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目的:探讨以需求为导向的全科医师岗位临床技能培训及评估方法.方法:通过调查分析,结合全科医师的职业特征需求,确定全科医师基本临床技能需求指标体系,制定临床技能规范化培训方法及培训效果评估方法,对规范化培训前后的临床技能考核成绩进行对比分析.结果:病例书写、体格检查、无菌技术、心肺复苏技术等临床技能为全科医师需求的基本技能;明确教学目标、统一教学内容、规范化培训方法、客观化评估方法可提高受训学员临床技能考核平均成绩(P<0.05)及各项技能考核成绩.结论:根据岗位需要确定培训方案、规范培训及评估方法,将有利于提高受训学员临床技能的培训效果. 相似文献
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目的:探讨客观结构化临床考核(OSCE)在护理本科生毕业考核中的应用方法及效果.方法:构建适合地方普通高校的OSCE考核方案,并对669名护理本科毕业生进行考核,评价考核方案的合理性,分析考核效果.结果:OSCE毕业考核方案难度适中,区分度较好,学生和考官对考核模式的认可度高.结论:OSCE能够较为合理地评价护理本科毕业生的临床护理技能. 相似文献
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客明结构化临床考试(OSCE)是一种客观、有序的考试框架,已经广泛地应用于国内外医学教育的考试.本文提出了在某医院实行这一方案的初步设想. 相似文献
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目的:探讨客观结构化临床考试(OSCE)在不同学年制临床专业学生培训及考核中的运用效果。方法:对37名5+3临床专业学生和20名5年制临床专业学生进行客观结构化临床考试模式考核,根据核心能力要求设为5站式,每站时间7min,无sp考站,比较每站考核成绩和操作时间。结果:临床5+3年制和5年制学生穿手术衣戴手套、拆线换药、静脉采血、缝合打结四项成绩无差异(p0.05)。临床5年制学生消毒铺巾项目高于临床5+3学生(93.6vs90.3,p0.01)。临床5+3年制和5年制学生穿手术衣戴手套、拆线换药、静脉采血、消毒铺巾四个项目操作时间无差异(p0.05),临床5+3学生缝合打结所用时间比临床5年制学生短(5.86vs6.55,p0.01)。结论:将OSCE考核评估系统应用于同年级不同临床专业学生操作能力考核,能客观、公正、全面评价学生的操作能力。 相似文献
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目的 评价和分析标准化患者用于全科医师考核中的作用.方法 对2008年至今参加过全科医师考核的19名标准化患者、57名全科医师及24名评委,进行有关标准化患者用于全科医师考核的问卷调查,并统计相关数据.结果 尽管存在个别差异,但是从统计学分析,无论是标准化患者、全科医师还是评委都对标准化患者用于全科医师考核持肯定态度.结论 标准化患者用于全科医师考核是有意义的、合理的、可行的、公正的. 相似文献
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目的 探究在口腔医学生临床实习考核中应用结构化临床考试的价值。方法 随机抽取40名医学生纳入实验研究范围,其均于2019年1~12月于我院实习,采用等量数字随机方式分组,分别应用结构化临床考试(实验组,n=20)及常规笔试考试(对照组,n=20)方式开展考核,分析考核效果。结果 20名口腔医学生各站点测试成绩合格率均高于80.00%,最高成绩为第五站点(89.6±4.8)分,最低成绩为第六站点(79.6±5.8)分。实验组医学生考试满意程度显著高于对照组,差异显著(P<0.05)。结论 采用结构化临床考试方式对口腔医学生开展临床实习考核,有利于提升实习生实践技巧及理论把握能力,应用价值较高。 相似文献
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目的 探讨基于客观结构化临床考试(OSCE)的以问题为基础的学习(PBL)教学模式在重症医学科(ICU)本科护理实习生带教中的意义.方法 前瞻性分析2020年7月至8月60名护理专业本科实习生,分为PBL组,OSCE组,每组30名.PBL组采用以问题为基础学习的情景教学模式,OSCE组采用基于结构化临床考核的以问题为导... 相似文献
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目的 基于OSCE考站设计及学员考核成绩,分析影响内科专业住院医师结业临床实践能力考核成绩的主要因素,为进一步改进完善内科专业住培方案提供参考依据。方法 对2022届江苏省某地级市10家住培基地的374名内科专业住院医师采用客观结构化临床考试模式的结业临床实践能力考核成绩录入SPSS 19.0软件进行统计学分析,数据采用单因素方差分析,多组组间采用LSD多重比较。结果 学历方面:总成绩博士学历者(86.56±3.40)分比硕士(84.08±3.15)分及本科学历者(84.31±4.53)分高,差异有统计学意义(P<0.05);单项站点成绩第三站临床思维2(15.68±2.04)分成绩最低。结论 要对住培医生加大在三大科以外内科三级学科的临床思维训练;要加强人际沟通能力培养;扎实诊疗基本功培训;培训年限界定当从严从紧。 相似文献
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深度学习是指在理解学习的基础上,学习者能够批判性地学习新的思想和事实,并将其融入原有的认知结构,其目的是让学习者灵活地掌握和理解学科知识,以及应用这些知识去解决课堂和未来工作中的问题.全科医师PBL课程是以教师提出具体问题为基础,全科医师围绕这些问题展开主动学习.通过构建PBL课程,可以有效地提高全科医师学习兴趣、培养其正确的临床思维、批判思维、创新思维能力,提高临床理论结构体系的建立,提高临床操作技能、团队合作能力和岗位职业核心竞争力.本文通过归纳深度学习在全科医师教学中的特征,分析深度学习与PBL课程的关系,从PBL课程的基本要素、设置方案,以及实施步骤等方面,设计和构建了基于全科医师深度学习能力培养的PBL课程. 相似文献
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随着医药行业的不断发展,医疗卫生体制不断完善,药学工作已由传统管理调配向临床药学服务过渡,临床药师已成为临床治疗中不可取代的团体,为临床全合理用药做出重要贡献。 相似文献
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通过查阅有关CRC的文献资料,并结合笔者在美国参加的CRC培训、参与的美国临床试验过程,以期对我国临床试验未来的发展有些许启示作用。 相似文献
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Background: Variations in the practice of artificial nutrition are partly a result of the judgements of clinicians. Little is known about these judgements, the decision processes used or the quality of the decisions that arise. The methodology of clinical judgement analysis describes and explains judgemental differences between clinicians and offers a window into why clinician choices sometimes fail to correspond with current best practice guidelines. Methods: A clinical judgement analysis with 27 clinicians using two judgement tasks was carried out. Clinicians expressed their ‘likelihood of feeding’ and ‘whether or not they would initiate artificial nutrition support’ in response to 54 patient scenarios. Measures of agreement between clinicians, the degree of linear reasoning employed, their judgemental consistency and concordance with National Institute for Health and Clinical Excellence (NICE) guidelines were assessed. Results: Clinicians’ judgements varied substantially both in