骨科临床带教的体会

临床见习和实习是医学理论联系实践的桥梁，在医学教学中起着承前启后的作用。医学生能否将课堂上和书本上学习的理论知识同患者的实际情况结合起来，临床见习和实习是非常重要的一环。骨科在外科系统的教学中占有重要地位，其内容繁多、概念抽象、专业性强、专科检查复杂，令不少学生感到困难。现将临床带教的体会总结如下。     

泌尿外科见习带教体会

医学生在完成基础课与部分临床课学习之后进入临床见习阶段。临床见习课程是理论同实践相结合的第一步，在医学教学中起着承前启后的作用，主要目的是巩固课堂讲授内容、培养学生独立思考与实际工作的能力。作者在传统见习带教模式中，不断探索新的带教方法，结合泌尿外科学自身特色，坚持“以兴趣为先导，以问题为基础，以学员为主体，以教师为主导”的教学模式，逐渐提高了医学生的学习兴趣，培养了发现问题、解决问题的能力，收到较好效果。     

以病例为中心的七年制骨科临床见习教学体会

七年制临床医学专业见习课是临床教学中非常重要的一环，教学的好坏，直接影响下轮学习的效果与教学质量。作者于2004年3月至2004年7月带教本院2000级七年制学生骨科临床见习课，采用以病例为中心的带教方式，效果良好。     

立足局部解剖学知识提高骨折临床见习带教质量

临床见习是医学教育中的一个关键环节，是医学生向医生角色转变的必经过程。与课堂教学相比，临床见习教学在教学环境、教学重点和教学方法上都有很大的不同。骨折的临床带教要求实践性强，其概念抽象、专业性强、专科检查复杂，学生常常不知所措。我们通过近几年的临床见习带教，摸索出了一些行之有效的教学方法，现总结如下。1借助标准化病人的模式灵活采集病史骨外科学涉及全身的骨、关节、韧带，专业性强，与其他外科学、内科学相通之处少，因此学生初到骨科临床见习，常感到困难。如果将学生直接领人病房，在真实的病人面前采集病史，往往难以把握骨折类疾病的问诊要领。国外医学教育家较为推崇开展标准化病人的培训，并将其应用于医生临床综合能力的考核。     

皮肤科见习课的带教体会

临床见习是医学、理论知识与临床实践相联系的桥梁，是培养学生建立科学的思维方法，提高分析问题和解决问题能力的重要阶段。学生要面临许多变化，在学习环境和学习方法上都将不同于以往，个人也将开始由学生向医生角色的转变，在这一过渡时期，如何引导学生尽快适应这些变化，提高见习教学质量，是每个临床科室需要总结和研究的内容。作者曾带过两届学生的皮肤科见习，认为皮肤科见习带教工作的关键是提高学生的兴趣，以引导学生积极思考为主线，使他们积极主动投身学习，达到既掌握专业知识，又能提高临床思维能力的目的。     

七年制医学生消化内科临床见习带教体会

七年制医学生基础知识扎实、自学能力强,但临床分析和解决问题的实际工作能力欠缺,而临床见习是医学生理论联系实际的纽带和桥梁。因此,努力提高临床见习的带教效果,对于医学生理解、巩固所学基础知识,为临床实习奠定良好的实践基础至关重要。现结合我科多年带教七年制学生见习的具体情况,探讨如何提高七年制医学生临床见习的带教效果。1传统消化内科见习带教中的困难和缺陷消化内科理论课学时多、专业性强,学习内容多、概念抽象,使学生理解较困难。过去见习带教中大部分时间以教师讲课为主,学生多处于被动地位,部分学生出现厌烦、兴趣不浓…     

启发式教学运用于口腔医学教学的见习带教体会

临床见习带教一直是带教老师所面临的一大课题。见习教学是以增加学生感性认识为主要目的的临床观察和初步操作实践，是理论与临床实践相结合的桥梁，具有不可替代的作用。常规的教学方法存在多种弊端，而启发式教学强调在教师的指导下，学生独立思考，这有利于培养学生独立思考的能力和发挥学生的创造力。     

骨科学临床见习带教的体会

随着现代化素质教育和创新教育模式的不断发展和推进，医学教育的模式也随之发生改变。医学生综合素质水平的不断提高对临床教学工作提出了更高要求。临床见习是理论联系实践的纽带，在医学教学中起着承前启后的衔接作用。骨科在外科系统占有着重要地位，学员在学习过程中反映内容抽象难懂，导致学习积极性不高。因此，教员临床带教成为学员将理论知识运用到实践中的关键环节，良好的临床带教和形象的讲解辅以影像学资料将充分激发学员的学习主动性并更好的掌握临床技能。     

教学医院如何带教神经外科见习医生的几点体会

临床见习是医学生由基础向临床过渡的重要阶段，尽管同学们初涉临床，学习热情高涨，有新鲜感，但由于中枢神经系统解剖关系复杂，如何带教神经外科见习医生，对神经外科医生来说是一个挑战。现将作者在神经外科见习带教中的—些体会总结如下。     

提高《老年护理学》临床教学效果的探讨

《老年护理学》是一门跨学科、综合性较强的课程，如何在临床见习带教阶段中提高教学效果，是保证该门课程教学质量的关键。我教学组通过对广州医学院南大学院2002级护理大专班临床见习教学改革的探索和实践，认为做好教学前的准备、狠抓教学安排及规范带教是保证教学质量，提高教学效果的根本保证。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.