脑血管外科专业研究生教学体会

目前医学教育从本科培养向研究生培养转化,脑血管外科专业的研究生毕业后主要从事脑血管疾病的外科治疗以及相关领域的科学研究,因此本专业研究生培养的水平决定了未来脑血管疾病诊断治疗的整体水平。本文主要介绍我们对脑血管外科专业研究生教学的一些经验和体会,重点是强调基本素质、基础理论学习、临床实践能力和科研能力的培养。     

鱼和熊掌如何才可以兼得?——血管神经病学专业研究生临床科研一体化培养模式初探

血管神经病学的迅猛发展,对研究生临床和科研全面发展提出了严峻的挑战。在研究生培养的过程中,应坚持临床和科研一体化的培养思路和模式,从研究生课题选题、临床与科研实践和综合评估等各个环节,始终坚持科研和临床兼顾,临床与科研并重的原则,全面提升研究生临床技能和科研相关的综合能力,培养多元化、高素质的脑血管病高层次人才。     

河南省护理学研究生教育设置专业学位的调查研究

目的调查河南省本科护士对设置护理学研究生专业学位的态度。方法采用问卷调查法,对河南省19家教学医院的249名具有本科学历的护士进行调查。结果 97.6%的本科护士认为有必要开设专业学位护理研究生教育。他们认为应优先设置的专业为临床护理教育、护理管理、外科护理、急危重症护理、手术室护理等,认为应该培养的能力依次是临床工作能力、合作沟通能力、临床教学能力、临床科研能力、组织管理能力。结论河南省有必要开设专业学位护理研究生教育,培养专业学位硕士研究生。     

神经血管介入专业研究生的培养

神经血管介入专业是一门新兴的临床医学专业,该专业的研究生培养要求临床与科研并重。在实践中加强研究生的专业技能训练、强化科研实践,并通过临床和科研教学例会、创造学生参与国际交流等形式,有利于培养具有科研创造性和具备国际竞争力的临床人才。     

神经血管介入专业研究生的培养

神经血管介入专业是一门新兴的临床医学专业,该专业的研究生培养要求临床与科研并重.在实践中加强研究生的专业技能训练、强化科研实践,并通过临床和科研教学例会、创造学生参与国际交流等形式,有利于培养具有科研创造性和具备国际竞争力的临床人才.     

培养临床与科研能力并重的神经外科研究生

培养高素质的神经外科医生,是培养神经外科研究生的目标。时代的发展要求研究生具备扎实的专业基础和理论知识,能熟练地掌握临床诊疗技能和科研方法。研究生应该临床与科研并重,二者相互结合,相互促进。导师应针对研究生的个人素质制定个性化、切实可行的培养计划,使研究生的临床技能和科研能力共同提高。     

基于住院医师规范化培训的神经外科硕士研究生带教体会

目的 总结基于住院医师规范化培训的神经外科专业硕士研究生临床带教体会。 方法 在带教老师转变带教观念的基础上,对2013-2015年在首都医科大学附属北京天坛医院神经 外科六、七病区进行规范化培训的专业型硕士综合运用多种教学方法,包括通过直接“呈现”的方式 开展医德教育,通过“实践”和“强化”的方式进行临床工作作风和临床实践能力的培养,以及通过 “发现”的方式培养研究生的临床科研能力。 结果 研究期间参加规范化培训的专业型硕士累计20人;期间,其研究生临床能力考核、执业医师 资格考试通过率均达到100%;在教学主管部门对带教研究生的反馈问卷中,关于老师带教意识、带 教能力及效果方面,满意率均为100%。 结论 通过综合运用上述4种教学方式,有助于参加规范化培训的专业型硕士在临床以及科研能力 的提升。     

脑出血神经外科治疗临床教学体会

正神经外科的专业知识艰深庞杂,更新迅速,患者临床表现千变万化,诊疗过程应用着最前沿的科技手段且风险重重,但大多数学生在本科阶段只接受了外科基本知识培养和基本技能训练,对神经外科非常陌生,因此当他们进入研究生阶段时,面对高度专业化的知识,只有通过规范化的教学和培训,才能培养出具有较强能力的神经外科人才。我院在研究生的神经     

神经外科专业学位研究生综合素质培养的几点体会

神经外科是外科学的二级学科,专科性强,在读的神经外科专业学位研究生的临床技能和科研能力不足是一个普遍现象,而英语水平的高低也在一定程度上制约他们在神经外科进行创新性研究[1].我们尝试改变研究生教学的传统授课模式,增加研究生学习的主动性,从学生的"被动式"接受知识革新为"主动性"摄取,全面提升神经外科专业学位硕士研究生的临床、科研、英文以及创新能力的综合素质[2].     

