大学协作型附属医院临床能力培养及考核体系研究

目的探索构建大学协作型附属医院临床能力培养及考核体系。方法本院为南华大学等三所高等医学院校的协作性附属医院,2014年底参照教育部临床能力认证系列丛书《中国医学生临床技能操作指南(第2版)》、南华大学医学毕业生临床技能多站式考核大纲和第8版《诊断学》,结合卫生部《国家执业医师考试标准》,并综合临床实际情况,构建本院临床实践能力培养及考核体系,开展临床医生及临床专业本科实习生(以下简称为学生)临床能力培养与考核的研究与实践。结果 2015—2016年的临床医生及学生的考核成绩显示,临床医生在完成一个培训考核周期后,其临床实践能力得到了强化、教学水平大有提高;学生在完成培训与考核后,大大提升了其临床实践能力。2015年、2016年临床医生及学生代表医院参加校级临床技能竞赛,均取得了团体特等奖和一等奖的好成绩。将临床医生及学生培训后考核成绩与前几年进行比较,差异有统计学意义(P<0.01)。从历年学生组和临床教师组参加高等医学院校临床技能竞赛获得的成绩看,可有力佐证现行临床能力培养及考核体系能有效提高学生和临床教师的临床实践能力。结论大学协作型附属医院临床能力培养及考核体系的建立,对提高临床医生和学生的临床实践能力及非直属附属医院的临床教学水平和教学质量提供了强有力的保障。     

医学影像学实践教学的改革和探讨

对临床医学专业医学影像学课程的实践教学开展基于问题式教学法(Problem-based learning,PBL)、团队式教学法(Team-based learning,TBL)等教学法研究,并通过浙江省学科竞赛、校医学节影像阅片竞赛、开放实验室影像技能培训、科研活动等第二课堂的实践教学,探讨医学影像学实践教学改革的效果。多元化的教学改革在培养学生合作能力方面具有明显的优越性,可以激励学生学习的主动性,提高学习能力,尤其符合医学教育国际标准的要求。     

医学模拟教学基地的建设及意义

目的：探讨医学模拟教学基地建设的意义。方法：介绍我院由医学救援培训中心和临床技能培训中心两部分组成的医学模拟教学基地的基本情况。结果：医学模拟教学基地建设的意义在于理论与实践相结合,教学考核直观化;教学与服务相结合,使社会效益最大化;教学与需要相结合,突出了武警救援医学教学特色。结论：医学模拟教学基地是一种更高效、更理性化和人性化的医学教育、培训以及考核手段。     

分组竞赛法在《基础护理学》实训教学中的应用

目的探索分组竞赛法在基础护理学实训教学中的应用效果。方法选取泉州某医学高职院校2014级三年制护理大专班学生,分为观察组和对照组,分别采取分组竞赛法和传统实训教学法进行基础护理学的实训教学。在教学结束后,采用问卷调查观察组学生对分组竞赛法教学效果的评价;通过操作技能考核比较观察组和对照组的技能成绩。结果观察组对分组竞赛教学法教学效果有较高的评价;观察组学生技能考核的成绩与对照组成绩差异有统计学意义(P0.05)。结论分组竞赛法有助于激发学生学习的兴趣,提高学习的积极性,提高学生的综合素质,增强学习效果。     

临床技能竞赛作用的探讨

探讨临床技能竞赛对于医学院校建设及临床技能教学的积极作用。各医学院校积极参加全国高等医学院校大学生临床技能竞赛,临床技能教学得到前所未有的重视,加速技能实验室建设,提高教师教学水平和学生综合素质,缩短各院校教学水平的差距,促使全国各院校临床技能教学水平的长足进步。     

基于临床技能培训中心平台的临床技能实践教学体系构建

临床技能实践教学是医学高等教育体系中的重要组成部分,是培养实用型新型医学专业人才的关键阶段.该文总结分析某医院建设临床技能培训中心平台的实践经验,探讨临床技能实践教学体系的构建问题,通过建设完善的临床技能中心平台,构建全院临床技能实践教学体系,建立全面的临床技能实践质量监控体系,有效促进了对医学学员的临床实践教学,使医院的临床实践技能教学质量持续提升.     

