心血管内科临床实习教学中引入微课的应用研究

目的 为了满足学生的个性化学习需求、推动教育信息化，探究“微课”教学模式在心血管内科临床实习教学中的应用情况。方法 纳入2016 年1-9月西安交通大学第二附属医院在心血管内科实习的学生98例，随机地将其分为对照组和观察组，对照组实习生进行传统实习教学，观察组实习生在传统实习教学中引入“微课”教学模式，对比两组在心血管内科实习的理论和技能考核成绩，并且进行对心内科实习教学满意度情况的调查。结果 观察组实习生的临床技能考核成绩显著高于对照组，差异有显著性(P<0.05)。并且，观察组对心血管内科教学方法满意度明显高于对照组，差异有显著性(P<0.05)。结论 将“微课”模式引入心血管内科临床实习教学中可显著增强实习生对临床操作技能的掌握，并且可增强实习生对心血管内科实习教学的满意度     

网络时代如何做好临床实习生思想教育工作

临床实习是一个特殊的学习阶段，实习生既是学生又是医生，面临学业、就业、考研的多重压力，同时初涉社会，思想易波动。多种因素导致临床实习生容易出现心理问题，加强学生思想政治教育十分重要。而临床实习生相对分散，作息不统一，增加了管理的难度。互联网拓展了思想教育的空间和时间，同时具有生动性、趣味性和及时、开放、节约资源的特点。在此，在分析临床实习生思想教育特点、难点和网络信息技术利弊的基础上，提出如何充分利用网络信息技术的优势来加强临床实习生思想政治教育工作。     

临床技能强化训练在外科学实习教学中的作用

通过师生对外科临床技能强化训练的重要性认识，并配套应用病历书写、外科手术基本技能和非手术外科临床操作技能、临床思维能力和医患之间沟通能力等多种临床技能强化训练手段，不断提高实习生外科临床技能操作水平，并巩固和加深理论知识的学习，也增强实习生医患关系良好地沟通，从而全面提高实习生的素质教育。因此，外科临床技能强化训练可有效提高实习生的教学效果和教学质量，值得推广。     

临床实习、带教综合评价分析

为培养护理实习生具有扎实的理论基础，良好的职业道德和较强的临床实践技能，更好地适应医疗服务、社区服务、适应新世纪医疗事业发展的需要。我们对99届，2000届实习生制定了实习生临床实践教学质量综合评价标准、实习生调查表、实习生工作问卷调查表及临床带教工作考评表、实习生临床带教调查表。前三项针对学生进行自评和他评：后两项针对教师的教学工作进行评价，改变了以往单一的只是老师对学生进行理论操作考核的方法，增添了对教师评价的新内容，形成了以教带学以学促教的新模式。对各项指标进行综合分析，及时发现学生在实习中存在的问题并加以指导改进，也促使带教老师不断地完善教学计划，使被评价者（包括老师和学生）不断地提高自身素质，从而提高整体临床实习生教学质量。     

微课在心血管内科临床实习教学中的应用

目的　探讨“微课”在心血管内科临床实习教学中的应用情况。方法　西安交通大学第二附属医院在心血管内科实习的学生98例,随机分为对照组和观察组,对照组实习生进行传统实习教学,观察组实习生在传统实习教学中引入“微课”;对比两组学生在心血管内科实习的理论和技能考核成绩,并且进行对心内科实习教学满意度情况的调查。采用SPSS 17.0进行t检验和卡方检验。结果　观察组实习生的临床技能考核成绩明显高于对照组,差异有统计学意义（P<0.05）。观察组实习生对心血管内科教学方法满意度明显高于对照组,差异有统计学意义（P<0.05）。结论　将“微课”引入心血管内科临床实习教学中,可显著增强实习生对临床操作技能的掌握,并且可增强实习生对心血管内科实习教学的满意度。     