“病例为基础，文献为导读”的教学方式在神经科学生培养中的模式探讨

神经科研究生在完成了基础课学习之后进入到临床轮转和培养阶段,而临床期间的学习在神经科临床教学中占有举足轻重的地位。而研究生在这个过程中能否熟练掌握神经科及脑血管病的相关内容,更是衡量其能否将理论知识与临床实践有机结合的先决条件,也是我们对研究生临床学习教育的重要要求。研究生在经过本科教育后已经打下扎实的理论基础,对神经科脑血管病相关基础知识有了基本的掌握,而进一步通过优质的临床学习培养教育,对培养神经科研究生的临床意识、临床思维、临床技能以及帮助研究生适应医生社会角色的能力方面都有极大的推动作用。但要真正     

Teaching mental health skills to general practitioners and medical officers.

David Goldberg opened by describing the research that had led up to the present WPA teaching package. Early research had demonstrated that many psychological illnesses were not detected in primary care settings (Goldberg & Huxley 1980; ibid 1992), and these findings have been replicated in 14 centres round the world, with broadly similar results (Ustun & Sartorius 1995). We have found that in the UK the problem is not defects in factual knowledge, but not having clinical skills to assist in the management of mental disorders in general medical settings. The clinical skills needed in primary care are seldom taught in medical schools, and cannot be learned by listening to a lecture: it is necessary to practice them after they have been demonstrated. To do this it is convenient to break complex clinical skills down into their components: these are called "micro-skills", and we will deal later with the way in which these are taught. The most powerful method for improving mental health skills in this setting is to provide doctors with feedback--either video or audio--of their interview with real patients. The emphasis of such teaching must be on the interview techniques used by the doctor, rather than the clinical problems displayed by the particular patient being interviewed (Gask et al 1991). The problem with this is that video-feedback teaching of the necessary type is not always available, so we have developed videotapes that we can send out to distant locations, and which focus the attention of both local tutor and postgraduates on what should be learned. Because it is essential that most of the teaching is done by the live teacher rather than the videotape, there are always several "discussion points" so that postgraduates can ask questions, or describe their own way of dealing with particular situations. The videotapes are supplied together with teaching notes for the tutor, power points slides which can be adapted to suit local conditions, "role plays" to allow postgraduates to practice each skill they wish to learn, and other support materials. There is also a paper written by ourselves in association with Norman Sartorius, who has encouraged us to prepare the teaching package under the auspices of the WPA. Linda Gask described the process of teaching specific 'microskills', by working through how the skills necessary for the management of people who present in primary and general medical settings have been described and taught in the UK (see box 1). A model of the strategies and skills to be [figure: see text] taught was first developed utilizing the experience professionals and teachers from both primary care and mental health. A videotape was produced in which the skills to be acquired were demonstrated by real primary care doctors in role-played interviews with the addition of subtitles to label particular skills. The videotape is then utilised in a group teaching session to model the specific component skills of the model or 'microskills' to the participants in order to demonstrate exactly how the strategies of the model are applied in a real consultation. Watching the videotape will not however change behaviour. To do this, it is necessary to role-play brief scenarios so that the professional is able to practice the actual words he or she would use. This role-play work may be carried out in pairs, with one doctor playing the professional and the other playing the patient, or in threes, with the addition of an observer who ensures that the participants keep to the task. At the end of the role-play all participants provide feedback. These methods are described in much more detail in Gask (1999). Finally, there is also the possibility of videotaping one of these role-played interviews and teaching on this tape with the group as a whole. The specific skills and methods required to do this are described in much more detail along with the research evidence for these methods in Gask (1998). Our approach to facilitating the group in the exercise of videofeedback teaching is summarised in box 2.     

