加强青年医师临床综合素质培养的探讨

新世纪医疗市场竞争日趋激烈,广大患者的医疗需求不断增长,作为工作在临床一线的青年医师,其综合素质正面临着前所未有的挑战[1],如何加强青年医师临床综合素质的培养,以适应当今临床实际工作环境的需要,这是临床医学教育工作者必须思考的问题。1新世纪医学教育和临床工作面临的挑战1.1临床医师的知识结构和综合素质的改变科技的发展向医学领域不断的渗透,促进了临床医学的发展,同时也带来了各学科之间的交叉与融合,导致传统的学科界限变得模糊,另一方面要求掌握一门新的专科知识和技能需要了解更多其它相关学科的知识,这无疑改变着临床医师…     

检验医师培养的实践探讨

采取临床科室轮转学习、临床教学查房、临床会诊和病例讨论、检验项目和质量控制宣传教育、定期学术汇报、规范考核制度以及加强科研创新能力培养等多种形式进行检验医师规范化培训,积极探索检验医师临床工作模式,并对我国检验医师培养面临的问题进行剖析与思考。     

加强实习医师临床实际工作能力培养方法的探讨

课堂学习的结束步入临床实习阶段,是将几年来的基础理论、基本知识和基本技能与临床实践相结合的过程;也是对每一个实习医师医学的思想性、科学性、先进性、启发性和适用性特点的总检验过程;同时也是临床教师如何将以上三基、五性及医学的进展全面准确,概念清楚,言之有据及丰富的临床经验,通过言传身教传授给实习医师的过程;也使实习医师通过临床的实践,拓开知识,成为一名合格的医师的全过程。如何提高医学生综合素质,创新能力的理论和实践探讨,现将我30年来的带教工作体会总结如下。1树立全心全意地为病人服务的意识首先要树立救死扶伤、全…     

泌尿外科基层进修医师的培养体会

基层单位医生进修学习是进行深造的一条重要途径,是培养业务技术骨干的重要手段,也是医学继续教育的重要组成部分[1-2].     

心血管外科医师重症监护能力的培养

心血管外科学是近年来发展最为迅速的科学之一,其内容丰富,相关新业务、新技术多,涵盖面广。近年来,随着心血管外科医师队伍的发展壮大,专职的重症监护医师已出现且达到一定规模,主要负责ICU的监护、急救、治疗等工作,使其他外科医师有更多的时间进行外科手术、临床科研、教学等工作。本文针对心血管外科医师重症监护能力的培养进行分析讨论,希望对临床诊断提供帮助。     

实验诊断学教学在检验医师培养的创新与研究

实验诊断学是临床基础课，是医学生在完成了医学基础课程学习后，进入临床专业课学习之前所开设的一门课程。实验诊断学是从实验检查的角度讲授疾病的诊断、鉴别诊断、疗效观察和预后判断等。因此，实验诊断是基础医学向临床医学过渡的桥梁，是疾病诊断的依据，是临床对疾病治疗的前提。无论将来做哪一个专科的医生，都首先要学习好实验诊断学，尤其是培养既懂临床又可以从事检验工作的检验医师尤为重要。     

军队医院临床医师绩效考评系统的设计与实践

随着信息化建设的飞速发展.军队医院进入数字化阶段后,医院管理更趋于科学化、标准化、规范化.军队实施"军卫一号"工程以来,针对每位临床军医的医疗数质量指标、科研、经济、为兵服务、各项军事训练、军事行动、军人素质等等方面从未开发过统计查询系统软件,对医生的总体工作绩效考评更是一个盲区.本院开发的军队医院临床医师绩效考评系统解决了上述问题,可以方便快捷的查询临床医师的相关工作数质量情况、生成报表,并建立了科学的考评l临床医师指标体系,改变了以往时临床医生的粗放型、经验式、印象型的考评方法 .不仅提高了医师的各项工作业绩,而且也提高了管理者的工作效率,使医院的科学规范化管理、信息化建设又上一台阶.     

浅谈人文素质教育与实习医师临床能力培养的关系

医学应当是最具有人文精神的学科,医务人员的人文精神失落不仅严重影响医学教育的质量,并且妨碍了医学自身的发展[1].     