护理实习生的考核与教学体会

目的如何提高临床实习质量，做好实习生的环节控制，规范实习生的考核机制，充分发挥临床带教的积极作用，为适应我院教学改革发展的需要。方法深入了解我院实习同学情况，加强我院实习同学的三基理论和操作技能的培养力度。结果教学改革，首先应建立健全的护理部考核方案，严格学生出科考核是保证实习任务顺利完成的重要保证。学生的出科考核成绩也是评价临床带教质量的主要依据；通过实习生的考核也是对实习生实习的一个全面、客观、真实的实习总结，有利于调动学生的积极性。规范实习生的出科考核，有利于提高临床整体带教水平。通过制定规范性的考核，避免了老师对学生考核的随意性。结论通过考核可以及时发现和了解实习生的薄弱环节，带教老师可以有的放矢的进行带教，使护理教学工作循序渐进的发展。另外在全院范围内建立实习生的专题讲座、护理查房的教学文档，充分体现护理教学的科学性、严谨性和规范化。从而制定了一套具有全面性、可行性、可操作性的考核制度。     

病例追踪讨论式教学模式在实习教学中的探讨与思考

病例追踪讨论式教学模式是以临床教学过程中真实病例为背景，一种采用追踪病例并以学生为中心的教学模式。实习生搜集患者临床相关资料，按照临床思路进行分析、提问和讨论，追踪患者直至其康复出院。病例追踪讨论式教学模式弥补了传统实习教学模式的缺陷，这种教学模式不仅可以调动实习生的学习积极性和主动性，还可以提高学生临床处置能力。随着临床教学改革与发展的不断深化，该模式的推广对临床实习生教学有着积极的意义。     

检验医学实习生培养与就业

临床检验医学实习是巩固、提高、延伸和发展所学的专业知识。为培养符合要求,毕业后能胜任临床检验工作做铺垫,同时增强学生在多元的知识结构和文化环境下,适应社会的能力和就业竞争力,本文从检验医学实习生带教与管理现状存在的主要问题进行剖析,对如何在高校教学改革和医疗改革中有效培养检验医学实习生提出对策,为提高临床检验医学实习生的整体素质、学习效率及就业指导提供参考。     

浅谈口腔实习生在实习中存在的问题及其对策

临床实践是实习生由学生转向医生的过渡阶段，其工作能力多取决于此阶段打下的基础。因此，做好临床带教，解决好实习生存在的问题，为将来培养合格的实用型人才。是临床带教教师义不容辞的责任。我们总结近10年的带教经验，包括了解实习生的知识结构、心理状态、学习需求、临床工作需要及市场需要的变革，于1995年对实习生提出了存在的问题，制定了带教计划，采取了相应的措施，取得了一定的效果。     

浅论对实习生的岗前培训

医院是实习生临床实习的重要基地 ,实习生通过临床实践加深对理论的理解 ,从而达到增强独立工作能力的目的。为使实习生能尽快地进入角色 ,从而达到从学生到护士、从理论到临床的转变。我院护理部对安排来我院实习的学生 ,每期均进行 3d的岗前培训 ,培训内容 :学习医院的各项规章制度 ;加强医德医风教育 ;学习护士礼仪 ,提高自身素质 ;护理技术操作的培训 ;熟悉实习大纲要求。通过培训的实习生进入工作岗位角色快 ,责任心强 ,护理技术操作规范 ,无差错事故发生。因此 ,对实习生进行岗前培训有着非常重要的意义     