烟雾病方向研究生的培养和带教体会

近年来烟雾病的检出率不断增高,已经成为脑血管病专业一个重要的发展方向,如何提高烟雾病方向研究生的教育质量直接影响到未来这个专业的发展.本文主要介绍烟雾病方向研究生教学的一些经验和体会,在注重培养其科研思维的同时,还加强其临床实践能力的培养,尤其是手术操作技能的训练及提升.     

Analysis on the Driving Factors and Realization Path of the Value of Tutor-Student Relationship of Postgraduates-with Medical and Pharmaceutical Universities as an Example

A harmonious relationship between teachers and postgraduates presents the comprehensive value of psychological education, which guarantees training quality and acts as an effective carrier of mental health education of the postgraduates. Based on Bandura’s theory of reciprocal determinism and Austin’s input-output theory, this paper constructs a model concerning the value of psychological education in the tutor-student relationship. The path of realization is also explored in a structural equation model through a questionnaire survey of 1112 graduate supervisors and administrators in medical colleges. The experimental result indicates that (1) The interaction between teachers and postgraduates promotes the value of psychological education in the highest measure, among which the quality and frequency of tutor-student communication, mutual trust, and respect act as the key influencing indicators. (2) Tutor’s professional quality is considered as the fundamental driving force in the realization of psychological education value in the tutor-student relationship, the maximum mediating effect is observed in the developing path of “tutor’s professional quality-interaction behavior between teachers and postgraduates-psychological growth of teachers and postgraduates. (3) The objective results obtained by teachers and postgraduates, such as the improvement of quality and quantity, positively promote the overall quality of life satisfaction of both sides, which improves the major psychological growth indicators. (4) In the path that affects the psychological growth of teachers and postgraduates, female groups mainly focusing on natural sciences pay more attention to the tutor-student emotional experience, while male and lower-grade groups pay more attention to behavioral interaction; In the path that affects the interaction between teachers and postgraduates, the tutor does not value the difference in the quality of graduate students, lower-grade and natural science professional groups pay more attention to institutional environment.     

Qualitative outcome assessment of a medical ethics program for clinical clerkships: a pilot study.

This study assessed the usefulness of an open-ended case analysis test instrument for evaluating the effects of a 1-year ethics course on medical students' decision-making skills. Through case-oriented seminars in gynecology, internal medicine, obstetrics, pediatrics, psychiatry, and surgery, third-year medical students were taught a structured analytic framework for analyzing clinical ethical problems stressing the interactive relationships among medical indications, patient preferences, quality of life, and contextual (social, legal, economic) matters. At precourse, the students were given a test case and asked to provide a line of reasoning for their clinical decisions. At postcourse, the students were given the same case. Content analysis of pre- and postcourse responses of a random student sample revealed increases in student awareness in the following areas: 1) consideration of informed consent, 2) professional liability, 3) physician-assisted suicide, and 4) resource utilization. With some modifications, open-ended case analysis holds promise for evaluating medical ethics courses. The authors make recommendations for future research in evaluating the true impact of clinical ethics courses in medical education.     

Effects of peer‐assisted training during the neurology clerkship: a randomized controlled study

Objective: To determine the efficacy of peer‐assisted clinical skills training for students during their neurology clerkship. Methods: Students (n = 122) were randomized to get clinical skills training from either student (peer) instructors (experimental group) or from experienced clinical staff (control group). The remaining schedule during the clerkship did not differ between both groups. Primary endpoint was students’ practical skills and knowledge tested at the end of the course by a written test and objective structured clinical examination (OSCE). Secondary endpoints were evaluation of the practical training and self‐estimated gain in theoretical and practical competence. Results: In the written test, the peer‐trained group (n = 66) scored 69.5 ± 10.2 (95% CI 67–72) points of 100 and the postgraduates‐trained group (n = 56) 66.7 ± 11.4 (95% CI 63.6–69.8) (P = 0.15). In the OSCE the peer‐trained group scored 93.7 ± 6.3 (95% CI 92.1 to 95.2) points of 100 and the postgraduates‐trained group 92 ± 5.1 (95% CI 90.6 to 93.4) (P = 0.11). In the evaluation and self‐assessment items, there was no significant difference between the two groups except for the postgraduates’ higher competence (P = 0.004). Conclusion: Peer‐trained students pass written exam and OSCE as efficient as postgraduates‐trained students. Self‐assessed learning success is equally rated in both groups.     

