基于BP神经网络模型的人体解剖学实验室开放影响因素分析

目的基于误差逆转播(back propagation, BP)神经网络模型,探讨临床医学专业学生(临床医学生)参与人体解剖学实验室开放教学的影响因素。方法通过在线调查的方法进行问卷调查,采用单因素分析和BP神经网络模型,分析影响临床医学生参与人体解剖学实验室开放教学的因素。结果共收集595名临床医学生的有效调查问卷,单因素分析显示,临床医学生的开放愿望影响临床医学生参与实验室开放(P < 0.05),且位居BP神经网络模型标准化后重要性第一,模型的ROC曲线下面积为0.724。结论临床医学生对人体解剖学实验室的开放愿望是影响临床医学生参与人体解剖学实验室开放的重要因素。     

医学本科生导师制在非直属附属医院教学中的效果评价

目的评价非直属附属医院医学本科生导师制实施效果。方法将非直属附属医院32名大四医学本科生分为两组,研究组采用导师带教的教学形式,对照组按照传统的带教方式进行教学。对两组学生专业理论知识、临床能力、操作能力、外语测验、科研基础能力及科研活动参与情况进行评价。采用SPSS 19.0进行t检验、卡方检验及U检验。结果导师制组医学生在操作能力(t=3.537,P=0.000)、阅读文献数(t=6.961,P=0.000)、文献质量(U=68.000,P=0.017)、撰写综述和读书笔记数量(t=4.747,P=0.000)、参加科研活动(χ^2=6.788,P=0.009)等方面成绩优于非导师制组,而在同时期的理论成绩、临床能力、外语测验等方面两组差异无统计学意义。结论非直属附属医院实施医学生导师制是提高培养质量的有效措施。应充分利用短暂的见习时间,通过建立完善的规章制度和教学评价体系,因人施教、因材施教,全面提升学生综合素质。     

口腔医学生交流与沟通能力培养新模式的构建与应用

为了提高作者所在医院口腔医学专业学生的交流与沟通能力,将2009级和2010级口腔医学专业学生分为实验组和对照组,分别采用传统教学方式及交流与沟通能力培养新模式进行能力培养。通过教师评价和学生评价比较两组学生的问诊技能水平和学生反馈意见。结果表明:实验组学生通过角色扮演、专家讲座、小组讨论三方面培养,在沟通能力、技巧上明显优于对照组学生。作者所在医院在学生中施行交流与沟通能力培养新模式有助于提高口腔医学生的沟通水平,对学生未来的发展有着极大的促进作用。     

Teaching Medical Students,what do Consultants think?

Background:

The approach to and delivery of medical student education has undergone significant change within the last decade. There has been a shift away from didactic lectures to small group tutorials, facilitated by clinicians. Anecdotally there is an impression that enthusiasm for teaching is waning. The aim of this qualitative study is to assess the current attitudes of consultants, across all specialities, to teaching medical students in small group settings.

Methods:

A Likert scale questionnaire, relating to teaching medical students in small group tutorials, was distributed via email to all consultants working in one region. Questions considered the categories: attitudes to teaching, financial considerations, time constraints and attitudes to students.

Results:

367 responses were received. 72% of responders were actively involved in teaching. 72% of respondents indicated that medical students should be taught by consultants and 80% felt that teaching medical students was enjoyable. 60% felt they were not financially remunerated for teaching and 50% indicated teaching was not included in job plans; despite this a significant proportion of these respondents remain involved in teaching (68%). Non-teachers were more likely to indicate that teaching was not paid for (p=0.003). 78% indicated consultants do not have adequate time to teach medical students. 82% felt that medical students appreciate consultant led teaching but only 55% felt students had an appropriate level of enthusiasm for learning.

Conclusion:

Consultants in this Deanery are actively involved in medical student teaching and enjoy it. Consultants perceive that they are not adequately financially rewarded but for the most part this is not a deterrent. Time constraints are an issue and there is a desire to have teaching included in job plans to counteract this. Most consultants are complimentary about student attitudes but there is a perception that medical students need to contribute more to their own learning.     

