差异化培养结合多种教学法在脑血管病亚专科医师培养中的运用

目的 探讨差异化培养结合多种教学法对不同基础的脑血管病亚专科医师的培训效果。 方法 选取2015年1月-2017年12月在复旦大学附属华山医院培养的96名脑血管病亚专科医师，根据 不同的脑血管病亚专科临床工作时间、学历、职称、医院等级以及导师初评分为初级、中级和高级3组， 针对性地采用差异化教学培养模式。采用学员自评和导师评价综合评估教学效果，评价等级分为好、 较好、一般、较差和差5个等级。 结果 初级、中级和高级组的“好”评率分别为81.8%、71.4%和72.7%，平均75.3%±4.3%，无“一 般”“较差”和“差”评。差异化培养结合多种教学方法具有“因才施教”、阶梯性、系统性和全面性 的特点。 结论 在现实存在的参差不齐水准的脑血管病亚专科医师中，差异化培养结合多种教学方法的教 学模式可达到较好的亚专科医师培训效果。     

个体化多模式教学在脑血管重症监护病房进修护士培养中的临床实践

目的   探讨个体化多模式教学在脑血管重症监护病房培养进修护士综合技能的效果。 方法  将2013年1月～2014年12月在首都医科大学附属北京天坛医院脑血管重症监护病房的进修护士分为两组,2013年72人为对照组,采用“一对一”传统临床带教模式,2014年74人为实验组,采用个体化多模式教学模式。采用临床带教老师评价、结业综合技能考核对教学效果进行综合评价。 结果  实验组进修护士结业综合技能考核结果及各项临床护理核心胜任力评分显著高于对照组（P＜0.01）。 结论  个体化多模式教学不仅能有效提高进修护士所应具备的各项临床护理能力,而且能有效提高其评判性思维能力。     

整形外科临床型研究生带教体会

目的随着经济社会的发展,我国整形外科事业取得了蓬勃发展,对于整形外科技术人才的需求量日益增加。本文旨在探索一种适合整形外科临床型研究生的带教方法。方法作者回顾了整形外科研究所以往在培训进修生及研究生方面的临床带教经验和体会并进行分析,总结了6条行之有效的带教方法:(1)相关基础理论的学习;(2)教学查房、病例讨论与读书报告;(3)手术带教;(4)学术活动;(5)技能培训;(6)专题授课。结果为了提高临床型研究生的带教效果,将以上6种带教模式进行综合运用。结论我科作为整形外科研究生培养的重要基地之一,培养出了大量优秀的研究生,其中以临床型研究生所占比例最大。本文的6种带教方法切实可行,将会对临床型研究生的带教起到良好的效果。     

多种教学方法在神经内科住院医师规范化培训中的应用

    针对神经内科住院医师规范化培训过程中存在的神经系统查体不规范,诊断方法认识不足、临床技能培训不够、带教科室管理和培训不得法,提出完善培训制度、改进培训方法等方面的对策,介绍多种教学方法,以便带教老师在有限时间内,高质量完成神经内科规范化培训目标。     

ICU护生实习带教与管理

目的 通过对护生实习有计划的带教与管理,提高护生的实际护理工作能力 . 方法 设定专职带教老师,制定带教计划,合理调整实习时间,重视良好职业道德的培养,加强动手能力的锻炼,提高护生沟通能力,加强理论知识的再学习,重视反馈意见,不断改进带教方法. 结果 本组护生经过在ICU(重症医学科)的临床实习后,临床实际工作能力得到明显提高,出科后受到其他科室及单位好评,并且带教老师的综合业务素质能力也得到进一步提高. 结论 对ICU护生进行有计划的带教与管理,能明显提高护生的实际工作能力,同时也有助于提升带教老师的综合业务素质能力.     

脑血管病专业研究生对导师的期望调查分析与导师培训启示

目的 调查脑血管病专业研究生对导师的期望,探讨脑血管病专业研究生导师的培训思路.方法 2021年8月,采用自制问卷对首都医科大学附属北京天坛医院在读全体脑血管病专业的163名研究生进行问卷调查,问卷内容包括性别、年龄、培养层次(博士研究生、硕士研究生)、培养类型(学术型、专业型)、选择导师时考虑的主要因素(如师德师风,...     

首都医科大学附属北京天坛医院2017-2019年脑血管病方向研究生生源情况分析

目的 对首都医科大学附属北京天坛医院近年脑血管病方向研究生生源情况进行分析，探讨生源 质量提高策略。 方法 以首都医科大学附属北京天坛医院2017-2019年入学的脑血管病方向研究生为研究对象。对 研究生的性别、年龄、政治面貌及是否为应届生等一般情况，毕业院校情况及入学方式等进行分析。 结果 2017-2019年脑血管病方向研究生生源总量持续增长，依次为35名，41名和59名；女生构成 比高于男生，三年女生比例分别为82.9%、85.4%和78.0%；以应届毕业生（84%以上）及本校生源 为主（56%以上）；来自“211”或“985”高校毕业生较少，不足10%；近三年推免生占比分别为14.3%， 12.2%和22.0%，首都医科大学“5+3”长学制学生所占比例逐年减少，分别为34.3%，22.0%和15.3%。 结论 天坛医院脑血管病方向研究生生源存在着优质生源缺乏、优质生源流失等问题。应在扩大 招生宣传、制定相关奖励配套政策、提高培养质量等方面不断推进，提高研究生生源质量。     

