Rural background and clinical rural rotations during medical training: effect on practice location

BACKGROUND: Providing health care services in rural communities in Canada remains a challenge. What affects a family medicine resident's decision concerning practice location? Does the resident's background or exposure to rural practice during clinical rotations affect that decision? METHODS: Cross-sectional mail survey of 159 physicians who graduated from the Family Medicine Program at Queen's University, Kingston, Ont., between 1977 and 1991. The outcome variables of interest were the size of community in which the graduate chose to practise on completion of training (rural [population less than 10,000] v. nonrural [population 10,000 or more]) and the size of community of practice when the survey was conducted (1993). The predictor or independent variables were age, sex, number of years in practice, exposure to rural practice during undergraduate and residency training, and size of hometown. RESULTS: Physicians who were raised in rural communities were 2.3 times more likely than those from nonrural communities to choose to practise in a rural community immediately after graduation (95% confidence interval 1.43-3.69, p = 0.001). They were also 2.5 times more likely to still be in rural practice at the time of the survey (95% confidence interval 1.53-4.01, p = 0.001). There was no association between exposure to rural practice during undergraduate or residency training and choosing to practise in a rural community. INTERPRETATION: Physicians who have roots in rural Canada are more likely to practise in rural Canada than those without such a background.     

“早临床、多临床、反复临床”教学模式探索与实践

“早临床、多临床、反复临床”是21世纪世界高等医学教育改革的主流趋势。某高校立足现行医学教育模式存在的不足,从理论教学和实践教学两方面着手改革,构建适合我国实际的“早临床、多临床、反复临床”教学模式;并运用问卷调查和OSCE考试进行效果评定。评价结果表明该模式对促进医学生知识、能力和素质的全面发展具有较好的成效。     

临床医学专业实习教学模式的改革与实践

目的探索适合当前医学教育实习环境的临床实习教学模式。方法针对青岛大学医学院培养应用型医学人才的教学目标,借鉴执业医帅资格考试的形式,按照《本科医学教育标准——临床医学专业（试行）》的要求,以教育目标分类和现代心理元认知理论为指导,建立由临床实习培训和考核模块组成从认知领域、精神运动领域和情感领域三方面培养的临床实习教学模式。结果参加实习的青岛大学医学院2002级～ 2004级临床医学专业357名学生毕业考试的理论、临床技能及医患沟通技能成绩逐年提高,差异具有统计学意义。结论改革后的临床实习教学模式对提高医学生临床技能、职业素质及未来临床工作适应能力具有积极作用。     

高度重视临床实习教学工作努力培养实践技能型卫技人才

临床实习教学是卫生职业教育的主要环节之一，是培养合格卫技人才的主要途径。我校紧紧围绕提高学生职业能力与职业素质的目标，创新思路，转变观念，高度重视临床实习基地建设，积极拓宽临床实习渠道，加强学生实践技能的培养，取得了一些成绩。