Improving medical undergraduate trauma education through the Trauma Evaluation and Management programme at Mona

This study examines the potential role of the Trauma Evaluation and Management (TEAM) programme in the undergraduate curriculum for medical students in Jamaica. Thirty-two final year medical students were randomly assigned to two groups of 16. One group (No TEAM) completed two 20-item multiple choice question (MCQ) examinations on trauma resuscitation topics. The second group (TEAM group) completed the first 20-item MCQ. The TEAM manual was then distributed to both groups. After the TEAM programme for both groups, the TEAM group had the second MCQ examination. Unpaired "t" tests were used for in-between group and paired "t" tests for between group comparisons with p < 0.05 being considered statistically significant. Both groups completed a post-course questionnaire rating five items on a scale of one to five. The No TEAM group showed no difference in mean scores between the 1st and 2nd tests (55.3% in the 1st test to 52.2% in the 2nd test, p = 0.32). The TEAM Group improved their MCQ scores from 53.1% pre-module to 69.4% post-module (p < 0.001). A score of four of five was assigned by 28 students for the statement that the objectives were met, that trauma knowledge was improved and that there was overall satisfaction; by 17 students that clinical trauma skills were improved and 29 students that TEAM should be mandatory in the undergraduate curriculum. The TEAM programme improved trauma knowledge skills among senior medical students in Jamaica. The questionnaire results suggested enthusiasm for the programme and that it be made mandatory in the senior undergraduate medical curriculum.     

“翻转课堂”在普通外科实习教学中的应用评价

目的 探讨“翻转课堂”在普外科实习生教学中的应用与实践。方法 川北医学院第二临床学院普外科20个实习小组（每组3~5人）,以排列小组序号随机分为翻转组（45人）、传统组（40人）,每组10个小组。翻转组采用翻转课堂教学模式（发放资料学生课前自学—学生、教师课中讨论—课后评价）,传统组采用传统教学模式（学生课前预习—教师课中讲解—教师课后答疑）。教学结束,采用问卷法评估每位学生的参与度及完成度,以病史采集和病案分析得分评价教学效果。对比分析两组间参与度、完成度及教学效果。应用SPSS 23.0软件进行t检验和卡方检验。结果 翻转组参与度优于传统组[（17.45±1.83） vs. （15.57±1.52）],差异有统计学意义（P < 0.05）;翻转组与传统组完成度比较差异无统计学意义。两组间病史采集得分比较差异无统计学意义;翻转组病案分析优于传统组[（87.30±6.06） vs. （81.50±5.88）,P < 0.05]。调查问卷显示,约90%的学生认为翻转课堂能提高学习兴趣96%（43/45）,提高自主学习能力89%（40/45）,学习效果更佳;同时78%（35/45）的学生认为学习时间较长。结论 翻转课堂能提高普通外科实习学生教学参与度,提高学生学习兴趣,提高学生自主学习能力,提高学生病案分析思维能力。     

诺贝尔奖获得者事迹主题教学与实践活动对医学生科学素养形成的研究

目的: 探讨诺贝尔生理学或医学奖主题教学与实践活动对医学生素质培养的作用。方法: 在蚌埠医学院大学二年级医学生300名中开展诺贝尔生理学或医学奖主题教学、报告、演讲、辩论等活动(实验组),同时选择同年级未参加此项活动的医学生300名(对照组)进行问卷调查。对比该活动对参与者基础课重要性认知、基础医学学习热情、医学问题探究欲望、基础医学科研思维培养、基础医学科研思路形成的影响。结果: 实验组在医学素质培养方面受到积极影响;实验组学生各指标受影响的程度均显著高于对照组(P<0.01)。结论: 诺贝尔生理学或医学奖主题教学与实践活动对医学生素质培养有着积极作用,值得医学院校推广应用。     

两种教学方法在护理心理学教学中实施效果的比较

探讨在护理心理学教学中采用专题式小组教学方法的教学效果。选择某医科大学2011级护理学专业两个班105名学生为研究对象,随机将一个班设为实验组,另一个班设为对照组,两组学生在性别、年龄及入学考试成绩上差异均无统计学意义。实验组采用专题式小组教学方法,对照组采用传统教学方法教学。课程结束后,使用标准化试题及自编式调查问卷对学生进行两种教学方法的效果评估。结果表明,两组学生期末考试成绩差异无统计学意义;实验组在课堂的互动度、学生参与度、活跃课堂气氛、学生的沟通和表达能力、拓展知识面及增加信息量、提高收集资料的能力等方面较对照组有提高,差异具有统计学意义。与传统教学方法相比,专题式小组教学方法调动了学生学习的兴趣与积极性,提高了学生的自学能力。     