综合性医院儿科门诊就诊者心理行为问题调查

目的了解综合性医院儿科门诊就诊患者中有关心理行为问题,以及家长们对待儿童心理问题的态度及诊治需求。方法对2006年12月至2007年1月在本院儿科门诊就诊的4~15岁儿童的家长或监护人进行问卷调查,采用自行设计问卷及儿科症状检查表(PSC),对结果进行统计学分析。结果39.2%的家长认为患躯体疾病会使儿童产生心理行为方面的影响,如睡眠不好、易激惹发脾气等。16.6%的家长认为孩子平时有心理行为方面的问题,然而其中只有39.4%的家长与医师讨论过这些问题,与此相比78.8%的家长能与自己的亲友讨论这些问题。如果发现孩子有心理行为问题,55.8%的家长选择在心理门诊就诊,32.2%的家长选择在儿保门诊就诊,8.5%的家长选择在普通儿科门诊就诊,3.5%的家长选择在精神科门诊就诊。结论患躯体疾病会对孩子产生一些心理行为方面的影响,儿科门诊医师在诊治儿童的躯体疾病时不应忽略这些影响,应予早期的处理,问题严重时转诊到精神专科。虽然家长已经发现孩子平时存在心理行为方面的问题,真正与医师讨论过的家长还不到一半,这影响了儿童心理行为方面的问题的解决。与在精神专科就诊相比,家长们更愿意在心理门诊及儿保门诊就诊,但选择在普通儿科门诊就诊的家长不多,应该充分利用普通儿科门诊这个解决儿童心理行为问题的最便利的资源,改善我国儿童的精神健康服务。     

The pediatric walk-in clinic: competition for the private practitioner

In an affluent city with many pediatricians a 20% increase in patients seen in a hospital-based walk-in clinic in 1982 prompted a study to determine the characteristics of clinic users and their reasons for using the clinic. It was found that users of the clinic were middle-class, that they had a higher employment rate than the average for the region, and that in 54% of the families both parents worked outside the home. The children of 85% of the families were patients of pediatricians in private practice; most of the others were patients of a family physician in private practice. Most of the children seen at the clinic had had symptoms for more than 24 hours, but few parents had attempted to contact their own physicians. In the previous 12 months 95% of the children had been seen at the clinic, 43% in the month preceding the study. They came to the clinic for two main reasons: the broad range of services offered --laboratory, radiology and pharmacy as well as medical--and the convenient hours, with 71% coming outside of their physicians' office hours. Given the reality of social trends pediatricians will either have to share their patients with facilities that offer services outside of regular office hours or devise another system for the treatment of their patients.     

Walk-in clinics: implications for family practice.

To understand better the reasons for the growth in popularity of walk-in clinics in Canada we surveyed 321 patients with a regular physician in Toronto who attended a walk-in clinic in the same city over a 16-day period in February 1988. They were asked their reason for attending the clinic, their perception of the urgency of their problem, their choices as alternatives to walk-in clinics and their satisfaction and concerns with the type of care received at the clinic. The three most common reasons for attending the clinic were convenient location (in 33% of the cases), inability to see their regular physician soon enough (in 16%) and no appointment needed (in 13%). Most (80%) of the patients felt that they needed medical attention within 24 hours after the onset of their problem. Most (83%) of the respondents would have sought medical attention at another walk-in clinic, from their regular physician or at an emergency department had the clinic been closed. Only 36% and 18% of the patients respectively responded that their regular physician worked evenings or weekends. Most of the visits to the clinic were outside regular weekday business hours. The level of satisfaction with the service received at the clinic was high. The extended hours and no-appointment philosophy of walk-in clinics, coupled with family physicians' reluctance to work evenings and weekends, have made such clinics an attractive option for patients with primary care problems that they believe require prompt attention.     

生物制剂在类风湿性关节炎应用中的研究进展

随着类风湿性关节炎研究的深入,针对不同靶点如T细胞、B细胞、细胞因子和黏附分子及其受体等的生物制剂研究并应用于临床。这些生物制剂克服了以往传统药物的缺点,而显示出其独特的优势,生物制剂将成为以后临床重要的一类治疗药物。     

Patients' evaluation of outpatient medical care

150 patients attending an outpatient clinic at the University of Oklahoma Hospital over a 5-week period were asked whether the clinic care they were receiving was better than, as good as, or worse than the care they had received from local physicians. The patients were drawn from the general medicine, cardiology, and oncology-hematology units and tended to be elderly and chronically ill. Most of the patients viewed favorably the care they received in the medical outpatient clinics. 65% reported they had experienced pain or discomfort in the week prior to their visit, but there was no association between these factors and degree of satisfaction with clinic care. Patients averaged about 30 minutes with the physician, and 80% felt the doctor adequately explained their medical condition to them. Patients who rated the clinic care as being worse than the care of private practitioners felt that their condition was not adequately explained. When asked to define a "good doctor," patient responses were "interest in the patient," "skilled and thorough," and "explains things to you." Characteristics identified as being most important in a "good clinic" were; good doctors, well-trained staff, and information from doctors. Of all the factors examined, the one associated most directly with patient satisfaction was personal interest on the part of the physician in the patients.     