the amount of information employed and the weighting given to information. Clinicians had only moderate agreement with NICE recommendations and overestimated the need for artificial nutrition support. Suboptimal judgements were consistently applied by clinicians. When clinicians reasoned in more linear ways, their judgements and decisions improved. Conclusions: Overestimating the need for artificial nutritional support may inflate health service costs and increase risks for patients unnecessarily. A better understanding by clinicians of the information needed (as well as how to use it) for artificial nutrition support initiation may help improve clinical decision‐making. 相似文献
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Parker M 《Medicine, health care, and philosophy》2002,5(3):273-280
The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute.
For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other,
human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why
particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically
appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and
judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to
devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable
into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive
relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would
be both unethical and unwise.
This revised version was published online in July 2006 with corrections to the Cover Date. 相似文献
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M Glezerman A Witznitzer H Reuveni M Mazor 《International journal for quality in health care》1999,11(3):227-232
OBJECTIVE: To establish a system of Continuous Quality Improvement (CQI) which does not require substantial resources in a clinical setting. SETTING: A busy department of obstetrics and gynaecology. METHODS: The system is based on seven elements: (i) comprehensive accumulation of data; (ii) involvement of all faculty members and the majority of residents; (iii) continuous monitoring of processes within the organization; (iv) application of clinical indicators; (v) file review system; (vi) task force approach for evaluation of processes within the organization; and (vii) intervention measures. MAIN OUTCOME MEASURES: Quality of contents of files and documentation, satisfaction of customers (patients, family members), trends of clinical indicators, effect of task force work, incidence of complaints. RESULTS: Inadequate documentation was noted in 14.6% before, and 4% 1 year after the initiation of the CQI program. Task force work in a variety of projects led to a substantial improvement in measured outcome. The absolute and relative numbers of complaints against the department decreased from 44 in 1993, to 27 in 1994, 20 in 1995 and 16 in 1996. In terms of the percentage of complaints directed against the hospital these figures represent 12.4, 9.6, 6.9 and 5.4% for 1993, 1994, 1995 and 1996 respectively. CONCLUSION: Our proposed CQI system has proved to be highly efficient and requires only minimal additional resources. 相似文献
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临床医学是一门专业性、实践技能性很强的学科,高职高专院校临床专职教师参加临床实践是高职高专教育的要求,也是临床医学不断发展的要求,是双师型队伍建设需要,也有利于教师教学能力的提高。可以通过深入临床、现场观摩学习,积极参与医疗机构举办的临床实践项目培训,鼓励参与医疗机构科研项目,实行顶岗实践等多种途径,促进临床专职教师参加临床实践。 相似文献
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临床药师职业分析以及激励机制研究 总被引:1,自引:0,他引:1
对国内11所三级甲等医院内药学技术人员进行问卷调查,了解药师对薪酬、职称、教育等激励措施的满意程度以及改进意见,进而提出了建立按劳取酬的激励机制的具体建议. 相似文献
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目的调查临床医生对临床路径(CP)的认知现状,为推进CP管理提供可能的参考。方法以536位临床医生为调查对象进行匿名调查,调查内容包括临床医生对CP管理认知情况6个方面的11个问题。结果临床医生对于CP管理普遍持支持态度。结论应重视医院试点工作与专门培训渠道建设、医生以及医院自身发展,不断提高CP推广覆盖面;重视标准CP的制定与修订,尽快开发实用的CP操作软件;而大样本、跨区域、深层次、广覆盖的大型调查,有利于全面反映当前临床医生对CP管理的认知情况。 相似文献
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目的:探讨临床医师参与临床药学服务的主要方法。方法:综合国内外的文献,结合作者单位临床药师的工作实际,从多方面论述临床药师应如何开展临床药学服务。结果:临床药师参与临床药学服务在中国还刚刚起步,面临许多的困难和问题,临床药师应通过不断加强学习、逐步专科化、提高人际沟通能力等多个途径,提高自身工作能力,更好地服务于患者。结论:临床药学的不断推进是大势所趋,是当前医学和药学发展趋势所决定的,广大临床药师应主动作为、积极工作,探索出一条适合中国国情的临床药学发展之路。 相似文献