基于检验效能的诊断性试验Meta分析及系统评价方法

本研究提供一种基于检验效能的诊断性试验Meta分析及系统评价的方法,其特征在于以检验效能为主线贯穿于以诊断性试验Meta分析为主体的系统综述评价中,实现检验效能与传统Meta分析中纳入研究的质量评估、总效应量合并、敏感性分析以及Meta分析后效评价的一体化整合。该方法实现了对纳入研究质量评估从定性到定量的转变,弥补了基于样本量权衡合并效应量导致的不足,是检验效能在循证医学领域的拓展和延伸,也有利于诊断性试验Meta分析更加科学规范化、精确具体化和综合全面化。     

留学生烧伤湿性医疗技术见习带教体会

烧伤湿性医疗技术(MEBT/MEBO)现已形成了较为系统的皮肤原位再生学术体系,由于留学生语言交流因素,对这一技术了解不多,本文通过作者教学的亲身体会,对留学生烧伤湿性医疗技术的见习教学提出一些新的思路.以期达到把基本理论运用于临床实践,培养正确的临床思维方法和独立解决问题的能力,同时向外国留学生介绍我国烧伤湿性医疗技术之目的.     

检验医学人员对循证医学应用及认知能力的初步调查

循证医学(evidence-based medicine,EBM)是近10年来现代医学实践中迅速发展起来的一个新兴学科,带动了医学领域各个分支学科的发展。检验医学在其影响下,也将跨入一个新的境界—循证检验医学(evidence-based laboratorymedicine,EBLM)。“以当前最好的证据为基础”的原则,用临床流行病学的方法学规范检验医学的研究设计和文献评价;用当前最好的检验技术和质量控制体系对检验结果进行严格的质量控制和评价,其任务是向临床医师提供反映患者真实情况的证据。因此,循证医学对于现代检验医学的发展和临床工作的质量有着极其重要的作用。但是,…     

2种无创性手段(CT/MRI)评价左心室功能比较的荟萃分析

正摘要目的比较CT与MRI在评估左心室(LV)整体及局部功能的诊断准确性。方法对MEDLINE、EMBASE和ISI Web of Science进行回顾性综述,评价内容包括:射血分数(EF)、舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)和左室质量(LVM)。使用Bland-Altman一致性界限值(Lo A)分析模态之间的差异。采用Egger’s回归检验测量文献偏倚,Cochran’s Q检验和Higgins I2统计评价非均匀性。在非均匀性存在的情况下,运用Der Simonian-Laird方法估计非均匀性方差。结果 53项研究中共1 814例病人纳入本     

PBL教学法在医学七年制临床MEBT/MEBO教学中的应用

烧伤湿性医疗技术(MEBT/MEBO)现已形成了较为系统的皮肤原位再生学术体系,由于PBL教学法强调培养学生分析问题和解决问题的能力,强调基础学科与临床医学的密切联系,通过尝试在七年制医学生外科学临床教学中引入PBL(Problem-based learning teaching method)教学法,以期达到提高学生的临床综合分析能力和临床操作技能之目的.作者从MEBT/MEBO教学目标、问题的设计及小组讨论方案各方面提出了具体需要解决的问题,对PBL应用于MEBT/MEBO教学就必要性、优越性、缺陷性及存在的问题等方面进行思考和分析,并提出了其发展展望.     

研究型生物化学实验教学改革的初步探索

通过对研究型生物化学实验教学改革的尝试,初步探索了研究型生物化学实验教学项目的评价及实验考核体系,探讨了研究型实验在教学实践中对学生科研创新能力的培养。通过上述教学的探索和实践,提出了研究型生物化学实验教学中存在的一些问题。     

武警医院应急卫勤保障分队规范化建设探讨

 目的 研究武警部队医院应急卫勤保障分队的规范化建设.方法 综合采用文献综述法、德尔菲专家咨询法、卫勤演练、桌面推演和实践检验等研究方法,对应急卫勤分队的人员抽组、物资配备、组织指挥、集成运行、训练实战和评价验收等要素进行研究,建立规范化标准.结果 以任务需求为牵引,建立了以组织指挥体系、物资保障体系、训练实践体系、评价验收体系为标准的应急卫勤分队标准化指标.结论 应急卫勤保障分队的规范化建设要立足于快速机动能力、战伤救治能力、组织指挥效能、医疗后送能力的提高.     

