中药制剂分析课程教学改革的探索与实践

采用PBL教学和多媒体教学等多种途径,对现行的中药制剂分析课程进行改革.实践证明,通过课程教学改革,不但活跃了课堂气氛,提升了教学效果,更培养了学生的自我学习能力和创新意识.     

问题式教学法在中药制剂教学中的应用与探讨

目的:探讨以问题为导向(PBL)的教学方法在中药制剂教学中的应用。方法:以中药制剂课程为例,采用PBL的教学模式,开展分组-布置问题-小组讨论-班级讨论-小组总结-小组评价-教师点评的教学。结果与结论:我院中药制剂教学中采用PBL的教学方法,取得了一定的成效。PBL是跨学科的学习方式,其可以激发学生自主学习的热情,培养学生主动学习、分析和解决问题的能力以及独立思考和逻辑思维的能力。     

手术人员术前准备课程教学的研究

手术人员术前准备工作是无菌技术的重要组成部分，是外科护理工作的重要环节。无菌准备是避免伤口感染、确保手术成功的关键。通过教学，了解贵阳护理职业学院护理专业高职学生对手术人员术前准备的掌握情况，同时探讨如何改进教学模式。首先在模拟手术室进行教学，考核合格后再到医院手术室进行参观学习，按照理论-演示-实操-点评-考核-医院见习进行，共计8学时，该教学方法注重理论联系实际，培养学生技术应用能力，教学效果好于单纯性理论授课，学生学习的积极性得到提高，实现了教、学、做一体化，考核结果满意，实习医院反馈较好。     

An Asynchronous Learning Approach for the Instructional Component of a Dual-Campus Pharmacy Resident Teaching Program

Objective. To describe the shift to an asynchronous online approach for pedagogy instruction within a pharmacy resident teaching program offered by a dual-campus college.Design. The pedagogy instruction component of the teaching program (Part I) was redesigned with a focus on the content, delivery, and coordination of the learning environment. Asynchronous online learning replaced distance technology or lecture capture. Using a pedagogical content knowledge framework, residents participated in self-paced online learning using faculty recordings, readings, and discussion board activities. A learning management system was used to assess achievement of learning objectives and participation prior to progressing to the teaching experiences component of the teaching program (Part II).Assessment. Evaluation of resident pedagogical knowledge development and participation in Part I of the teaching program was achieved through the learning management system. Participant surveys and written reflections showed general satisfaction with the online learning environment. Future considerations include addition of a live orientation session and increased faculty presence in the online learning environment.Conclusion. An online approach framed by educational theory can be an effective way to provide pedagogy instruction within a teaching program.     

Physiological considerations in the design of particulate dosage forms for oral vaccine delivery

The gastrointestinal tract provides a variety of morphological (e.g. epithelial cells, mucus) and physiological (e.g. enzymes, pH, transporters) barriers to the absorption of peptides and proteins. Approaches to overcome these barriers have included the use of particulates which are taken up by specialized mechanisms present in M cells of the gastrointestinal tract. Due to its limited capacity, this approach has found particular application in the delivery of vaccines. In this review, morphological and physiological characteristics of the gastrointestinal tract which influence the design of particulates for oral delivery will be presented. Particulates have been designed to resist luminal factors responsible for limiting absorption and to target a specialized cell population, the M cells, within the gastrointestinal tract employing both physical and biological approaches (e.g. charge, size, hydrophobicity, surface ligands such as lectins). For vaccines, this approach may have 'particular' attraction due to the signal magnification which can be accomplished in the gut associated lymphoid tissue (GALT). Recent studies have demonstrated that epithelial cells can be converted to M cells following exposure to Peyer's patch lymphocytes. Future studies designed to identify the factor(s) responsible for transient conversion of epithelial cells to M cells could provide an approach to enhance efficiency of vaccine delivery.     

