加强继续医学教育构建终身学习的教育体系

世界医学教育联合会在2003年3月就提出了继续职业发展的概念,即从学生时代到整个工作生涯,每个人将作为学习型社会的一分子,需要不断更新知识和提高能力,继续职业发展将贯穿在整个毕业后职业生涯中,终身教育已经成为教育发展与社会进步的共同要求.继续职业发展、终身教育、学习型社会等理念的提出,反映了国际经济和科学技术发展的新趋势,对医学教育也提出了新的挑战和更高要求,通过医学"四新"知识的学习、医学实践技能的培训、专科医师准入制度的建立,达到培养适应21世纪卫生事业发展需要的医学人才的目标.     

患者视角:医师应该告知医疗差错吗?——全国10城市4000名住院患者问卷调查研究报告之三

<正>《新世纪的医师职业精神——医师宣言》指出,医师具有对患者负有诚实的责任,在发生医疗伤害时,应该立即将情况告知患者,以赢得患者和社会的信任[1]。医师如何认识医疗差错,在发生医疗差错时怎样处理,发现差错后是否及时报告,不仅直接影响着患者的诊疗质量,而且也从另一个层面反映了医师的专业精神。可见,医疗差错是研究医师职业精神的一个重要问题。本文是"从患者视角对医师职业精神的问卷调查的研究"的一部分,通过对全国10个城市、4000     

骨科进修医师培养中的问题与对策

随着继续医学教育的不断发展,进修已成为越来越多医务人员学习的手段。本科经过多年进修医师培养,积累了一套行之有效的方法。1确定基本标准保证人员素质每年报名进修本科的医师很多,由于其原有教育程度和工作环境不同,技术水准不一。入选基础好、适应性强、接受新知识快、能较快适应三级甲等医院要求的进修医师,是提高医疗质量的保证[1]。要求进修医生具备本科毕业、主治医师以上,优先接受懂电脑的进修医师。2端正态度明确目标进修医师因为社会环境和工作资历不同,进修目的也不一样。大部分进修医师希望通过进修提高自己的整体医疗水平,少…     

建立我省专科医师培养制度——访省卫生厅科技教育与国际合作处副处长梁军

记者：您怎样看待专科医师培训？ 梁军：医学工作的特殊性决定了医学教育的特殊性和复杂性。医学教育体系由医学院校教育、毕业后医学教育和继续医学教育三阶段组成．其中以住院医师、专科医师培训为主要内容的毕业后教育是医学人才临床能力培养极为重要的阶段。通过住院医师、专科医师培训．     

国外全科医学发展与上海全科医学专科医师制度探索与实践

医学教育是由院校医学教育、毕业后医学教育和继续医学教育三个阶段组成．应当强调指出的是，其中毕业后医学教育是培养合格专科医师的主要途径，也是医学教育的特有阶段。欧美等发达国家业已建立了十分完善的毕业后医学教育制度——专科医师制度，包括专科医师的培训制度、准入制度和管理制度。美国是世界上最早实施专科医师准人管理制度的国家之一，于1917年组建了第一个专科医师委员会——眼科委员会。     

医学继续教育措施探析

医院的生存与发展,关键在于提高医疗质量,而医疗质量的提高关键是医学人才的培养,继续医学教育则是实施规范化培养,提高医师水平,更新知识结构,加快掌握新业务新技术的良好途径与重要措施。 一、制定实施医师培训制度 对临床住院医师实行规范化培训,是使住院医师具备扎实的基础理论和临床基本功的重要内容之一。首先要制定出符合本专业特点的培训计划,即培训期     

我国现有医师培养制度存在的问题及对策

通过分析我国现有医学院校教育、毕业后医学教育和继续医学教育等医师培养三阶段的现状,结合我国卫生事业目前发展水平,对其中存在的问题进行较深入地探讨与分析,就实施医师培养相关阶段中存在的问题提出了解决对策。     

南通市三甲医院医师职业精神现状调查

目的:了解目前南通市三甲医院医师职业精神的现状,提出改善和提升医师职业精神的措施和建议.方法:从医生的职业认识和职业态度、职业情感和职业责任、职业理想和职业意志、职业良心和职业荣誉、职业作风和职业信念等方面对南通市三甲医院在册在职医师进行问卷调查.结果:目前南通市三甲医院医师职业精神整体尚可,但是有的医生不能始终坚持以患者利益为首住,并且不能积极地报告或披露医疗差错,评判周围不称职的同事,以最大程度地避免对患者的伤害.结论:建议加强医师职业精神的学习教育,加强行业内部的制度化管理与行业自治,加大对医疗卫生事业的投入,推动国家医疗体制改革成功有效,以进一步促进医师职业精神水平的提升,推动医疗行业向前发展.     

