美国儿科住院医师及新生儿-围生期医学专科医师规范化培训体系简介

毕业后医学教育是所有临床医师在医学院毕业后走上独立行医之前必须要经过的一个阶段。中国目前推行的毕业后医学教育是借鉴和参考了美国加拿大等发达国家多年来实行的临床执业医生培养体系,其目的是建立一套培训制度来保证所有的临床执业医师都达到并维持一定的行医水准。在此,文章简单介绍了美国儿科住院医师及新生儿-围生期医学专科医师规范化培训体系及现状,并阐述了美国儿科专业委员会和毕业后医学教育认证委员会的重要作用。     

基层儿科医师培养体系建设

基层儿科医师培养体系包括4个层面的建设模式:住院医师规范化培训(住培)中全科医师的儿科专业训练、普儿科专科医师规范化培训(专规培)、社区在职全科医师技能培训和全科儿科专委会组织的全科医生继续教育,规范化、同质化的培养将有助于完善各级儿童卫生服务体系,改变目前基层儿科临床医师短缺现象。     

模拟医学教育在儿科住院医师培训中的应用

模拟医学教育（simulation-based medicine education,SBME）是指应用医学模拟设备或模拟人设计模拟临床场景,以交互式的方式取代真实医疗场景中的实质内容,代替实际病人实行临床教学的方法。模拟在儿科住院医师培训中尤其重要,大量循证证据证实,模拟培训在住院医师培训中应用,保障患者的安全,改善了患者的预后。该文主要通过阐述模拟医学教育在儿科住院医师培训中应用原则,理论依据,主要内容以及模拟中心建立的方法,拟推动国内儿科住院医师培训中模拟培训的进一步发展。     

罕见病儿科医师培训

罕见病的儿科医师培训是罕见病工作面临的诸多挑战和难点之一。应充分认识培训重要性,密切关注国内罕见病相关政策和规定,科学客观根据罕见病疾病特点以及各地罕见病患者诊治需求,分层次、按需求、重实践地有序开展罕见病儿科医师培训,旨在使罕见病患者最大获益。     

儿科急诊医务人员培训体系建设

儿科急诊医学发展的关键在于培养专业人才.本文简要介绍美国等发达国家儿科急诊医护培训体系,分析我国存在的主要问题,提出发展建议.     

全球儿科重症监护医师网络学术交流平台建设

背景互联网技术发展带来了史无前例的国际合作和学术共享,但到目前为止,该技术尚未充分用于增进全球儿科重症监护医师学术共享。目的在世界儿科危重症学会的帮助下,建立开放式、同行评议式、非盈利性在线学习软件OPENPediatrics,旨在增进全球儿科危重病医师、护士及其他医疗相关人员的继续教育学术共享。设计程序开发介绍。场所覆盖6大洲的多家三级PICU,为国际性多中心研究。对象各专业儿童重症监护医护人员。干预措施一款应用软件,可按需求提供信息,提供网络课程、视频会议和下载服务。测量指标和主要结果2010年,世界儿科危重症学会及下属各分会调查并评估了儿科危重症医护人员继续教育需求。49个国家共429名重症医护人员回复了调查邮件,其中医生占68％,护士占28％。52％回复至少每周上网1次以获取专业教育信息。教育需求排名前5的分别为呼吸监护（机械通气）[48％（38％）],脓毒症（28％）,神经病学（25％）,心脏病学（14％）,体外膜肺氧合（10％）及伦理学（8％）。基于这些结果,通过与成人教学和在线课程研究者合作,我们研发了这款应用软件,现已有60个国家共770名注册用户。结论本文介绍了一项在线应用软件的开发和应用,该软件主要用于增进全球儿童危重症医护人员间的学术交流。该软件可能将成为一种新的继续教育模式,有必要对在线学习平台的有效性进行持续评价。     

《临床儿科杂志》举办2015年度继续医学教育函授班通告北大核心CSCD

经《临床儿科杂志》编委会讨论决定,从2014年下半年起举办2015年度继续医学教育函授班,具体方法如下。     

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??Post-graduation medical education is the only way for pediatric medical graduates to become qualified pediatric clinicians?? which play a key role in the process of pediatricians becoming talented. Post-graduation medical education in China has been continuously institutionalized and standardized?? and has achieved remarkable progress. However?? there are still many problems in the implementation process. The author will carry out in-depth analysis concerning the national policy?? base construction?? teacher construction and students themselves?? propose countermeasures and suggestions for existing problems?? and provide ideas for the formation of an efficient and sustainable mechanism for pediatric talent training.     