The semi-structured triple jump—a new assessment tool reflects qualifications of tutors in a PBL course on basic pharmacology

In spite of major efforts, there are only a few assessment tools reflecting learning outcomes particularly attributed to problem-based learning (PBL). We aimed to design a more appropriate assessment method by merging elements of the key features and the triple-jump approach. In a prospective, two-phase study, we designed and validated a new assessment tool, called the semi-structured triple jump (sTJ). At the end of a course on basic medical pharmacology, it was performed in addition to a final exam composed of multiple-choice questions. Since in a previous study we had shown tutor expertise to influence students’ perception of the learning process, we examined the effect of tutor expertise on results obtained with these assessment tools. We newly developed a questionnaire for student evaluation of the PBL learning process that was validated and tested for reliability. Our aim was to answer two major questions: (1) Does our newly designed assessment tool come up with methodical claims like validity, objectivity and reliability? (2) Does our newly designed assessment tool reflect differences in tutors’ expertise? The semi-structured triple jump turned out to be a valid and highly objective assessment tool showing a moderate reliability as found with other triple-jump modifications before. Interestingly, several steps of the sTJ showed a significant correlation to either tutors’ subject- or method-matter expertise, respectively. Our data support the approach of supplementing the assessment by structured case-based tools to make it more appropriate for PBL.     

Polymer based drug delivery systems for mycobacterial infections

In the last decade, polymer based technologies have found wide biomedical applications. Polymers, whether synthetic (e.g. polylactide-co-glycolide or PLG) or natural (e.g. alginate, chitosan etc.), have the property of encapsulating a diverse range of molecules of biological interest and bear distinct therapeutic advantages such as controlled release of drugs, protection against the premature degradation of drugs and reduction in drug toxicity. These are important considerations in the long-duration treatment of chronic infectious diseases such as tuberculosis in which patient non-compliance is the major obstacle to successful chemotherapy. Antitubercular drugs, singly or in combination, have been encapsulated in polymers to provide controlled drug release and the system also offers the flexibility of selecting various routes of administration such as oral, subcutaneous and aerosol. The present review highlights the approaches towards the preparation of polymeric antitubercular drug delivery systems, emphasizing how the route of administration may influence drug bioavailability as well as the chemotherapeutic efficacy. In addition, the pros and cons of the various delivery systems are also discussed.     

Pharmacy involvement in a multidisciplinary diabetic teaching program

The following article describes a method of developing a workable diabetic teaching program within a hospital setting. Emphasis is placed on involving other health professionals with expertise in their respective areas. Development of behavioral and learning objectives along with learning activities and methods of evaluation are discussed. The purposes of this program are: 1) to reduce the overlap in educational instructions given to patients with diabetes, and 2) to remove the problem of an unorganized patient education effort by placing such patients into a structured learning situation in which they feel comfortable and which is conducive to learning. This program has proved successful and provides a viable means of involving staff pharmacists with patients. It has taken a minimal amount of time and did not necessitate an increase in our staff.     

Targeting inhibitor of apoptosis proteins (IAPs) for cancer therapy

Since cell death by apoptosis plays a key role in the regulation of tissue homeostasis, dysregulation of the cell's intrinsic death program may foster tumor formation and progression. "Inhibitor of apoptosis proteins" (IAPs) block apoptosis at the core of the apoptotic machinery by inhibiting effector caspases. Aberrant expression and/or function of IAPs are found in many human cancers and have been implied in resistance to current treatment approaches. Recent insights into the role of IAPs have provided the basis for various exciting discoveries that aim at modulating expression or function of IAPs. Thus, targeting IAPs, e.g. by antisense approaches or small molecule inhibitors, presents a promising novel approach for future drug development and may proof to be a successful strategy to overcome apoptosis resistance of human cancers.     

A clinical pharmacy program for cardiac patients

Through efficient staff scheduling our 481-bed community teaching hospital has been able to expand its pharmacy services. This paper describes how a clinical pharmacy service program for cardiology and cardiac surgery patients was developed and defines the service components. After over two years of experience with the cardiology program, we have found this pharmacy service area to be very successful and well received. Various forms and proposals are provided to assist other pharmacists interested in expanding into this area of practice.     

A multidisciplinary approach to patient controlled analgesia.

Patient controlled analgesia (PCA) is an innovative method for delivering intravenous analgesia, which requires therapeutic and technical expertise from various health care professionals. This article describes a multi-disciplinary process of implementing a PCA program including approaches to solving problems encountered. A pharmacy and therapeutics subcommittee was established with various aspects of the program assigned to the medical, nursing and pharmacy staffs, intravenous (IV) therapy team, and clinical equipment support. A detailed comparison of PCA pumps was prepared to aid in selection. A pharmacy-based protocol describes the role of each health care professional. Usage guidelines are presented and evaluated. Physician order sheets and narcotic disposition forms were designed specifically for PCA. Problems encountered include dedicated IV access, PCA use in specialized hospital units, and use in pediatric patients. A multi-disciplinary approach was successful in implementing and maintaining a quality PCA program. Similar approaches should be used for other sophisticated drug-delivery systems.     