神经外科研究生科研能力的培养

随着社会的发展,中国的神经外科事业也随之飞速的发展,而这对神经外科医生就有了更高的要求,对于如何培养具有创新意识的专业研究生,笔者结合神经外科专业的特点、个人经历及带教的体会,对神经外科研究生科研能力培养的意义及方式、方法进行阐述。     

科研与临床相互融合的教学理念与实践

目的探讨科研与临床相互融合的教学模式,以期更好地在实践中将二者有机地结合起来。方法通过深入分析科研及临床教学工作的特点,将其分解为不同阶段,在实际带教过程中,对医学生进行循序渐进式教学实践。结果培养了研究生严谨的工作态度、构建了严密的逻辑思维、增强了其独立思考与动手能力。结论这种科研与临床相互融合的教学新方式可以更大程度地提升医学生的学习能动性与专业技能,具有很强的理论与实践意义。     

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。     

精神病与精神卫生学专业学位研究生教学案例库的建设

本文目的是探讨精神病与精神卫生学专业学位研究生(MDPM)教学案例库的建设。随着医学模式的转变和教育教学改革,探索新的研究生培养模式势在必行。MDPM教学案例库是理论联系实践的桥梁,可帮助学生巩固理论知识,提高研究生学习的自主性、主动性,锻炼临床思维,提高临床能力,从而提高研究生培养质量。     

Collaboration entre médecins généralistes et psychologues en libéral

Psychologists and general practitioners (GPs) are the stakeholders most consulted by patients with psychological difficulties. They each have their own professional identity, their own working framework, references, and language. In France, interactions between them seem limited in private practice. The importance of developing collaboration between GPs and psychologists is supported by data from collaborative mental health practices developed in various countries. Such practices have shown significant improvement in health care, and benefits for patients’ health, as well as for GPs’ and psychologists’practices, and for the community. In 2018, the French National Authority for Health published an overview of the situation and recommendations to improve the coordination between GPs and other healthcare actors concerning adult patients with mental health disorders. The review invites healthcare actors to work with better conviction, involvement, and shared culture, as well as to recognize each other's roles and competences. The professionals interviewed in this article, three psychologists and three GPs, outline the current state of collaboration between psychologists and GPs in France and in Belgium, reviewing professional identities, barriers to interactions and organizations. Interprofessional collaboration in mental health involving these actors is formalized and developed in several countries, unlike in France where work and experimentation are rare. The role of each is not well known, and few opportunities are offered for interprofessional practice and education. The authors report on their experience in the field, and on initiatives that have been implemented in a Southern France region. Several actions are reported: joint professional training evenings, “public cross-consultations” and “joint case studies” (with patients’ agreement), working group between faculties leading to a joint Study Day, programming paired cross-consultations in the practice of each, as well as exchanging medical and psychology students. This experience allowed for constructive meetings, exchanges within “professional couples” on common patients, and opportunities to expose medical and psychological views. It also enabled the authors to observe their different professional language and tools used, to break the isolation of mental health care actors, to accelerate the understanding of patients’ situations, and to mutually enrich professional knowledge and practices. This feedback from field experience, which is not representative or generalizable, shows that it is possible to take advantage of interprofessionality in the field. When the actors know each other, working together in the interest of the professionals and of the patients shows better results. Finally, the authors question what desirable directions should be adopted–particularly concerning the institutional frameworks recently implemented in France, and the need for shared professional training–and interrogate the definition of “collaboration” itself.     

Psychosomatic education in Turkey

Psychosomatic education during medical study is achieved within psychiatry courses in Turkey. Generally, postgraduate education in psychiatry provides, during the specialization period, also a certain amount of education in psychosomatics. Only the Cerraphasa Medical Faculty at Istanbul University presents a unique form of practice and educational activity in the field of psychosomatics. Here, the Psychoneuroses and Psychosomatics Department within the Psychiatry Clinic (the foundation of which goes back to 1970) provides for medical students a psychosomatic approach and an introduction to psychosomatic concepts within the medical psychology courses and a further theoretical as well as practical knowledge during the psychiatry courses and internships. Postgraduate training in psychosomatics is also unique for Turkey in this department, where psychiatry residents with special interest for psychosomatics spend the major part of their training period in the psychosomatics department and receive theoretical and practical training. Training in psychotherapy is also included in the program. The regular series of seminars and open-lectures organized by this department are directed also to other medical and non-medical staff in various departments and faculties. Consultation-liaison-psychiatry is also part of this training. The department provides under- and postgraduate training (master training) for psychologists. Nurse training (under- and postgraduate) and occupational therapist training are also included in the training program of this Department. The training as well as other therapeutic and research activities of this department are also supported by the Society of Psychosomatics and Psychotherapy.     