PanCan肺癌风险预测模型预测的精确性——基于Danish肺癌筛查试验的CT模型外部验证

<正>摘要目的肺癌风险模型行外部验证,检验其广泛性及临床有用性。Danish肺癌筛查试验(DLCST)是基于人口的前瞻性队列研究,用于评价Pan Can模型。方法 DLCST数据库     

多层螺旋CT薄层重建对孤立性肺结节的诊断价值

目的 评价多层螺旋CT薄层重建在孤立性肺结节诊断中的价值.方法 回顾性分析55例临床病理证实的孤立性肺结节病例,行多层螺旋CT扫描,后进行10.0 mm、5.0 mm、2.5 mm、1.25 mm重建.评价不同层厚影像对孤立性肺结节CT征象检出率及薄层CT与常规CT对孤立性肺结节良恶性诊断效能,结果采用χ2检验进行分析.结果 在SPN CT征象检出上,1.25 mm薄层CT优于2.5 mm及常规10.0 mm CT(P＜0.05);对肺内结节的良恶性鉴别评价方面,1.25 mm薄层CT诊断假阴性率＜10.0 mm常规CT (χ2=24.856,P＜0.05).结论 多层螺旋CT薄层重建可提高SPN的征象检出率,降低诊断小肺癌诊断的假阴性率.     

CT仿真内窥镜成像质量分析

目的 分析并评价ＣＴ仿真内窥镜（ＣＴＶＥ）在人体各部位临床应用的成像质量及其影因素。方法 根据阈值模式将１４３例ＣＴＶＥ成像分为２大类;低密度管腔ＣＴＶＥ（１２０例,包括自然充气管腔及被动充气管腔）及高密度管腔ＣＴＶＥ（２３例）。应用４级评分法评价组管腔ＣＴＶＥ图像在诊断信性、伪影及图像总体质量之间的差异。统计方法应用非参数秩和检验,３组之间的总体差异用ｒｕｓｋａｌ Ｗａｌｌｉｓ检验,组与组之间的     

国际互联网在医学检验教育中的综合应用

目的:提高国际互联网在医学检验教育中的综合应用水平。方法:通过HTML、Java语言、VB语言及图形制作工具等,编制医学检验教学课件,创建自己的国际互联网站点,建立考试题库及日常管理和学习系统。结果:在医学检验教育中利用国际互联网实现了计算机多媒体教学;在医学检验科研中建立了方便的中、英文信息查询及国内外学术交流系统;建成了医学检验考试题库及日常管理和网上学习系统。结论:通过国际互联网在医学检验教育中的综合应用,可极大地提高医学检验的教学、科研及管理水平。     

Integrated medical school ultrasound: development of an ultrasound vertical curriculum

Background

Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate.

Methods

The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings.

Results

Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum.

Conclusions

Focused ultrasonography is an evolving concept in medicine. It has been shown to improve education and patient care. The indications for and implementation of focused ultrasound is rapidly expanding in all levels of medicine. The ideal method for teaching ultrasound has yet to be established. The vertical curriculum in ultrasound at The Ohio State University College of Medicine is a novel evidenced-based training regimen at the medical school level which integrates ultrasound training into medical education and serves as a model for future integrated ultrasound curricula.     

强化专业特色,培养高素质医学影像学技术人才

适应医学影像学快速发展的趋势,优化课程体系,加强专业特色建设,强化实验室建设和教材建设,不断更新教学内容和改进教学方法,探索培养学生的动手能力、创新能力和综合素质的专业教育模式。     

Implementation of a new undergraduate radiology curriculum: experience at the University of British Columbia.

OBJECTIVES: The purpose of this study was to review and revise the undergraduate radiology curriculum at the University of British Columbia to improve radiology education to medical students and to meet the needs of a medical program with province-wide distribution. METHODS: We identified the radiology content of the curriculum from the Curriculum Management and Information Tool online database, from personal interviews with curriculum heads, and from published information. Undergraduates' and recent graduates' opinions were solicited by means of surveys. Information on radiology curricula at medical schools across Canada was gathered from email surveys and personal contacts with members of the Canadian Heads of Academic Radiology (CHAR). RESULTS: Review of our curriculum indicated that lack of a unified syllabus resulted in redundant content, gaps in knowledge, and lack of continuity in the curriculum. Results from the survey of programs across Canada indicated that most schools also lacked a formal radiology curriculum for medical students. By adapting the guidelines from the Association of Medical Student Education in Radiology, we revised our undergraduate radiology curriculum to emphasize integration and self-learning. The modified curriculum includes a combination of instructional technology, focused lectures in preclinical years, and in-context seminars in clerkship rotations. CONCLUSION: Most medical schools in Canada do not have a formal radiology curriculum for medical students. A structured curriculum is required to improve the quality of radiology teaching for medical students.     