优秀临床医师的人格特征

目的了解优秀医师的人格特点。方法通过卡特尔16种人格因素问卷对160名临床医师进行测查,使用SPSS软件分析优秀医师和对照组的人格特点差异。结果优秀男医师的A(t=2.912,P0.05)、C(t=2.103,P0.05)、F(t=7.031,P0.01)、Q2(t=-2.221,P0.05)、Q3(t=2.501,P0.05)5个因子与男临床医师存在显著性差异;优秀女医师的A(t=6.308,P0.01)、C(t=3.077,P0.01)、F(t=7.258,P0.01)、G(t=2.315,P0.05)、H(t=4.269,P0.01)、O(t=-2.596,P0.05)、Q3(t=2.227,P0.05)7个因子与女临床医师存在显著性差异。结论男女优秀临床医师在16PF的A(乐群性)、C(稳定性)、F(兴奋性)、Q3(自律性)4个因子上与对照组相比均表现出高分特征,这些特质可能与临床医师的工作绩效相关。     

腹膜透析亚专科医师手术技能与综合素质培养模式的探索

<正>腹膜透析是肾脏内科尿毒症患者常用的替代治疗手段,但由于其手术能力和病患随访管理要求较高,许多中小型医院,甚至一些三甲医院并不具备开展腹膜透析的能力,给一些应该进行腹膜透析治疗的患者造成了极大的影响。近年来随着血液透析的广泛开展,过度压缩了腹膜透析的实施空间,使适用于腹膜透析治疗的患者在医生和自我意识的主导下放弃了腹膜透析的机会,导致患者替代治疗年限和生存率降低。另一方面,目前肾脏内科腹膜透析专业技术人才非常匮乏,而国家临     

Patient preferences for medical doctors

A sample of 395 white, native English‐speaking adults were asked to rate eight medical doctors (general practitioners (GPs) and consultants), representing all permutations of the following three attributes: age (<35 versus >50), training location (UK versus Asia) and gender. Approximately half the participants were allocated in a group with a condition involving an intimate type of health problem and the rest in a group with a non‐intimate condition. Participants showed a preference for UK‐trained doctors, although it was unclear whether this was due to the homogeneous composition of the sample. There were significant two‐way interactions involving patient gender and doctor gender in the first case and doctor age and training location in the second. Additional interactions were specific to either the general practitioner or the consultant ratings. Overall, there were more significant effects in general practitioner ratings, suggesting that people de‐emphasize their preferences when selecting consultants.     

Getting supervisory experiences with 'Socialization' and professional training of young medical doctors in psychiatric care units

Relations with psychiatric and psychotherapeutic patients call for a high degree of social competency on the part of the staff and the patient's physician. Successful education and socialization of young physicians therefore depend to a large extent on the milieu and structure of the institution and the team they are working in. Material from supervisory hours in two different psychiatric units was collected over several years. It could be shown that the choice of cases presented very often reflected the team's situation, covertly and to a certain extent unconsciously mirroring the challenges, fears and other emotional problems. The work of a supervisor should tend to make such covert and generally burdensome reactions to institution-bound influences and structure accessible and more conscious.     

Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: An empirical study

Background

Informed consent is a legal and ethical doctrine derived from the principle of respect for autonomy. Generally two rights derived from autonomy are accorded legal protection. The constitutional right to bodily integrity followed by the right to bodily well-being, protected by professional negligence rules. Therefore healthcare professionals treating patients' without valid consent may be guilty of infringing patients' rights. Many challenges are experienced by doctors obtaining informed consent in complex multicultural societies like South Africa. These include different cultural ethos, multilingualism, poverty, education, unfamiliarity with libertarian rights based autonomy, and power asymmetry between doctors and patients. All of which could impact on the ability of doctors to obtain legally valid informed consent.

Methods

The objective of this study was to evaluate whether the quality of informed consent obtained by doctors practicing in South Africa is consistent with international ethical standards and local regulations. Responses from 946 participants including doctors, nurses and patients was analyzed, using a semi-structured self-administered questionnaire and person triangulation in selected public hospitals in Durban, KwaZulu-Natal, South Africa.

Results

The median age of 168 doctors participating was 30 years with 51% females, 28% interns, 16% medical officers, 26% registrars, 30% consultant/specialists. A broad range of clinical specialties were represented. Challenges to informed consent practice include language difficulties, lack of interpreters, workload, and time constraints. Doctors spent 5-10 minutes on consent, disclosed most information required to patients, however knowledge of essential local laws was inadequate. Informed consent aggregate scores (ICAS) showed that interns/registrars scored lower than consultants/specialists. ICAS scores were statistically significant by specialty (p = 0.005), with radiologists and anaesthetists scoring lowest, while internists, GPs and obstetricians/gynaecologists scored highest. Comparative ICAS scores showed that professional nurses scored significantly lower than doctors (p ≤ 0.001).

Conclusions

This study shows that though doctors had general knowledge of informed consent requirements, execution in practice was inadequate, with deficiency in knowledge of basic local laws and regulations. Remedying identified deficiencies may require a 'corps' of interpreters in local hospitals to assist doctors in dealing with language difficulties, and continuing education in medical law and ethics to improve informed consent practices and overall quality of healthcare service delivery.