八年制医学生心脏外科学轮转培训的探讨

八年制医学生的临床培养过程中，心脏外科学是必修学科之一，但心脏外科工作性质的复杂性、特殊性常使初入临床的医学生望而生畏。为使他们在心脏外科学的实习达到预期效果，北京大学人民医院心脏外科学教研室制定了切实可行的培养方案并付诸了实践，使他们在心脏外科学的有限实习时间内，尽可能多地学到临床医学知识和技能，达到培养要求。     

Graduate education in surgery in the Kingdom of Saudi Arabia. The challenge of growing pains

With the establishment of undergraduate medical education and the progress of health care in the country heralded by the return of well trained and dedicated physicians and surgeons, it was only natural that the attention will be focused on establishing graduate training for the different medical specialties in the Kingdom of Saudi Arabia. This paper addresses the current status of general surgery training in the country and compares our model with the experience of others from the perspective of a program director. It is not the exception, but it is the rule to have challenges at this stage of development. The problems are multifactorial and need to be addressed by all those concerned with an open mind. I pretend no special farsightedness and my authority rests only on genuine concern about the issues and experience from being both a surgeon and a program director. The aim is of course to produce a future generation of well trained surgeons able to meet the challenge and take the lead in the medical care of this country. Once sound general surgery training is in place, training in specialty surgery such as thoracic and cardiac to name a few will follow suit.     

中美胸心外科住院医师培训的比较和启示

通过对中美两国胸心外科住院医师培训体系的培训前教育背景、培训制度及培训后执业方向进行比较,发现美国胸心外科住院医师培训入学门槛高、培养周期长、教育支出高,但其管理专业化、专科特点突出、评价体系完善,适合培养胸心外科专科医学人才。而我国目前的胸心外科住院医师培训尚需进一步完善,需借鉴美国住院医师培训体系的优点,制定更为合理和专业化的胸心外科住院医师培养方案,为我国培养优秀胸心外科专业人才。     

《外科学》教学质量调查分析与思考

目的采用调查问卷形式,了解2009年外科学教学中课堂教学效果的影响因素并据此制定改进措施,进一步提高该课程的教学效果。方法由学员填写问卷调查表,结合教员职称、学历、专业、是否为精品课程教员、是否参评精品课程等项目,由不同专业、学制的学员对课堂教学效果进行评价打分,采用双盲法对学员打分结果进行统计学处理分析。结果不同专业科室、不同教学职称、精品课教员与普通教员、参加过精品课程评比与未参加评比的教员、五年制与八年制学员、不同专业学员之间的教员得分均有明显差别(P<0.05);而不同教室、不同学历的教员得分无统计学差异(P>0.05)。结论学员对外科学课堂教学总体评价较高,但个别科室以及中级职称教员的教学工作有待改进,同时应广泛开展精品课程评比,进一步提高外科学教学质量。     

以“住-专一体化”为导向的分级带教模式在口腔颌面外科基地的实践研究

目的 以上海交通大学医学院附属第九人民医院口腔颌面外科基地为研究对象,探索“住-专一体化”分级带教模式在口腔颌面外科住培与专培中的实践效果。方法 在2022年6月至2023年4月期间,共计入组学员144名,其中试验组（住培72人、专培16人）和对照组（住培72人、专培16人）。分别采用传统模式与“住-专一体化”分级带教模式制订临床及学习任务,并记录学员在理论考核和自我评估中的表现。采用 SPSS 23.0进行t 检验。结果 “住-专一体化”分级带教模式在理论考核和学员自我评估中均取得了明显的效果。专培学员中,试验组（84.56±4.05）与对照组（81.13±2.78）之间分数差异具有统计学意义（P<0.05）。住培学员中,试验组（84.74±4.85）相对于对照组（82.10±4.34）表现更好,组间差异具有统计学意义（P<0.01）。自我评估问卷结果显示,试验组学员在多项自评指标中的积极评价比例高于对照组。结论 本研究的结果表明,“住-专一体化”分级带教模式为口腔颌面外科住培与专培教育提供了一种有效的教学模式。该模式有助于提高学员学科兴趣、促进临床实践能力,并为我国医学教育提供有益经验和未来发展方向。     

设置口腔专科临床药师培训专业的必要性探讨

目前,我国临床药师培训体系中未设置口腔专业,而且对于口腔专业培训规划的相关研究还是空白,口腔临床药学的发展也因为专科临床药师的匮乏而较为缓慢。本文从国家口腔健康政策、口腔疾病特点及口腔临床需求3个方面进行分析,为我国口腔专科临床药师培训专业的设置提供理论依据。同时,对口腔专科临床药师培训体系的构建进行初步探讨,为口腔专业临床药师培训的设计及具体内容提供参考意见。     