Reasons for medical students selecting a rural prefecture in Japan for initial clinical training: a single-center-based cross-sectional study

Objective: Securing a sufficient number of medical residents to work in rural areas is an urgent issue. This study sought to clarify the factors that cause medical students at a rural university in Japan to select a particular place for their initial clinical training.Materials and Methods: A questionnaire was administered to all medical students at Saga University between February and March 2021. Participants were divided into two groups based on their training location choice: those who chose Saga Prefecture (Saga group) and those who selected other prefectures (non-Saga group). Then, logistic regression analysis was performed.Results: The questionnaire was answered by 300 students (46.3% response rate), of whom 291 agreed to participate in the study; 122 (41.9%) and 169 (58.1%) students were allocated to the Saga and non-Saga groups. Within the Saga group, the following factors were statistically significant: being admitted to Saga University’s medical school through the system of special allotment of admission to applicants pledging to work in Saga Prefecture following graduation (or regional quota programs for admission) (odds ratio [OR], 19.18; 95% confidence interval [CI], 6.99–52.60); and being from Saga Prefecture (OR, 6.05; 95% CI, 2.24–16.35). With the non-Saga group, the desire to work in an urban area (OR, 0.03; 95% CI, 0.00–0.37) was statistically significant.Conclusion: To encourage medical residents to choose this prefecture for their initial clinical training, the focus should be on medical students who are from Saga Prefecture or admitted through the regional quota program.     

“手足并用”形象教学在股骨颈骨折理论授课中的应用

目的 探讨“手足并用”形象教学融入股骨颈骨折理论授课中的可行性及优越性。方法 选取内蒙古医科大学2017级五年制临床医学专业60名学生作为研究对象,采用随机数字表法分为试验组和对照组（各30人）。授课内容为股骨颈骨折理论课。试验组采用PPT+“手足并用”形象教学,对照组采用PPT+模型教具的传统教学。课后对两组学生进行教学效果的评价。采用SPSS 22.0统计软件进行t检验和卡方检验。结果 试验组学生课堂满意度调查评价：学习兴趣度（8.60±0.72）,积极性和参与度（8.40±0.93）,课堂活跃度（8.37±1.07）,师生互动度（8.57±1.01）,理论知识掌握度（8.57±0.97）;对照组学生课堂满意度调查评价：学习兴趣度（7.10±1.03）,积极性和参与度（7.30±0.92）,课堂活跃度（6.83±1.18）,师生互动度（6.73±0.78）,理论知识掌握度（7.17±0.75）,组间差异有统计学意义（P<0.05）。试验组学生理论知识考试成绩（81.90±7.93）分,对照组理论知识考试成绩（75.33±7.79）分,组间差异有统计学意义（P<0.05）。结论 “手足并用”形象教学是一种可以广泛应用于临床教学中的先进、新颖的教学方法。其不仅提高了教学效果、活跃了课堂气氛,也增强了课堂师生互动,使学生的学习过程从抽象到直观,从单纯的死记硬背到理解记忆,取得了满意的效果。     

Faculty and house staff members as role models

In the fall of 1986 approximately 100 faculty members, community physicians, house staff members, and students associated with Indiana University School of Medicine participated in a conference on "Teachers as Role Models: The Impact on the Learning Process." Small-group discussions allowed the participants to define and discuss the impact of role-modeling in medical education. It was anticipated by the organizers that after the conference the participants would be more cognizant of their influence as role models and would be motivated to become better role models and support good role-modeling. A synopsis of the conference indicates that the participants identified both the positive and negative impact of role-modeling and concluded that medical educational programs should use positive role-modeling as a teaching tool to instill within students the desire to gain new knowledge and to apply that knowledge as medical professionals.     

Perceptions towards private medical practitioners' attachments for undergraduate medical students in Malawi

Objective

To describe perceptions of medical students, recent medical graduates, faculty of the College of Medicine, University of Malawi and private medical practitioners (PMPs) towards an attachment of undergraduate medical students in private medical doctors'' offices.