妇产科住院医师规范化培训的做法

住院医师培训是医学教育中三个重要环节之一,是医学生毕业后专业知识和技能进一步深化定向的过程,是提高I临床医疗水平的关键.尤其是规范化住院医师培训,对培养21世纪高层次的医学人才,起着承前(医学生教育)启后(继续医学教育)的重要作用.近年来,全国各地均逐渐实施专科医师规范化培训计划[1].妇产科学是一门实践性很强的学科,从医科毕业生到成熟的妇产科医师,不但需阅读许多专业文献,更重要的是必须进行大量的临床操作实践和总结,并逐渐养成良好的职业习惯.我院作为北京市惟一一家妇产科三级甲等专科医院,同时作为妇产科专科医师的培训基地,在住院医师培训模式上进行了探索和实践.     

新医师职业人格培养的重要性及其继续教育导向

职业人格是一个人为适应社会职业所需要的稳定的态度以及与之相适应的行为方式的独特结合。职业人格可从职业意识、职业精神、职业道德、职业技能、职业性格等五个方面进行体现。目前,在医患关系紧张的社会背景下,患者对医疗服务不断提出更高的要求,医师们在面临复杂的社会环境和巨大的工作压力,必需保持较强的心理承受能力,积极稳健的处世态度,以满足职业需要。因此,新医师的职业性格的培养尤显重要,应纳入医院继续教育的组成部分。     

新医改背景下医务人员职业精神的培育对策研究

目的调查医务人员职业精神的影响因素,研究其培育对策。方法抽取全国637名医务人员,进行问卷调查,分析其道德品质特征、社会责任特征、成就行动特征、人际关系能力四方面得分。结果性别、婚姻、科室对职业精神的影响差异无统计学意义(P>0.05),年龄、学历、毕业院校、职称、工作年限、接受职业精神培训的频率对职业精神的影响差异有统计学意义(P<0.05)。结论应根据年龄、学历、毕业院校、职称、工作年限、接受职业精神培训的频率这些因素建立医务人员职业精神的培育对策。     

The Eroding Principle of Justice in Teaching Medical Professionalism

This article examines the difficulties encountered in teaching professionalism to medical students in the current social and political climate where economic considerations take top priority in health care decision making. The conflict between the commitment to advocate at all times the interests of one??s patients over one??s own interests is discussed. With personal, institutional, tech industry, pharmaceutical industry, and third-party payer financial imperatives that stand between patients and the delivery of health care, this article investigates how medical ethics instructors are to teach professionalism in a responsible way that does not avoid dealing with the principle of justice.     

Professionalism and the basic sciences: an untapped resource

CONTEXT: Medical, technological and societal developments influence doctors' professional responsibilities and present challenges to educating medical students about professionalism. Medical education about professionalism generally focuses on behaviours and competencies which are taught primarily by clinicians in clinical courses and settings. DISCUSSION: Many professional competencies in medicine parallel those in science. We consider here whether medical professionalism can also be taught through the basic science courses which often initiate medical education, and which are typically taught by scientists. CONCLUSIONS: Like doctors, basic science faculty staff can teach professional competencies to medical students. Science faculty are well situated to teach professional competencies and should do so. They can model how to pursue evidence and manage conflicting information. They can also provide explicit messages to students about professional competencies and their value, and create learning objectives that reinforce those messages.     

互联网医疗推动医师多点执业的思考

国家“十三五”深化医药卫生体制改革规划明确将分级诊疗作为重点工作任务,医师多点执业作为推进分级诊疗的重要措施近年来虽然备受关注,但其实施却困难重重,互联网医疗的快速发展有望为医师多点执业带来新的改变。文章在深入分析当前医师多点执业发展现状与挑战的基础上,系统梳理出了互联网医疗背景下医师多点执业呈现出的新形势以及存在的新问题,并从行业监管、机制设计、平台建设和服务模式等方面提出了对策建议,力求为医师多点执业的规范实施提供参考,加快推进分级诊疗政策落地。     