快速成型技术辅助医学影像技术在教学医院神经外科研究生教学中的实践探索

目的分析快速成型技术即3D打印辅助医学影像技术在神经外科研究生教学中的作用,探索教学新方法。方法利用医学影像技术对神经外科低年级研究生进行典型病例的教学;使用3D打印辅助医学影像技术进行二次教学。使用现场提问、调查问卷等方式评估学生对新方法的反映。结果学生普遍认为两种技术结合后,对疾病的感觉理解、空间认识能力有了很大的提升。但当前3D打印技术存在的问题,如打印时间长、不能完全模拟病变等,是限制学生认识水平进一步提升的障碍。结论在神经外科研究生教学领域,3D打印辅助医学影像技术是一个非常有潜力的教学方法,随着3D打印技术的提高,这种优势将更加明显。     

医学统计学在硕士研究生脑血管病教学中的应用

目的   探讨医学统计学在硕士研究生脑血管病教学中的内容和方法。 方法  选择首都医科大学附属北京天坛医院脑血管病专业硕士研究生8名,硕士研究生导师3名,采用文献检索和小组讨论方法学习医学统计学在脑血管病中的应用和方法。 结果  脑血管病专业硕士研究生能够掌握基础的统计学概念和方法;对复杂统计学问题或高级统计学问题,具备查阅有关书籍或文献的能力及与统计学家交流的能力。结合毕业研究课题的设计、实施和数据统计分析,提高实践应用能力。 结论  应注重脑血管病硕士研究生基本医学统计学理论和应用能力的培养。     

计算机技术在冠状动脉粥样硬化性心脏病治疗链中的应用

目的：计算机已经成为医疗工作中的重要工具,但是IT系统的迅速发展与医院临床工作者计算机应用技能的进步却极不平衡。讨论如何适应信息技术及医疗信息系统,合理整合IT资源,基于调查提出了对医院信息技术应用的一些看法。 方法：追踪1例冠状动脉粥样硬化性心脏病患者,对从早期诊断治疗、介入治疗、以至最后冠脉搭桥手术及康复整个诊治链条中的各个环节进行了针对计算机相关信息的收集分析,主要对这个治疗团队中医务人员的计算机技能进行调查分析,抽测了调查对象的一般状况、计算机技能、知识结构、对计算机应用的接受程度。 结果：该治疗链条中所有计算机相关数据的主要特征为软件变异性大,从属门类多;病历时间跨度大;数据的类型多,且为不常见数据类型;动态数据和三维数据较多。计算机知识调查可以明显看出医务人员个人IT技能不足使自己不能熟练地完成自己的本职工作。从自身IT知识自我评估结果来看,护理人员和技师似乎比医生在IT技能方面更为缺乏,部门教育、自学、互联网是他们的主要学习途径;住院医师和主治医师对IT办公系统比较熟悉,他们对目前应用的IT也比较满意。护士和多数高级别的教授或主任医师感觉IT学习不容易,但是多数护士喜欢自己的办公系统。31~40岁的调查对象最容易接受IT系统。 结论：在冠状动脉粥样硬化性心脏病治疗链的计算机技术应用方面,加强计算机研究开发者与治疗团队中医务人员的密切合作互动,在目前这个阶段非常重要。     

定期文献报告会在血管神经病学研究生培养中的体会

目的 探讨定期文献报告会在血管神经病学研究生临床教学中的效果。      

神经病学研究生就业情况分析

目的对神经病学毕业研究生就业情况进行调查,分析如何提高研究生就业质量。方法以首都医科大学附属北京天坛医院神经病学2011-2015届毕业研究生为研究对象。采用Fisher精确检验分析毕业生就业数据。结果 2011-2015届天坛医院神经病学研究生共毕业69人,就业率、医疗单位工作率和留京率为100%(69/69)、85.5%(59/69)和79.7%(55/69),一直维持在高水平。结论通过保证研究生录取和培养质量、提升研究生核心竞争力、提高研究生就业意识和发挥导师作用,可以促进神经病学专业高质量研究生就业流向。