临床医学技能培训中心的建立和完善

通过建立和完善临床医学技能培训中心，探讨临床医学实践教学的有效途径。我院自1999年以来陆续投资1500万元建造了临床技能培训中心，并有目的、有步骤地完善临床技能培训和考核中心的功能，为医学实践教学提供了设备完备、环境逼真、技能训练规范的教学环境；并结合教学对象及其教学目的、教学方式方法和师资状况，整合设置了不同类型的培训项目；开展不同层次的临床技能培训，为学员临床实践能力的提高奠定良好的基础。     

案例教学结合临床路径在儿科临床教学中的应用研究

目的探讨案例教学结合临床路径在儿科临床教学中的应用效果。方法选择该院2018年1-12月儿科临床实习生100名,根据随机数字表法进行分组,各组为50名,对照组采用传统教学法。按照医院的统一安排对学生进行培训,根据教学大纲要求对学生进行考核。观察组采用案例教学法和临床路径式教学法。比较两组实习生对儿科教学的满意度,比较两组实习生的学习成绩。结果①与对照组对比,观察组实习生对儿科教学的教学态度、教学方式、教学内容、自我提升4个方面的满意度明显更高(P<0.05)。②与对照组对比,观察组实习生学习成绩的优良率明显更高(P<0.05)。结论案例教学结合临床路径应用于儿科临床教学中,能够有效地提高实习生对儿科专业知识的学习兴趣和学习成绩,有利于培养实习生的临床思维能力、独立解决问题能力、探索创新能力。     

情景模拟法在临床护理急救技能培训中的应用

目的探讨情景模拟教学法在临床护理急救技能培训中的效果。方法对全院451名护士采用情景模拟教学法进行急救技能培训,培训结束后进行模拟情景考核,并于1周后随机抽考,将效果与传统教学方法进行比较分析。结果观察组护士各个项目的考核得分均高于对照组护士。结论情景模拟教学法有利于提高护士综合急救技能能、增强急救意识、激发学习兴趣和培养团队协助精神。     

情景引入式思维导图教学法在急诊临床教学中的应用

目的探讨情景引入式思维导图教学法在急诊临床教学中的应用效果。 方法回顾性分析山东省济宁医学院2016级本科临床医学系见习学生共90名，随机分为调查组和对照组，每组45人。针对《急诊与灾难医学》教学中心肺脑复苏章节实施分组教学，对照组按照传统教学模式，调查组则以典型临床案例作为背景引入，利用思维导图将知识点分解拓展，便于培养学生临床思维及团队协作能力。对比两组学生理论考试及操作考核结果，对调查组学生发放教学反馈表进行教学方法反馈。 结果调查组学生在理论及技能操作成绩相比对照组均高，差异有统计学意义(P<0.05)。教学过程不仅培养了学生临床思维及团队协作能力，同时督促教师注重实际教学成果，通过反馈表对教学法进行完善。 结论情景引入式思维导图教学法更适合急诊临床实际教学，对培养学生临床思维及团队协作能力有较好的效果，值得在院校进行推广。     

Performance of medical students in case-based and essay components of written anatomy examinations

This paper reports on second-year medical students' performance in the case-based and traditional essay components of the gross anatomy written examinations at the University of Otago held at the end of 1988 and 1989. The mean marks for these two components of the examinations are presented for the three main categories of student entry. Differential performance on the case-based component relative to the essay component has been determined for each student in the class and ranked in order. The proportions of students in the three entry categories falling in the various quartiles for the class are given. The data show that when an intensive programme of case-based learning was followed, as in 1988, all three categories performed similarly on the case-based component relative to the essay component. When a less intensive programme of case-based learning was used, as in 1989, the differential performance of the preferential undergraduate and graduate categories was different to each other. The findings suggest that the achievement of students in the case-based projects is dependent upon the organization of the programme and the extent to which students and staff become involved in the projects. The writing of reports on the cases by students for assessment in 1988 may have had an important influence on the outcome for this year.     