七年制儿科专业医学生带教探索

七年制儿科专业医学生的前5年学习中并未特意接触儿科,因此其研究生阶段的2年是培养儿科专业能力的关键时期。学生的临床学习特点是理论知识较扎实,儿科专业能力尚不突出。临床带教中应强调全面培养学生儿科知识和技能,避免过早过细实施亚专科教育;注重培养学生与患儿及家属的沟通;临床教育由面到点,理论联系临床;注重临床工作的实践,培养学生向儿科医生角色转变;同时培养学生作为儿科医生的临床科研能力。     

外科教学门诊实践与体会

教学门诊是一种新的、独特的教学模式，其特点是一对一，针对性强，在教学过程中，学生是主体，教师是协助者，通过反复实践、总结、体会，提高了学生理论与实践结合的能力，加强了学生的社会实践与交流能力，提高了学生的独立工作能力，也进一步训练了学生的归纳总结能力。实践证明是一种良好的医学教学模式，值得提倡。     

Antenatal care of low risk obstetric patients by midwives. A randomised controlled trial.

OBJECTIVES: To assess the practicality, acceptability to patients and salary costs of the antenatal care of low risk obstetric patients by midwives. DESIGN: A randomised controlled trial. SETTING: The antenatal clinic at Westmead Hospital, a teaching hospital of the University of Sydney in western Sydney. PATIENTS: From January 1989 until November 1990, 89 women booking for full antenatal care at Westmead Hospital and classified as low risk were randomly allocated to one of two groups. Group 1 (43 patients) had their antenatal care provided by registered midwives. Group 2 (46 patients) had their antenatal care provided by an obstetrician (either Visiting Medical Officer or Staff Specialist) in a routine hospital antenatal clinic. INTERVENTIONS: Patients in the midwives' clinic were seen by an obstetrician at their first visit to the antenatal clinic and again at 30 weeks and at 40 weeks. MAIN OUTCOME MEASURES: These were the salary costs of each clinic and the patients' levels of satisfaction. Maternal and neonatal indicators, delivery details and analgesic requirements were also considered. These indicators were planned before data collection commenced. RESULTS: The major differences found were a 28% to 68% salary cost saving and that patients cared for by midwives showed appreciation of the continuity of care and information given at the midwives' clinic. CONCLUSIONS: The care of low risk obstetric patients by midwives in a midwives' clinic showed salary cost savings and high patient acceptance.     

紧密联系日常生活和临床提高生理学教学质量

探讨如何联系日常生活和临床实际上好生理课,提高生理学教学质量。教师要拓宽知识面,在教学中联系身边熟悉的事例,提高学生的学习兴趣和主动性；同时紧密联系临床病例突出生理学的临床实用性,笔者在教学中采取导入式和汇聚式教学方法,将生理学知识与临床相互渗透,即可加强基础理论知识的学习, 同时可培养学生运用生理知识分析问题和解决问题的能力,从而有效地提高生理学理论教学效果。     

卫生法学专业法律诊所教学体系的构建

起源于美国的法律诊所教育以对学生进行法学实践技能教育为目的,在全面培养学生理论联系实际的能力和锻炼各项实用的职业技能方面具有积极作用。我国目前的卫生法学专业在培养学生的实务能力方面存在不足,法律诊所教育对此有较好的弥补作用。因此,本文借鉴美国高校在开展法律诊所教育中积累的专业划分细致、开展校外诊所、注重先期培训、评价机...