The effects of a continuing medical education programme in interpersonal communication skills on doctor practice and patient satisfaction in Trinidad and Tobago

This study investigates the effects of a brief training programme on the communication skills of doctors in ambulatory care settings in Trinidad and Tobago. Evaluation of doctor performance is based on analysis of audiotapes of doctors with their patients during routine clinic visits and on patient satisfaction ratings. A pre-test/post-test quasi-experimental study design was used to evaluate the effects of exposure to the training programme. Doctors were assigned to groups based on voluntary participation in the programme. Audiotapes of the 15 participating doctors (nine trained and six control) with 75 patients at baseline and 71 patients at the post-training assessment were used in this analysis. The audiotapes were content-coded using the Roter Interaction Analysis System (RIAS). Doctors trained in communication skills used significantly more target skills post-training than their untrained colleagues. Trained doctors used more facilitations in their visits and more open-ended questions than other doctors. There was also a trend towards more emotional talk, and more close-ended questions. Patients of trained doctors talked more overall, gave more information to their doctors and tended to use more positive talk compared to other patients. Trained doctors were judged as sounding more interested and friendly, while patients of trained doctors were judged as sounding more dominant, responsive and friendly than patients of untrained doctors. Consistent with these communication differences, patient satisfaction tended to be higher in visits of trained doctors.     

论医学职业道德教育的终生效应

根据医学职业的特殊性,从对医务工作者的学校医德教育(重要性、内容、方法)、医疗实践过程中,医德教育的效应作用及效应评价,阐明了医德终生教育在医疗实践中对提高医疗社会效益和经济效益、促进医学科学健康发展的重要作用.     

口腔治疗师培养规划的初步研究

目的进行口腔治疗师医学技术岗位和教育现状分析,提出我国口腔治疗师培养的初步规划。方法通过现有资料收集和现场调查,了解口腔技术职业教育的现状和发展趋势。采用专家咨询法讨论口腔治疗技术专业的培养目标与方向。结果在基本口腔治疗技术专业方面,以高职教育为主要培养途径,培养高级应用型口腔治疗师,以培养通科口腔治疗师为主。教学内容应以实践技能为主,通过专业课程评价的学生可以获得口腔治疗师资历,同时对课程设置、教学模式和专业师资配备提出初步规划。结论与高等职业教育的目标相适应,口腔医学高职教育应致力于培养应用能力强的口腔治疗师。口腔治疗师标准从人文素质、理论知识、专业技能和其他相关能力四个方面对学生提出要求,通过准入标准的具有口腔治疗师资历的人可以在国内登记注册,作为口腔治疗师开业。     

Professional Literature: One View of a National Perspective

Content, citation and theme analyses of articles and editorials published during two five year periods (1963-67 and 1983-87) in the Australian Occupational Therapy Journal are presented. A comparison of the two publication periods shows that: there has been no increase in the number of journal issues per year, nor in the total number of articles published since 1963. The number of articles in the research category has substantially increased; research appears to reflect the scope of practice. However, the need for a unifying conceptual framework that identifies Australian occupational therapy remains. A broader service network is evident; emphasis on promoting the profession in the wider community and a functional orientation are indicative of the shift that has taken place in marketing occupational therapy services. Recommendations are made regarding issues that relate to areas of professional concern and publication management.     

Attitudinal educational objectives at therapeutic consultation: measures of performance, educational approach and evaluation

The study aims at measuring doctors' performance while giving therapeutic instructions and testing the effectiveness of an educational technique for affective objectives. For this purpose doctors' performance was analysed into nine components. Twenty-five trainees in internal medicine were observed and rated regarding the nine components, while instructing 40 patients with a chronic disease. Both doctors and patients were then questioned regarding the verbal components of the doctors' performance and the answers were compared to assess the degree of concordance. One to 3 months later the patients were interviewed to assess whether they complied with the instructions or not. Eighteen months later a 4-hour seminar on affective objectives was held, involving listening and small-group discussion on tape-recorded doctor-patient consultations. After completion of the seminar, 25 doctors instructed 39 patients and were assessed as above. The findings suggest that the doctors' performance regarding the nine components did not predict patient compliance. However, sufficient doctor-patient concordance regarding the verbal components of the behaviour significantly predicted patient compliance. Following the seminar, significant improvement was noted in doctors' performance, in doctor-patient communication and in patient compliance. It is concluded that observing the doctors' behaviour independently of the patient does not predict patients' compliance; the analysis of the total doctors' behaviour into components is valid in predicting patient compliance if it is used in order to assess doctor-patient communication; and a programme based on audiotape-assisted education is both simple and effective in improving the trainees' behaviour and communication skills.     

试论检验医学中的人本管理理念

从制度建设、人才建设和提高实验人员的工作热情几个方面论述了以人为本的多元化管理模式在临床实验室管理中的作用.     

Teaching clinical methods to medical students

Summary. This paper demonstrates that it is feasible to teach clinical methods in general practice and describes the organization of an appropriate attachment. Willing practitioners, properly briefed, are competent to undertake clinical methods teaching and the attachment provides satisfaction to both students and teachers. It is possible to provide in primary care the elements which seem to be the key to this outcome — protected time, teaching in very small groups, direct observation and concentration on systematic examination rather than on particular physical signs. There is a strong case for the promoting of clinical methods teaching by general practitioners.     

人类数能力的神经心理学和脑功能成像研究

临床神经心理学和脑功能成像研究表明 ,不同类型的数信息处理需要不同的脑区和神经回路的参与。人的脑内似乎存在着三个与数功能相关的神经回路 :数量回路 (负责数的比较和减法等数任务 )、语言回路 (负责乘法等涉及语义处理的数任务 )和视觉 空间回路 (负责比例、顺序等涉及空间信息的数任务 )。后顶叶在数功能中起至关重要的作用