Students' perceptions of a near-peer Objective Structured Clinical Examination (OSCE) in medical imaging

IntroductionNear-peer learning, where peers from more senior year levels teach more junior peers is a popular teaching strategy in healthcare education. There is an emerging trend to utilise this teaching strategy in preparing students for Objective Structured Clinical Examinations (OSCEs) in the form of near-peer led formative OSCEs (NP-OSCE). However, there is little exploration of this teaching strategy in medical imaging education, nor how students perceive NP-OSCEs as beneficial to their learning. This study addresses this gap.MethodsUsing a students as partners inquiry approach, 47 near-peer learners' (NPLs) and 6 near-peer teachers' (NPTs) perceptions of participating in a NP-OSCE were examined using an anonymous self-report questionnaire.ResultsNPLs reported that participating in the immersive NP-OSCE helped their performance in the summative OSCE by helping with their preparedness; including understanding expectations, experiencing emotions and being able to identify gaps in their knowledge and skills, which they then used to direct their revision in a manner that demonstrated the development of skills in evaluative judgement. There were mixed findings regarding the impact the NP-OSCE had on NPLs' levels of anxiety. NPTs also found the NP-OSCE beneficial for identifying gaps in their own knowledge and skills, yet found taking on the role of an examiner challenging.ConclusionStudents perceive NP-OSCEs as a valuable learning activity that helps them prepare for their OSCEs by providing a student perspective of an authentic immersive learning experience. NP-OSCEs enable students to focus their revision and develop skills in evaluative judgement.Implications for practiceEducators should consider including NP-OSCEs in their medical imaging curriculum as students perceive it as a valuable learning experience that assists them to prepare for their OSCE.     

Radiology curriculum for medical students: clinicians' perspectives

This study was conducted to establish clinicians' perspectives of a set of radiology curriculum topics for medical student teaching, which were held to be important by radiologists. A questionnaire was sent to clinicians in all specialties. Forty-six clinicians (51.1%) out of 90 returned the questionnaires. All curriculum topics were scored above an average of 4 (agree). The five highest ranking curriculum topics in order of importance were: developing a system for viewing chest radiographs (5.59), developing a system for viewing abdominal radiographs (5.56), developing a system for viewing bone and joint radiographs (5.33), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.33) and identifying gross bone or joint abnormalities in skeletal radiographs (5.22). Correlative analysis between speciality groups showed surgical and medical specialities were significantly different in their responses of two learning outcomes: basic knowledge about the contrast media benefits and risks (P= 0.01) and ability to select the most appropriate and the most cost-effective methods of radiological investigations for clinical situations (P= 0.03). Acute specialities were not significantly different from the other two groups for these two learning outcomes. There was no statistically significant difference for other learning outcomes between the three speciality groups.     

Diagnostic imaging in undergraduate medical education: an expanding role

Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, "virtual endoscopy", functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences.     

对医学研究生《临床流行病学》课程教学的满意度及影响因素分析

目的 了解医学研究生对临床流行病学课程教学的满意度及影响因素,为提升教学质量提供依据。方法 调查对象为某医学院2020级全体研究生,共652人。采用横断面研究设计,以问卷调查的形式收集数据,采用Logistic回归分析教学满意度的影响因素。结果 调查的研究生中统招461名,在职191名。对教材教具及课程安排的评价中,理论教材、实习教材满足学习需求,课程安排合理度方面评价较低;对授课教员及考核方式的各项评价均较高。总体满意度方面,对该课程非常满意和比较满意的比例分别为52.9%和44.3%。总体满意度的影响因素主要包括培养层次、实习教材的实用性、课程安排的合理度、理论结合实习授课方式的合理度、PPT是否满足学习需求、教员授课方式满意度和闭卷考试是否能达到考察知识掌握的目的。 结论 该医学院临床流行病学课程总体满意度较好,但在教材质量及课程安排上仍待提高。提升教材质量、进一步优化教员的授课方式、根据不同类型研究生开展个性化教学、适当增加实习课课时及比重和考试中增加课题设计和文献评价的分数比及等改进措施,可能有助于提升临床流行病学教学的总体满意度。     

The utilisation of radiology for the teaching of anatomy in Canadian medical schools

Objective

To determine the utilisation of diagnostic imaging (radiology) as a department and/or imaging medium in the teaching of anatomy at the Canadian undergraduate medical education level.

Methods

The study objectives were achieved through the use of a questionnaire and a literature review. The anatomy department head at each English-based Canadian Medical School was contacted, and the individual most responsible for anatomy teaching in the medical school curriculum was identified. This individual was subsequently asked to complete a questionnaire that evaluated the involvement of radiology for anatomy teaching in their curriculum.

Results

The use and integration of radiology is a common practice in the teaching of anatomy in Canadian undergraduate medicine. Although the methods and extent of its use varied among institutions, every English-based Canadian medical school, except one, was using diagnostic imaging material in their instruction of anatomy. Furthermore, half of the institutions had a radiologist as a faculty member of their anatomy department to help teach and to use imaging to its full potential.

Discussion

This audit of anatomy departments suggests that diagnostic imaging has an important role to play in anatomy teaching in Canadian English-speaking medical schools.