设计性实验在外科手术学教学中的应用初探

目的：激发学生学习外科手术学的兴趣，提高学生观察、分析和解决问题的能力，探索外科手术学的教学方法。方法：根据典型病例，通过查阅资料，写出手术计划并实施。结果：全部手术均按计划完成，问卷调查结果显示，绝大多数学生认可教学方法和效果，基本技能考核，实验班优于对照班。结论：在外科手术学教学过程中，实施设计性实验是可行的，能提高教学效果，因此，在五年制临床医疗专业外科手术学的教学过程开设设计性实验是必要的。     

Certification of specialists: survey of candidates and review of the literature

To evaluate the specialty certification process, the Canadian Association of Internes and Residents (CAIR) surveyed 634 candidates who had attempted the written and oral exams of the Royal College of Physicians and Surgeons of Canada. The results suggest that in-training evaluation is a more reliable and valid assessment of competence than the written and oral exams. There is a lack of well defined program objectives that are coordinated with the examinations. CAIR recommends that the present concept of an examination "hurdle" be replaced by different, integrated methods of assessment during training, and that an effective appeal mechanism be developed.     

Contributions of Ibn Zuhr (Avenzoar) to the progress of surgery: a study and translations from his book Al-Taisir

This study of the original Arabic edition of the book Al-Taisir Fil-Mudawat Wal-Tadbeer (Book of Simplification Concerning Therapeutics and Diet) written by the Muslim physician Abu-Marwan Abdel-Malik Ibn Zuhr (Avenzoar, 1093-1162 AD) aimed at evaluating his contributions to the progress of surgery and providing English translations of relevant excerpts. Ibn Zuhr s unique experiment performing a tracheotomy on a goat, proved the safety of this operation in humans and represented a further step in the development of the experimental school started by Al-Razi (Rhazes) of Baghdad in the ninth century who is known to have given monkeys doses of mercury to test it as a drug for human use. Ibn Zuhr also performed post mortems on sheep in the course of his clinical research on treatment of ulcerating diseases of the lungs. Same as all his predecessors in the Islamic Era, he stressed the importance of a practical and sound knowledge of anatomy for surgical trainees. Furthermore, Ibn Zuhr insisted on a well supervised and structured training program for the surgeon-to-be, before allowing him to operate independently. He also drew the red lines at which a physician should stop, during his general management of a surgical condition; a step forward in the evolution of general surgery as a specialty of its own. He believed in prophylaxis against urinary stone disease and reported the importance of dietary management for that purpose. Furthermore, Ibn Zuhr enriched surgical and medical knowledge by describing many diseases and treatment innovations not ever described before him.     

高级护理专业病理学教学探索

高级护理专业是我校重要专业,近来来开设了病理学课程教学,本文针对高级护理专业开展病理学教学的必要性,以及护理学专业病理学中理论和实验教学内容、方法的改革探索进行了阐述。     

PBL应用于口腔颌面外科临床教学的对照研究

目的研究PBL（Problem-based learning）口腕颌面外科临床教学中的适用性。方法本教学小组在2007年4月-2008年3月间在牙槽外科教学中采用了PBL教学法,参加教学的学生为2003级本科实习医生38人,另有40位2002级本科实习医生参加传统教学法教学。在教学前后,两组学生接受客观题考核和临床口试。同时,给出主观问卷对两组学生的主观能动性、学习时间进行自我评价。结果客观考核表明,两组学生成绩均获得一定程度的提高。PBL教学组的口试成绩优于传统教学组,有显著性差异。PBL教学组在＂病例分析能力＂和＂操作能力＂上得分较高,其他方面没有显著性差异。两组学生在课堂所用时间相同,但总体学习时间PBL教学组明显长于传统教学组。PBL教学组学生的学习能动性明显强于传统教学组。结论 PBL教学法对口腔颌面外科教学有一定帮助,但需要更多的证据及对学生长期发展的观察才能明确PBL教学是否适合目前中国教育实际。     

临床医学八年制学生就业分析及其对人才培养的启示

目的 使用北京某高校临床医学八年制毕业生就业数据,对其就业情况及变化趋势进行分析,以期探讨对人才培养的启示。方法 采用描述性分析方法,所分析的指标包括就业人数、就业率、就业地域及专业分布。结果 在2009至2021年间,该校共有2 281名临床医学八年制毕业生。其中,毕业当年就业者2 188人,占比96.0%。在医疗机构就业者所占比例平均为90.8%（2 034/2 241）,但呈下降趋势。就业地域主要集中在东部经济发达省份,在北京就业者最多,占比78.7%（1 723/2 188）。在专业选择方面,以学习外科专业者最多,占比33.0% （753/2 281）;其次为内科学,占比24.4%（557/2 281）;选择儿科、精神病与精神卫生学等社会急需紧缺专业者极少。结论 临床医学八年制毕业生整体就业形式好,但也需要关注就业呈现的新趋势,进一步优化人才培养方案。在二级学科的选择中,需要进一步加强引导,为学科发展建立合理的人才梯队。需要加强课程思政教育,引导和激励毕业生为急需紧缺专业和边远地区卫生服务作出贡献。     