Method

Qualitative cross sectional study conducted in Blantyre, Malawi in 2004 using in-depth key informant interviews and content analysis.

Results

In general, private medical practitioners were favourable to the idea of having medical students within their consulting offices while the majority of students, recent graduates and faculty opposed, fearing compromising teaching standards. The lack of formal post-graduate qualifications by most private medical practitioners, and nationally-approved continued medical education programs were mentioned as reasons to suspect that private medical practitioners (PMPs) could be outdated in skills and knowledge. Private medical practitioners however reported participation in credible continued professional development (CPD) programs although these were not necessary for re-registration. Students and faculty suggested that the need for privacy in private institutions unlike in the public teaching hospitals as one reason why patients may not be willing to participate in the teaching in PMPs facilities. The fact that the patients profiles with regard to disease presentation (mostly ambulatory) and higher socio-economic status may be different from patients attending the public, free for service teaching hospital was not seen as a desirable attribute to allocate students to PMPs clinics.

Conclusion

Faculty, medical students and recent graduates of the Malawi College of Medicine do not perceive PMPs as a resource to be tapped for the training of medical students.     

三阶梯模式提高妇产科学生的临床技能

目的:探讨如何更好的提高妇产科临床的教学质量,提高医学生的临床技能。方法:将126名临床见习学生随机分为两组,其中实验组64名学生接受"三阶梯模式教育",对照组62名学生接受传统模式教育。结果:实验组学生在教学模式满意度及临床技能考核方面均优于对照组(P<0.01)。结论:"三阶梯教学模式"对比传统教学模式,更能提高妇产科见习生、实习生的临床技能,提高妇产科教学质量。     

Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students' attitudes

OBJECTIVE: To explore the attitudes of Australian medical students to the balance between work, family and other aspects of lifestyle, within a broader exploration of the issues that they regard as important to their decisions about future career. DESIGN: Qualitative study using semistructured focus groups and individual interviews. SETTING: The three medical schools in New South Wales and a national conference for students interested in rural practice. PARTICIPANTS: First- and final-year medical students who volunteered for focus groups held between March and August 2002 (82 students in 10 groups) or for individual interviews held between July and December 2003 (48 students). MAIN OUTCOME MEASURES: Emergent themes relating to the balance of work, family and other aspects of lifestyle. RESULTS: Most students referred to a balance of work, family and lifestyle as an important factor in their career decisions. While indicating they were committed to medicine, they were unwilling to work to the exclusion of all else. Most saw family commitments as a high priority, and many saw "time out" as important in maintaining their health. Female students spoke of part-time work as essential for future happiness, while some male students expressed a preference for working part-time. They would seek to achieve balance by choosing to work in disciplines, locations and structures where limited-hours work is available, and would negotiate support from their partners and parents in caring for children. CONCLUSIONS: It is important that the medical profession continue to develop working and training structures that allow a balance of work, family and lifestyle.     

Effectiveness of early cardiology undergraduate learning using simulation on retention,application of learning and level of confidence during clinical clerkships

INTRODUCTION

This study aimed to assess the effectiveness of the use of a cardiopulmonary patient simulator in the teaching of second-year medical students. Effectiveness was measured in terms of the extent of knowledge retention and students’ ability to apply the skills learned in subsequent real-life patient contact.

METHODS

In this study, ten third-year medical students who had previously undergone simulator training as part of their second-year curriculum underwent an objective structured clinical examination (OSCE) and a multiple-choice question (MCQ) test to assess their ability to apply the knowledge gained during the simulator training when dealing with real patients. The performance of this group of students was compared with that of a group of ten fourth-year medical students who did not undergo simulation training.

RESULTS

Although the third-year medical students performed well in the OSCE, they were outperformed by the group of fourth-year medical students, who had an extra year of clinical exposure. The MCQ scores of the two groups of students were similar. Post-simulation training survey revealed that students were generally in favour of incorporating cardiopulmonary simulator training in the preclinical curriculum.

CONCLUSION

Cardiopulmonary simulator training is a useful tool for the education of preclinical medical students. It aids the translation of preclinical knowledge into real-life clinical skills.     