Active learning in a Year 2 pathology curriculum

PURPOSE: Team-based learning (TBL) has been successfully used in non-medical curricula, but its effectiveness in medical education has not been studied extensively. We evaluated the impact of TBL on the academic performance of Year 2 medical students at Wright State University by comparing this active learning strategy against a traditional method of case-based group discussion (CBGD). METHODS: A prospective crossover design assigned 83 Year 2 medical students to either CBGD or TBL for 8 pathology modules in the systems-based curriculum. The effectiveness of both learning methods was assessed by performance on pathology-based examination questions contained in end-of-course examinations. The highest and lowest academic quartiles of students were evaluated separately. Students' opinions of both methods were surveyed. RESULTS: No significant differences in whole group performance on pathology-based examination questions were observed as a consequence of experiencing TBL versus CBGD. However, students in the lowest academic quartile showed better examination performance after experiencing TBL than CBGD in 4 of 8 modules (P = 0.035). Students perceived that the contributions of peers to learning were more helpful during TBL than CBGD (P = 0.003). CONCLUSION: This study demonstrates that TBL and CBGD are equally effective active learning strategies when employed in a systems-based pre-clinical pathology curriculum, but students with lower academic performance may benefit more from TBL than CBGD.     

Fostering diagnostic knowledge through computer-supported, case-based worked examples: effects of erroneous examples and feedback

Objectives  A case-based, worked example approach was realised in a computer-based learning environment with the intention of facilitating medical students' diagnostic knowledge. In order to enhance the effectiveness of the approach, two additional measures were implemented: erroneous examples and elaborated feedback. In the context of an experimental study, the two measures were varied experimentally.
Methods  A total of 153 medical students were randomly assigned to four experimental conditions of a 2 × 2-factor design (errors versus no errors, elaborated feedback versus knowledge of correct result [KCR]). In order to verify the sustainability of the effects, a subgroup of subjects ( n  = 52) was compared with a control group of students who did not participate in the experiment ( n  = 145) on a regular multiple-choice question (MCQ) test.
Results  Results show that the acquisition of diagnostic knowledge is mainly supported by providing erroneous examples in combination with elaborated feedback. These effects were independent from differences in time-on-task and prior knowledge. Furthermore, the effects of the learning environment proved sustainable.
Conclusions  Our results demonstrate that the case-based, worked example approach is effective and efficient.     

生物医学工程专业程序设计类课程信息化与案例化联合教学实践

目的:探索生物医学工程专业程序设计类课程信息化与案例化联合教学实践.方法:首先根据课程目标和学员特点对信息化手段进行筛选和创新设计,在辅助教学的同时,作为学员最直观的教学案例,引导课程知识点的学习;再以学员为中心通过"使用案例—学习案例—设计案例—完善案例(师生共同)"的闭环学习过程,反作用于信息化手段与教学案例的完善...     

Self-directed learning in anatomy: incorporation of case-based studies into a conventional medical curriculum

This paper reports an attempt to develop self-directed learning skills in second-year medical students by introducing case-based projects into the gross anatomy course at a long-established medical school. The programme and students' responses to a questionnaire completed at the end of the year are presented. Information on the various resources used by students to find information is given. The performance of students in the case-based components of the course has been evaluated and also in the more traditional end-of-year written examination. The data confirm that students have recognized that the projects were about obtaining a deeper understanding of the anatomy, and the programme appears to have promoted the use and study of library texts.     

European dissemination of a web- and case-based learning system for occupational medicine: NetWoRM Europe

Objective Occupation has a large impact on health in Europe. In order to prevent and recognize occupational diseases, medical students and physicians should know about the potentially causal relationship between profession and diseases as well as the basic legal aspects of occupational medicine (OM). However, the opportunity of bedside teaching, the students’ most favoured way of teaching, is limited. Methods One possibility to complete and improve traditional training in OM is computer-oriented case-based learning. Using the authoring system “CASUS” (INSTRUCT AG) cases can be created and handled without knowledge in computer sciences. Results So far, 19 cases have been created and evaluated by students of German universities. Due to the great efforts arising from the creation of such multimedia cases it is desirable and cost-effective to use the existing cases at several medical universities. Therefore, the Net-based Training in Work-Related Medicine (NetWoRM) project shares cases on an international base. In February and April 2005, 13 case-authors from 12 centres were trained in the basics of case creation during a 3 week programme in Munich. The overall evaluation of the participants indicated that this way of teaching case creation is very efficient. Up to now, nine cases were translated into English and five into Spanish. First implementation of the cases in Spain and Finland showed a good acceptance by the students but more evaluation has still to be done. Conclusion Based on these results we conclude that exchange of case-based e-learning in OM is feasible and rewarding on an international base.     