Professional Identity Formation in Medical Education: The Convergence of Multiple Domains

There has been increasing emphasis on professionalism in medical education over the past several decades, initially focusing on bioethical principles, communication skills, and behaviors of medical students and practitioners. Authors have begun to discuss professional identity formation (PIF), distinguishing it as the foundational process one experiences during the transformation from lay person to physician. This integrative developmental process involves the establishment of core values, moral principles, and self-awareness. The literature has approached PIF from various paradigms??professionalism, psychological ego development, social interactions, and various learning theories. Similarities have been identified between the formation process of clergy and that of physicians. PIF reflects a very complex process, or series of processes, best understood by applying aspects of overlapping domains: professionalism, psychosocial identity development, and formation. In this study, the authors review essential elements of these three domains, identify features relevant to medical PIF, and describe strategies reported in the medical education literature that may influence PIF.     

Medical participation in and leadership of quality programmes

Notes that medical participation in organization-wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports research into doctors' involvement in such programmes as distinct from doctors' involvement in medical quality activities. Reveals the lack of systematic evidence on the subject, suggests areas for future research, and summarizes what is known. Gives recommendations based on reported research and experience for quality training for doctors and how medical managers might engage their colleagues and other professions in quality programmes.     

The Osler Student Societies of the University of Texas Medical Branch: A Medical Professionalism Translational Tool

This essay reviews some of the issues associated with the challenge of integrating the concepts of medical professionalism into the socialization and identity formation of the undergraduate medical student. A narrative-based approach to the integration of professionalism in medical education proposed by Coulehan (Acad Med 80(10):892?C898, 2005) offers an appealing method to accomplish the task in a less didactic format and in a way that promotes more personal growth. In this essay, I review how the Osler Student Societies of the University of Texas Medical Branch developed and how they offer a convenient vehicle to carry out this narrative-based approach to professionalism. Through mentor-modeled professional behavior, opportunities for student self-reflection, the development of narrative skills through reflection on great literature, and opportunities for community service, the Osler Student Societies provide a ready-made narrative-based approach to medical professionalism education.     

论新医疗改革背景下医生生产力的发展

摘要随着经济社会的不断发展,国家对医疗改革的决心和举措日渐明晰,而医疗改革的核心内容之一,便是如何最大化地解放和发展医院最具价值的入力资本——医生生产力,新医改方案中大刀阔斧的改革措施为实现这一可能提供了政策依据。从解放医生生产力的现实意义出发,初步探究了医生的生产力受到束缚的现状,并提出了相应的对策、建议。     

The theory of planned behaviour in medical education: a model for integrating professionalism training

Context  Teaching and evaluating professionalism remain important issues in medical education. However, two factors hinder attempts to integrate curricular elements addressing professionalism into medical school training: there is no common definition of medical professionalism used across medical education, and there is no commonly accepted theoretical model upon which to integrate professionalism into the curriculum.
Objectives  This paper proposes a definition of professionalism, examines this definition in the context of some of the previous definitions of professionalism and connects this definition to the attitudinal roots of professionalism. The problems described above bring uncertainty about the best content and methods with which to teach professionalism in medical education. Although various aspects of professionalism have been incorporated into medical school curricula, content, teaching and evaluation remain controversial. We suggest that intervening variables, which may augment or interfere with medical students' implementation of professionalism knowledge, skills and, therefore, attitudes, may go unaddressed.
Discussion  We offer a model based on the theory of planned behaviour (TPB), which describes the relationships of attitudes, social norms and perceived behavioural control with behaviour. It has been used to predict a wide range of behaviours, including doctor professional behaviours. Therefore, we propose an educational model that expands the TPB as an organisational framework that can integrate professionalism training into medical education. We conclude with a discussion about the implications of using this model to transform medical school curricula to develop positive professionalism attitudes, alter the professionalism social norms of the medical school and increase students' perceived control over their behaviours.     

医疗保障的核心命题——医生行为的正向干预

医生行为是医疗费用的阀门，也是医疗费用过快增长的直接责任者．直接关乎医疗保健产业乃至整个经济社会的可持续发展。在市场经济社会．医生行为与居民医疗保障水平和医疗保险制度效果存在原发性矛盾。在居民主要自费医疗的情况下，依靠医生的自律以及与患者的博奔无法解决这一矛盾，关键的路径是政府通过体制的、制度的、行政的等方式对医生行为进行正向干预。