乳腺外科教学中的体会

本文介绍了乳腺外科理论教学、临床见习和实习带教中的几点体会，对提高乳腺外科的临床教学有所帮助。     

TBL联合CBL教学法在脊柱外科临床教学中的应用

脊柱外科研究生的临床教学是医学院校教学工作的重点和难点,而临床教学方法是脊柱外科临床教学的关键。本文对当前脊柱外科研究生临床教学存在的问题,以及 TBL 教学法和 CBL 教学法联合应用于脊柱外科研究生的临床教学进行探讨。     

外科临床教学查房工作体会

结合3年来外科临床教学实践,总结了外科临床教学查房基本要求,规范化的教学查房流程,具体内容,指出目前教学查房不良现状的各种表现形式,提出教学查房实施上存在的问题及各种应对策略、注意事项等,初步探索外科临床教学查房内容、组织形式,进一步规范临床教学查房实施,提高外科临床实习医师的教学质量。     

外科临床教学师资梯队的建设

外科临床教学是外科教学的重要组成部分，是医学生的重要实践阶段。外科教学包括理论授课、见习及实习带教，还包括外科基本操作和手术基本功的培训。临床教学质量好坏直接关系到毕业生的培养质量，是医学院校教学水平的重要指标。临床教学的师资的水平是保障教学质量的一个重要条件。     

高职高专外科临床实践教学探讨

高职高专的外科教学是医学生教学中很重要的一部分,是联系临床与基础医学理论的桥梁,同时也会对医学生的实习和工作产生影响。因而,在高职高专的外科教学过程中,培养医学生的临床能力成为实行外科学教学的关键。文章主要是对高职高专的外科临床教学方法进行探讨。     

提高临床本科生在急诊外科实习质量的体会

急诊外科教学是医学生外科教学过程中的重要环节,也是基础医学理论和临床有机结合的桥梁,在急诊外科教学中对如何提高医学生的实习质量,笔者总结一些带教经验,从教与学两方面加强医学实习中的临床思维能力的培养,注重实习生动手能力的培养;通过个案分析,培养规范的临床诊断思维能力。为进一步提高急诊外科临床教学质量提供参考。     

微信平台在烧伤外科监护室外国留学生教学中的应用

烧伤外科监护室外国留学生的临床教学是一项具有挑战性的教学任务.将微信平台引入烧伤外科的临床教学,将专业知识、医学图片、视频等内容采取基于手机的主动推送方式发布微信,形成师生之间点对点、点对面的三维时空教学模式,在临床带教中贯彻病例教学法,实现积极的教学反馈和师生互动,显著提高烧伤外科监护室的临床教学质量,取得良好效果.     

外科教学质量管理原则的探讨

一、外科教学质量管理的要求 根据外科教学大纲的要求和医教部对临床教学的具体实施方案,遵循临床管理的原则,采取科学的方法,组织、管理、协调教学过程的人、财、物、时间、信息等多参数的关系。正确处理好外科中各科室之间的关系,充分利用一切有利条件,全面优化外科教学全过程     

学习合同在高职护理外科临床教学中的探索与实践

目的：通过学习合同在高职护理外科临床教学中的实践,旨在探讨学习合同在高职护理外科临床教学中的运作方式与教学效果。方法：125名学生被随机分成实验组和对照组,实验组采用学习合同教学策略,对照组采用传统带教方式教学,比较两组学生入科考试、出科考试、临床技能考核、实习生结业考试外科成绩的差异,数据采用SPSS13.0软件进行统计分析。结果：实验组在出科考试、临床技能考核、实习生结业考试方面外科护理成绩显著高于对照组。结论：学习合同教学策略较传统临床教学法更能提高高职护理学生的理论水平和临床技能,达到更好的教学效果。     

医用仿真乳房教具模型结合PBL教学法在乳腺外科临床教学中的应用

乳腺外科的特点是患者群体以女性为主、疾病所在部位是女性的第二性征部位,如何处理好保护患者隐私权与临床学习、工作之间的关系也是问题之一。以问题为基础的教学法（Problem—basedlearning,PBL）是一种以自我学习为主,教师引导的新型教学方法。采用PBL教学法实施乳腺外科临床教学,应用医用仿真乳房教具模型,可以锻炼并提高学生的检诊技巧,减少患者隐私部位暴露时间,启迪学生关注人文,提高医患沟通能力,处理好患者隐私权与临床教学需要的矛盾。     

提高普外科临床教学质量的探讨

普外科临床教学是医学生培养的重要组成部分,是将学生培养成为医生的必经阶段之一。本文分析了现阶段普外科临床教学的特点和存在的问题,从教师、学生、教学内容和患者四个方面阐述了改进教学方法、提高教学质量的具体方法和体会。     

Education for breast self-examination: Why,who, what,and how?

Analysis of the continuing controversy about the value and effectiveness of breast self-examination is provided and suggestions are made about the kinds of data needed to establish it's effectiveness. Research data about characteristics of women who perform breast self-examination regularly and those who do not and about the usefulness of mass communication, group efforts, and individual approaches to obtain regular and correct self-examination are assessed. Research and educational efforts focusing on six activities are needed: (a) obtaining regular and correct breast self-examination practice by women, (b) reducing delay by women after suspicious findings, (c) teaching physicians to do correct breast examinations, (d) reducing delay by physicians in referring suspicious cases to surgeons, (e) reducing women's delay after referral, and (f) teaching surgeons to do breast examinations correctly and reducing their delay in beginning treatment. Most of the research reported deals with regularity of breast self-exam, while some deals with correctness. The only intraindividual variables that have differentiated consistently among regular and less-regular BSE practitioners have been knowledge and confidence of ability. Very little research has been carried out on the other five activities and is therefore sorely needed. Suggestions for desirable educational efforts in each of these six areas are made.     