PBL教学方法在传染病学临床见习带教中应用探讨

将PBL教学方法引入七年制及五年制临床医学生的传染病见习教学中,通过在一个见习周期内对比不同临床见习方法下学生的主、客观反映和理论考试成绩,评价其教学效果.研究结果显示,学生对传染病见习教学中PBL教学方法的总体评价高,PBL教学有助于培养学生的临床思维方式和解决临床问题的能力,是一种适合于传染病见习学习的教学模式。     

显微神经外科培训在神经外科临床型研究生培养中的作用

以显微神经外科入路及手术应用解剖培训为核心,结合理论教学和围手术期培训为主要内容的培训计划,在神经外科临床型研究生培养过程中效果明显。并提出成立显微神经外科培训中心,以建立更完整的以显微神经外科培训为核心内容的培训体系,提高神经外科临床型研究生的临床能力。     

The regional graduate medical education program of the University of Washington

To address problems of geographic and specialty distribution of physicians in the states of Washington, Alaska, Montana, and Idaho, the University of Washington School of Medicine and its affiliated hospitals developed a regional program of graduate medical education beginning in 1971. The program in 1986-87 had 77 percent of the residency positions in the region and involved more than 30 hospitals and clinics. In 1986-87, 58 percent of the residents completing training were in family medicine, internal medicine, or pediatrics. The program is centrally coordinated by the school's associate dean for clinical affairs, who works with departmental program directors and hospital and university administrators.     

口腔外科实习中基于微信平台的混合教学设计与实践

基于微信平台,在口腔外科实习中设计与实施混合教学。让学生对实习工作早接触、早熟悉和早计划;在实习中获得多提问、多总结和多考核的过程;在实习后进行巩固复习、学科交流和拓展学习。初步实践显示,该教学激发了口腔外科实习学生的临床学习兴趣和动力,增强了师生之间的互动和教师对学生的监管,提升了实习教学效果。     

提高临床医学专业实习生外科临床技能的探讨

目的探讨不断循环的个体化培训方案在临床医学专业实习生外科临床技能培训中的价值。方法42名实习生按人院临床技能考试成绩分为A（优）、B（中）、c（差）3个组,分别进行常规培训、统一强化训练和专人强化训练,在实习全过程中进行6次考查记分。结果与入院时比较,毕业时成绩为优秀的人数明显增加,而成绩较差的人数大幅减少。结论不断循环的个体化培训方案结合有效的统一考核措施,有助于提高临床医学专业实习生的外科实践能力。     

拔牙：是结束,还是开始？——谈牙槽外科的发展

长期以来,牙槽外科给人们的印象就是＂拔牙科＂,拔掉患牙,任务就结束了。在飞速发展的现代牙科医学中,牙槽外科似乎已是暮气沉沉的＂老年学科＂,看不到明确的发展方向。我们结合近年来的临床实践和研究,并分析国际和国内牙科相关热点新技术,提出对牙槽外科发展方向和策略的思考。我们认为,现代牙科的最终目的是保护和恢复牙齿功能及美观,而牙齿的发育及存留离不开周围牙槽环境的支持。从环境角度思考牙齿相关疾病治疗,构想牙齿牙槽功能重建,牙槽外科可以成为外科和牙科的交叉点,在外科微创治疗和牙齿即刻重建的结合方面有着独有的能力和潜力,将迎来重要的专业发展机遇。让拔牙不仅是牙源病痛的结束,还是口腔完善功能的开始。     

口腔医学实践教学体系的研究与构建

口腔医学是一门实践性很强的临床学科。在口腔医学专业教学中,通过修订培养方案、专业教学前伸化、构建实践教学平台、改革教学方法、改革实践考核制度等措施构建了口腔医学专业实践教学体系,对培养特色应用型口腔医学专业人才起到了一定的促进作用。     

The specialty match: a necessity in the equitable resident selection process.

For many years directors of Canadian postgraduate specialty programs have selected candidates in an uncontrolled and haphazard way. Candidates and programs alike have therefore been unfairly treated. Since 1986 the Canadian Intern and Resident Matching Service has offered a centrally coordinated matching program to allow candidates to select specialty programs at centres of their choice and program directors to rate candidates. The result has been an effective method to achieve fairness in the selection of postgraduate trainees for participating Canadian specialty programs.