定“卓越医生教育培养计划”实施意见,卓越医学教育成为当前我国高等医学教育的重点工作.地方综合大学高等医学教育应认真落实意见要求,牢固树立卓越医生培养的社会责任与使命感,探索建立卓越医生教育培养新模式,着力构建卓越医生教育培养新平台与新机制,让卓越医学教育落到实处,把我国医学教育提高到一个新的水平.