A training needs survey of doctors' breastfeeding support skills in England

The study examined the training needs of paediatricians and general practitioners (GPs). Respondents rated their competence on 23 breastfeeding support skills, importance of update in the next 2 years, actual and potential helpfulness of different forms of professional updates, and accessibility in the next 2 years. The perception of organizational barriers to breastfeeding support and practitioners' knowledge of policies and guidance on breastfeeding were also examined. The sample comprised 120 paediatricians and 57 GPs. Response rates were estimated as between 4% and 29%, depending upon the method of recruitment. Although both groups rated themselves as fairly competent in most of the skill areas, they welcomed training in key areas of practice. Paediatricians identified more areas for update than GPs ( t  = 3.44; d.f. = 178; P  < 0.00001). Those who believed that they were less competent in clinical skills were least likely to seek update ( r  = 0.35; P  < 0.00001). Practical forms of training were most often welcomed. Only 47% of GPs and 62.5% of paediatricians had access to a local breastfeeding policy. There were evident gaps in knowledge on key aspects of public health policy, which could influence local practice; for example, 50.8% of GPs and 47.5% of paediatricians identified a younger age for introducing solids than the minimum according to current government guidance. Organizational barriers to breastfeeding support were experienced by all respondents. Recommendations include purposively targeting training to those least likely to seek training, and developing effective self-study and observational methods of learning. All training should be evaluated and implemented alongside breastfeeding policies and clinical leadership to improve the practice of all healthcare practitioners.     

《住院医师规范化培训基地认定标准》和《住院医师规范化培训内容与标准》修订的解读

住院医师规范化培训(住培)是医学生成长为合格医生的必由之路。自2014年国家全面推行住培,儿科住培工作总体进展顺利,取得有目共睹的成绩。为进一步适应住培现状,符合全国儿科培训需求,提高儿科培训质量,儿科专业委员会组织专家代表集思广益,对儿科《住院医师规范化培训基地认定标准》和《住院医师规范化培训内容与标准》两个标准进行适当修订。修订标准遵循两个标准的延续性、可及性、先进性和一致性原则。主要聚焦降低基地规模、提出专业组概念、灵活专业轮转、强化分层培训等,以期在床位规模等不提高前提下,能提高基地培养住培学员临床科研和教学等综合能力。相信通过良好政策引导和支持、医教协同,儿科住培体系将为儿科医学人才培养提供坚实基础。     

The state of the science for communication training in pediatric oncology: A systematic review

Within the field of pediatric oncology, communication skills training (CST) has been recognized as a high priority by professional and accrediting organizations. However, the effectiveness of formalized CST interventions for pediatric oncology providers remains poorly understood. We systematically searched PubMed, Web of Science, Scopus, and PsycInfo for original research articles assessing the effectiveness and quality of CST interventions targeting pediatric oncology clinicians. From 971 deduplicated references, eight articles representing six communication interventions were eligible for inclusion. This review summarizes the existing literature with respect to CST content, intervention methodology, targeted outcome metrics, measurement tools, short‐term and sustained benefits, design biases, and availability of materials to allow for reproduction of interventions. Ultimately, studies on CST in pediatric oncology are few, heterogeneous, and lacking in standardized outcome metrics; however, synthesis of the available literature suggests feasibility and effectiveness. Increased scientific rigor is needed, and specific recommendations to advance the field are described.     

Consensus on a core curriculum in American training programs in pediatric hematology-oncology: a report from the ASPHO Training Committee

The Training Committee (TC) of the American Society of Pediatric Hematology/Oncology created a foundation of common goals and objectives that could provide a structure for fellowship programs. The TC conducted a survey of program directors for input into the structure of their programs and training methods and the results are presented here. Additionally, a suggested core program is outlined, taking into account the new common requirements as stipulated by the ACGME and ABP, and additional suggestions from the program directors. This paper highlights the suggested training objectives and educational opportunities that should be afforded all fellows in this sub-specialty. The goal of this consensus statement is to provide a model curriculum to improve quality and consistency of training and achieve compliance with new requirements while simultaneously recognizing the importance of alternative approaches that emphasize each program's unique strengths and character.     

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??The standardized resident training is an important step for training high-level professionals in clinical medicine and it is an important part of medical education after graduation. The training of residents’ clinical thinking and clinical judgement should be emphasized in all resident training programs. Some resident programs in China still focus on the teaching of important knowledge that are originated from the medical colleges. Therefore??it is urgent for faculty to adopt new teaching methods aiming at the training of clinical thinking and clinical judgement. The paper introduces a mode for teaching clinical thinking and clinical judgement in the resident training programs. The goal is to improve the level of resident physicians in clinical diagnosis and treatment in China.