医学生参与临床医学专业认证的现状调查分析与思考

医学生是医学教育过程的主体，是医学专业认证的直接相关者，他们对高等医学教育质量具有发言权。为了了解医学生参与临床医学专业认证（以下简称专业认证）的具体现状及对专业认证的认知和态度，本文对汕头大学医学院2004级～2009级的五年制、七年制临床医学专业340名学生进行了问卷调查及对7名学生进行了访谈。调查结果表明，学生参与专业认证颇显不足，医学生并未对专业认证有太多的了解。所调查的学生中，36.5％的学生不知道学校将要或已经参加了专业认证，60.3％的学生不知道专业认证中有专家进校考察。然而，学生表示有参与专业认证的积极性和愿望。因此，有必要通过有效的途径保证学生参与的权利，并调动学生参与的积极性，为学生参与提供适宜的条件。     

高级综合模拟人联合以问题为基础的教学法进行心肺复苏教学的研究

目的 评价高级综合模拟人(ECS)联合以问题为基础的教学法(PBL)进行心肺复苏英语教学的效果,探讨现代麻醉学英语模拟教学的新方法.方法 42名学生分为对照组及ECS组.以人工呼吸、胸外按压单项操作成绩及对学生反馈意见调查表进行统计学分析,评估教学效果.结果 ECS组与对照组单项操作成绩差异无统计学意义(P＞0.05);ECS组在增强急救意识、提高急救能力等与对照组差异有统计学意义(P＜0.05);86%以上学生认为ECS组教学与对照组差别较大.结论 采用ECS联合PBL进行麻醉学中心肺复苏英语教学,使医学生直接参与"急救工作",处理"各类问题",在实践中增强急救意识和提高急救能力,能够显著提高教学质量,适应现代医学发展的需要.     

早期接触临床对医学生综合能力及职业认知提升效果评价

目的探讨早期接触临床对提高医学生综合能力及强化职业认知的作用。方法选择本校2014级儿科专业五年制学生,其中在大二结束的暑假开展早期接触临床教学活动的学生为实验组(78名),未参加的学生为对照组(81名)。在活动结束后,对参加教学活动的学生进行问卷调查。同时对该年级学生小儿外科学理论课成绩及临床实习表现进行统计分析。结果超过90%的学生对早期接触临床教学活动满意,认为该活动有助于提高医学生的临床思维、强化职业认知、增强学习兴趣、提高沟通技能、促进基础与临床知识相结合。同时,后期追踪分析发现,早期接触临床活动可以提高学生理论课考试成绩,实验组学生临床工作熟练度、临床思维、动手能力及医患沟通能力均优于对照组。结论在医学生中开展早期接触临床活动,能够提高学生的综合能力,有利于培养医学生的临床思维能力及医患沟通能力,强化职业认知,为医学教育培养高素质人才奠定良好基础。     

医学生创造力倾向对其参与科研情况的影响

目的 分析医学生创造力倾向对其参与科研情况的影响.方法 用自填式调查表调查临床医学等10个医学专业本科大三学生的一般情况、威廉斯创造力倾向、参与科研情况,将其分为未参与科研项目组（A组）、只参与教师的科研项目组（B组）、作为小组成员参与大学生科研项目组（C组）、作为项目负责人参与大学生科研项目组（D组）.用单因素方差分析4组学生之间创造力倾向4个维度分值及总分值的差异,用多项分类Logistic回归分析创造力倾向对学生参与科研情况的影响.结果 本次调查共回收有效调查表2 286份,有39.1％（894/2 286）的学生参与科研项目;相应将学生分为A组（1 392人）、B组（108人）、C组（626人）、D组（160人）.冒险性、好奇性、想象力、挑战性等维度分值及总分值在4组间的差异均有统计学意义（P=0.000）.C组和D组的冒险性、好奇性、挑战性分值和总分值分别高于A组（P＜0.05）.以“未参与科研项目”为参考类别,“作为项目负责人参与大学生科研项目”类别的冒险性（P=0.011）、想象力（P=0.023）和挑战性（P=0.025）的偏回归系数有统计学意义;“作为小组成员参与大学生科研项目”类别的冒险性（P＝0.009）和好奇性（P＝0.002）的偏回归系数有统计学意义.结论 高创造力倾向可能是促进医学生参与大学生科研项目的影响因素,应采取多方面综合措施培养学生创造力,提高学生科研能力.