Training general psychiatry residents in child and adolescent psychiatry

The authors describe the nature of current social and economic forces impacting on the education and future practice of general psychiatry residents in child and adolescent psychiatry. They review theoretical and practical reasons for training in child and adolescent psychiatry, analyze the form and content of what is currently taught based on a national survey of general training programs, and suggest guidelines for the training and postgraduate practice of general psychiatrists in evaluating and treating children and adolescents. The authors conclude that while social and economic changes necessitate general psychiatrists' clinical involvement with children and adolescents, insufficient general training may necessitate postgraduate education and supervision. They pose ethical and professional dilemmas for the field in meeting the national shortage of child and adolescent psychiatrists and propose strategies to enhance recruitment into child and adolescent residency training.     

精准医疗与脑血管病:教学实践与探索

目的阐述精准医疗在脑血管病专业研究生教学中的模式和意义。方法在临床实践、研究和教学中,通过观察与访谈,了解脑血管病专业研究生对精准医疗概念的理解以及应用精准医疗的理念和进展指导临床实践的能力进行评价。结果研究生在脑血管病精准医疗的知识结构和能力素养方面尚需提高。临床流行病学、生物统计学、分子生物学和计算机科学是精准医疗的学科基础,临床医学与这些基础医学的结合教学有利于研究生精准医学概念的建立。结论精准医疗的教学中应努力使专业学位研究生建立多个交叉学科的复合知识结构,应采用项目导向的方法进行综合能力训练。     

“慕课”式住院医师规范化培训对于医疗集团模式下神经内科教学的思考

随着医疗卫生体制改革的深化，医疗集团模式是近年来大型公立医院发展的一种重要模 式。“慕课”式培训可以有助于解决医疗集团模式下神经内科培训目前存在的诸多问题。“慕课”由具 有专业特长和带教经验丰富的医师精心准备并录制培训课程，再上传至网络平台，由住院医师根据 自身的时间和临床需求自行学习。“慕课”式培训集中了师资力量，具有形式更灵活、内容更丰富的特 点，是可供临床教学实践探索的方式。     

When psychiatric residents treat medical students: Passage through idealization and overidentification

The author describes a survey of psychiatric residents and faculty supervisors inquiring as to problematic aspects of the psychotherapy of medical students when treated by residents. Medical students' idealization of and identification with their resident-therapist were found to produce a significant amount of discomfort for the trainee. Difficulties in the psychotherapies were also attributed to the numerous possibilities of identification by the residents with their medical student patients. The varied forms of identification are detailed through the use of clinical vignettes submitted by respondents. It is the author's contention that psychotherapies involving these “special patients” provide a window for examining many issues in the development of the resident's professional self. Given the increasing number of medical students electing some form of personal psychotherapy and the declining number entering psychiatry residency training, the timeliness of this issue is noted.     

Advances in psychotherapy education.

Acquiring expertise in psychotherapy is central to the professional development of psychiatrists able to employ a broad therapeutic repertoire in their clinical practice. This article reviews how postgraduate psychiatry programs address this important aspect of training. We present the results of a national survey of psychotherapy education in Canadian psychiatry residency programs. The results highlight significant advances over the past decade in curriculum, in teaching methods, and in evaluation. These include training in evidence-based, manualized, time-limited therapies such as cognitive-behavioural and interpersonal therapy, greater attention to evaluating competence, and integrating electronic technology. Trends and advances in postgraduate and continuing medical psychotherapy education programs are considered in association with principles of adult learning. Health education research endorses the provision of longitudinal training programs that integrate learning and practice. We discuss issues related to the development of expertise, the importance of educational communities of practitioners, and the importance of attending to both educational process and outcomes, with a view to more effectively translating psychotherapy practice guidelines into sustained improvements in practice behaviours.     

Ongoing evaluation in psychiatry: the first step toward quality

Concern about quality control in psychiatric training has been heightened by the lack of standardized assessment within residencies to ensure that graduates reach a level of competence commensurate with the ability to practice independently and the high failure rate on the American Board of Psychiatry and Neurology examination. An APA task force explored the paucity of evaluation of both training programs and residents and made 10 recommendations for improving the quality of residency training. The authors describe the evaluative components of these recommendations and the political steps taken to gain professional consensus for their requirement in all training programs.     

The neurology resident as teacher: evaluating and improving our role

There is a need to improve the quality of teaching done by neurology residents because neurology residents are intimately involved in medical student education. This article reviews the available literature on techniques to improve the teaching ability of resident physicians. Eight randomized prospective studies were identified from health and education databases. The outcomes measured were student ratings of residents or objective ratings of interactions between residents and students. The skills curriculum provided a more robust response, and the objective standardized teaching examination (OSTE) provided a standardized outcome. There continues to be a need for studies specifically addressing the teaching by neurology residents and fellows.