PBL教学中教师的转变及作用

PBL(Problem-Based Learning)教学模式打破传统模式的"填鸭式"教育,注重学生的主体作用,强调以学生为中心,而非教师的讲授。教师不给学生提供问题答案或信息,而是教会学生如何探究问题的答案,促进学生自学,通过总结评价来衡量学习效果。从而教师的角色发生了根本性转变。教师所起到的作用趋向于多元化。     

Advanced neuroprotection for brain ischemia: an alternative approach to minimize stroke damage

Despite decades of research on neuroprotectants in the fight against ischemic stroke, no successful results have been obtained and new alternative approaches are urgently needed. Translation of effective candidate drugs in experimental studies to patients has systematically failed. However, some of those treatments or neuroprotectant diets which demonstrated only beneficial effects if given before (but not after) ischemia induction and discarded for conventional neuroprotection, could be rescued in order to apply an ‘advanced neuroprotection strategy’ (ADNES). Herein, the authors discuss how re-profiling those neuroprotective candidate drugs and diets with the best potential, some of which are mentioned in this article as an ADNES, may be a good approach for developing successful treatments that protect the brain against ischemic damage. This novel approach would try to protect the brain of patients who are at high risk of suffering a stroke, before damage occurs, in order to minimize brain injury by having the neuroprotectant drug or diet ‘on board’ if unfortunately stroke occurs.     

A scoping review of health professional curricula: Implications for developing integration in pharmacy

BackgroundIntegrated health professions curricula aim to produce graduates who are capable of meeting current and future healthcare needs. This is reflected in pharmacy education where integration is increasingly advocated by pharmacy regulators as the perceived optimal way of preparing students for registration as pharmacists. There is, however, no definition of integration. Integration can be described according to a model of horizontal, vertical or spiral integration. It can also be described by the themes used to integrate, such as a systems-based approach or by integrative teaching and learning approaches. The level of integration can also be described.ObjectiveThis scoping review aimed to explore health professions education literature to inform the optimal design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula?MethodsThe Arksey and O'Malley scoping review framework was utilised. Ovid MEDLINE, EMBASE, Scopus, Web of Science and ERIC were searched. Models of integration, themes for integration, integrative teaching and learning approaches, and level of integration were defined and supported data extraction.ResultsThere were 9696 records screened and of these 137 were included. The majority of studies (n = 88) described horizontal integration. Systems-based teaching (n = 56) was the most common theme reported. Various integrative teaching and learning approaches were described, including experiential (n = 43), case-based (n = 42) and problem-based (n = 38) learning. The majority of the curricula could be classified as levels 5–7 on Harden's ladder (n = 102). Perception outcomes were reported for 81 studies, and only 3 reported outcomes beyond perception. Reported outcomes were generally positive and included knowledge gains and increased motivation.ConclusionsThere is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to describing the model, theme, teaching and learning approach and level of integration. There remains a lack of evidence for integration.     

提问式互动教学法在《抗感染药物合理应用》课堂教学中的应用尝试

目的:尝试将提问式互动教学法应用于医学本科生《抗感染药物合理应用》课堂教学中。方法:课前进行教学设计,包括问题设计和开卷笔试相同试题2套,教学过程中采用提问式互动教学法。结果:授课课堂气氛活跃,充分调动和激发了学生学习的热情和积极性,学生平均成绩由课前50·2分增加到课后96·6分,并具有显著统计学差异(P<0·01)。结论:提问式互动教学在医学本科生《抗感染药物合理应用》课堂教学中的尝试是成功的,值得推广。     

Pharmacists' quality of learning in a diploma/MSc course in pharmacy practice

A rapid expansion of postgraduate courses in pharmacy practice has raised the issue of quality. An understanding of how pharmacists approach their learning is one factor that influences learning outcomes. It would, therefore, be of value to identify pharmacists' approaches to learning. This paper describes the approaches to learning on a postgraduate diploma/MSc course in pharmacy practice. The Approaches to Study Inventory was administered to a total of 103 pharmacists over a period of three years. Overall, the pharmacists demonstrated a high meaning orientation and low reproducing orientation, indicating a high quality of learning. This was supported by a consistently low negative attitude score. The surface approach increased significantly in 1993 and 1994 compared with 1992. This is difficult to interpret but may have been due to increased workload. The use of this instrument in combination with other methods of evaluation has allowed a good database to be built up for designing the future of the pharmacy practice course.