Students' written reports as an essential part of a casebased learning programme in anatomy

Summary. This paper reports on second-year medical students' views and performance on the written reports for the cases that were studied in a case-based learning programme in anatomy at the University of Otago in 1988. The mean marks for the reports for the three main categories of student entry are presented. Differential performance on the written reports relative to the case-based component of the examination held at the end of the year has been determined for each student in the class and ranked in order. The proportions of students falling in the top and bottom quartiles for the class are given. The data taken together indicate that with an intensive programme of case-based learning in 1988, optimal performance in the written reports was reached at an early stage by the graduates whereas the two undergraduate categories improved their performance towards the end of the programme.     

Not knowing that they do not know: self-assessment accuracy of third-year medical students

PURPOSE: The development of self-regulated learning is a major focus of our problem-based learning (PBL) medical programme. Students who are unsuccessful in assessments often seem to lack insight into the standard of their own performance, yet the ability to self-assess accurately is essential for the effective self-management of learning. The aim of this project was to evaluate the accuracy of self- and peer-assessment according to academic performance. METHOD: In 2004, 175 3rd-year students undertook an integrated, case-based, short-essay, formative assessment. After the assessment they were provided with model answers and marking criteria. Students marked their own assessment paper and the paper of one of their peers. Assessment papers were subsequently marked by faculty members. The following data was available for each student: self-mark, faculty-mark, score awarded by a peer and the score that they awarded to their peer. Self-assessment and peer-assessment ability was compared to overall academic performance. RESULTS: Low-achieving students score themselves and their peers generously. High-achieving students score themselves more harshly than faculty. However, they score their peers accurately. CONCLUSION: In the 3rd year of the programme low-achieving students are unable to assess accurately the quality of their own work or the work of their peers in a formative written assessment. The PBL curriculum does not guarantee the appropriate development of self-assessment skills.     

Service Learning Can Make Occupation-Based Practice a Reality: A Single Case Study

ABSTRACT

Service learning is philosophically congruent with the objectives of progressive occupational therapy curricula. This article presents a case-based research study that examined the attributes and outcomes of a service-learning course that included Level I fieldwork. Analysis of the case study identified three themes: (a) the translation of theory to practice, (b) the value of contextual learning, and (c) the gestalt of occupational awareness. Service learning can be considered a pedagogical [2] model that promotes the synthesis of conceptual models to clinical practice. Furthermore, it enables students to develop a professional and personal philosophy of occupation earlier in their careers.     

Simulation in undergraduate medical education: bridging the gap between theory and practice

OBJECTIVE: To evaluate the use of simulation-based teaching in the medical undergraduate curriculum in the context of management of medical emergencies, using a medium fidelity simulator. DESIGN: Small groups of medical students attended a simulation workshop on management of medical emergencies. The workshop was evaluated in a post-course questionnaire. SUBJECTS: All Year 4 medical students allocated to the resuscitation rotation during the first half of 2002. MAIN OUTCOME MEASURES: Student perceptions of learning outcomes, the value of the simulation in the undergraduate curriculum and their self-assessed improved mastery of workshop material. RESULTS: A total of 33 students attended the workshop and all completed questionnaires. Students rated the workshop highly and found it a valuable learning experience. In all, 21 (64%) students identified teamwork skills as key learning points; 11 (33%) felt they had learnt how to approach a problem better, particularly in terms of using a systematic approach, and 12 (36%) felt they had learnt how to apply their theoretical knowledge in a clinical setting better. All 33 students were positive about the use of simulation in their training; 14 students wrote that simulation should be used more or should be mandatory in training; 5 students commented positively on the realism of the learning experience and a further 5 said they valued the opportunity to learn new skills in a safe environment. CONCLUSION: This study demonstrates that medical students value simulation-based learning highly. In particular, they value the opportunity to apply their theoretical knowledge in a safe and realistic setting, to develop teamwork skills and to develop a systematic approach to a problem. A medium fidelity simulator is a valuable educational tool in medical undergraduate education.