提高急诊外科临床教学水平的探讨

为培养合格的临床医生,急诊外科的临床实习是其重要组成部分。根据急诊外科工作特点,强化教学意识,采取多种形式开展临床教学是加强急诊外科临床教学工作的有效方法和途径。     

Treating early-stage breast cancer: hospital characteristics associated with breast-conserving surgery.

Despite growing acceptance of the fact that women with early-stage breast cancer have similar outcomes with lumpectomy plus radiation as with mastectomy, many studies have revealed the uneven adoption of such breast-conserving surgery. Discharge data from the Hospital Cost and Utilization Project, representing multiple payers, locations, and hospital types, demonstrate increasing trends in breast-conserving surgery as a proportion of breast cancer surgeries from 1981 to 1987. Women with axillary node involvement were less likely to have a lumpectomy, even though consensus recommendations do not preclude this form of treatment when local metastases are present. Non-White race, urban hospital location, and hospital teaching were associated with an increased likelihood of having breast-conserving surgery.     

Correlates of surgical treatment type for women with noninvasive and invasive breast cancer

There is concern that breast-conserving surgery is underused in some breast cancer patient subpopulations, including women with ductal carcinoma in situ (DCIS), an early-stage form of the disease. We conducted a population-based study to identify correlates of surgical treatment type and patient satisfaction, comparing women with DCIS and those with invasive disease. We used telephone interview and mailed survey of 183 women recently diagnosed with breast cancer (oversampling for women with DCIS), identified from the Metropolitan Detroit Cancer Surveillance System (response rate 71.2%). Overall, 52.5% of study subjects received a mastectomy (48.9%, 45.8%, and 73.5% of women with DCIS, local disease, and regional disease, respectively, p < 0.05). One third of women did not perceive that they were given a choice between surgical types, and an additional one third of women received a surgeon recommendation, most of whom received the treatment recommended. Patient attitudes, such as concerns about the clinical benefits and risks of specific surgery options, were important correlates of treatment choice but did not vary by stage of disease. Knowledge about differences in clinical benefits and risks between surgery options was low. Finally, satisfaction with the decision-making process was significantly lower in women who did not perceive a choice between surgery options. Correlates of breast cancer surgery type appeared to be similar for women with DCIS and invasive breast cancer, with surgeons playing a dominant role in the process. Results also suggested that the decision-making process may be as important for patient satisfaction as the treatment chosen.     

提高皮肤性病学教学质量的探索与实践

总结了皮肤性病学的基本特点和教授本课程时需把握好的几个环节,就提高皮肤性病学教学质量进行了一些思考,并结合我院经验提出了皮肤性病学教学改革的创新思路。     

Health disparity: time delay in the treatment of breast cancer in Louisiana

Previous studies have suggested that breast cancer patients with a delay of three months or more in initiating radiotherapy after breast conservative surgery, have increased recurrence and lower survival than those without treatment delay. In this study, the inequalities in receiving radiation on time after surgery were identified in five areas--patient's age at diagnosis, race, size of the facility where the patient received treatment, teaching status of the facilities and geographical location where the patient received treatment. All patients studied were female patients. Women younger than 50 years of age, of the black race, receiving treatment in a teaching hospital, and who were treated by surgeons in southeast and central Louisiana were more likely to experience delay in receiving radiotherapy after breast conservative surgery than their counterparts. Patient's insurance status, marital status and SES did not have any influence on treatment delay. Also, the surgeon's practice age at diagnosis, the surgeon's medical school, facility ownership status and Commission on Cancer approval status did not show significant effect.     

Breast self‐exams: Are health professionals doing their part?

Although breast cancer cannot be prevented at this time, early detection is the single most important factor in recovery. Early detection is largely dependent on discovery of the breast cancer by women through self breast examinations. This study indicates that health professionals either neglect to teach breast self‐exam (BSE) or fail to document teaching it in the patient's record. One hundred eight records of hospitalized clients who had identified risk for breast cancer were reviewed for documentation of teaching of BSE by the health professional. Even though all clients had multiple risk factors, no documentation of teaching BSE was present. These findings indicate a need for some structure in the health care system to assure that health professionals are fulfilling their obligations to teach BSE and to document it in the patient's records. Including it as part of nursing history, a standard nursing care plan, or as a part of audit criteria would assure more consistency in the teaching of BSE.     

Diffusion of breast conserving surgery in medical communities

Excluding skin cancers, breast cancer is the most common form of cancer in women. Due to an increased focus on early detection, many more cases of breast cancer are now diagnosed at an early stage, which makes the use of breast conserving surgery (BCS) an efficacious and often more desirable treatment choice than mastectomy. An analysis of the variation in the use of BCS in the United States was performed using data from the years 1988 and 1994, and stratifying hospitals on the basis of teaching status. In both 1988 and 1994, BCS was highest in academic teaching hospitals and lowest in community hospitals. This finding is interpreted within the framework of classical diffusion theory. Social and cultural norms in local medical communities have a strong effect on the degree to which innovations diffuse rapidly or not. This analysis is useful in the understanding of geographic and hospital-based variations in treatment for early stage breast cancer and other illnesses that have long and strongly held traditions of treatment.