三甲医院高层次卫技人才队伍建设发展现状及对策研究

通过对某三甲医院高层次卫技人才的规模、构成、引培和流失进行统计分析,了解医院高层次卫技人才队伍建设现状和流动变化规律,为制定和完善医院高层次卫技人才队伍建设策略提供证据参考。结果显示,该院高层次卫技人才规模、构成均得到有效改善,高层次卫技人才流失情况在可控范围内,但也面临着高层次卫技人才总量相对不足、流失人才中辞职占比较大等问题。未来要继续推动"人才强院"战略,创新人才引培考核机制,完善人才培养体系和计划,建立科学的测评体系以及健全绩效评价机制和薪酬分配制度。     

基于ISD模型的福建省医养护理员培训体系设计探索

目的:本研究针对福建省当前医养护理员的现状,基于医养结合背景下养老服务的需求,设计一个较为科学、系统、规范的医养护理员培训体系,为福建省养老护理人才的培养提供借鉴,从而提高福建省医养护理员的整体素质。方法:通过文献研究法,结合养老护理员国家职业技能标准以及医疗护理员培训与规范服务和管理标准,并基于实地调查法和深入访谈法,对医养护理员现状进行调查,拟定医养护理员的培训体系框架。结果:教学系统设计(ISD)作为一种常用的培训体系设计模型,针对目前福建省医养护理员及其培训的实际情况,提出了基于ISD模型的养老护理员培训体系。结论:基于ISD培训体系设计模型,从分析、设计、开发、实施、评价五个环节,构建了医养护理员培训体系,并详细介绍每个环节可操作的实施策略。     

新兵基础训练军训伤预防的主导措施

目的　评价新兵基础训练期间军训伤的预防措施 .方法　以驻陕某部新兵 2个连为研究对象 ,随机决定一连为重点措施分队 ,重点措施为对 5 km跑予以一定限制 :开训后第一个月不安排 5 km跑 ,跑步距离逐渐增加 ,从第二个月起每周 5 km跑 3次以下 ,间日进行 ;二连为综合措施分队 ,综合措施包括 :1同重点措施 ;2培训班排骨干 ;3心理测试与心理疏导 ;4上卫生课 (3次 ) .结果　综合措施分队军训伤的累积发生率为 2 8.6 % ,明显高于重点措施分队 11.6 % ,P<0 .0 1,两组在正课军事训练科目和时数安排上相同 ,心理测试无明显差别 .综合措施分队与重点措施分队在落实限跑措施方面实际 5 km跑累计数 (145 km对 10 5 km)和每周 5 km跑超过 4次的周数 (4 wk对 1wk)均有较大差别 .结论　 5 km跑是致伤的主要因素 .预防军训伤的主导措施应是科学训练 ,加强训练组织与管理 ,其他措施只能做为辅助     

女性输卵管结扎术后腰痛病机及医疗体育疗法

对女性输卵管结扎术后腰痛进行调查和病理分析 ,以中药配合医疗体育康复治疗术后腰痛 ,取得较好疗效 ,并提出预防措施。     

认真抓好临床住院医师规范化培训

当今医疗服务市场的竞争,实质上是医学专业人才的竞争,如何将一名刚步出校门的医学生尽快地培养成为高水平的临床专业人才一直是摆在医院管理者和医学教育工作者面前的重要课题,而临床住院医师规范化培训正是培养高水平医学人才的重要手段。本文总结了我院1993年以来实施住院医师规范化培训收到的较好效果,并从培训方法、培训内容、管理制度、考核办法等方面进行了阐述,旨在交流经验、提高管理水平。     

关于社区卫生服务人力资源开发的思考与探讨

基于北京市朝阳区大力发展社区卫生服务３年多的实践,就发展社区卫生服务的关键所在－人力资源开发,在配置卫生资源,实施全科医学培训工程,制定相应政策保障,充分展示社区卫生服务功能等方面的现状及其对策进行了充分的论述和有益的探讨。     

Examiner Differences in the Mini-Cex

Objective: The objective of this study was to analyze whether faculty ratings of residents, using the mini-CEX oral exam format, differed in stringency or were influenced by the clinical setting. It also sought to learn whether the examiners were satisfied with the format.Method: A mini-CEX encounter consisted of a single faculty member observing a resident conduct a focused history and physical examination in an inpatient, outpatient, or emergency room setting. After asking the resident for a diagnosis and treatment plan, the faculty member rated the resident and provided educational feedback. The encounters were intended to be short and occur as a routine part of the training, so each resident would be evaluated on many occasions by different faculty.Sample: Sixty-four attending physicians evaluated residents from five internal medicine training programs; data were analyzed for 355 mini-CEX encounters involving 88 residents.Results: There were not large differences among the examiners in their ratings. Moreover, there were not great differences among the ratings in terms of the training program with which the examiner was associated, the setting of the mini-CEX, or the nature of the patient. The examiners were generally satisfied with the format and their level of satisfaction was correlated with the residents' perceptions of the format.Conclusion: The mini-CEX adapts itself to a broad range of clinical situations, and these results show that it should produce roughly comparable scores over examiners and settings. This makes it a worthwhile device for evaluation at the local level.This revised version was published online in September 2005 with corrections to the Cover Date.     

Effect of regular training on the anthropometric parameters and urine steroids in childhood

The changes in the anthropometric data and urine steroid metabolites caused by regular training in children in two age groups (11 and 14 years old) were investigated. The skinfolds of older girls participating in regular athletic, swimming or soccer training were thinner compared with age-matched control groups (P < 0.01) and their body mass and constitution were lower (P < 0.05). In the other groups no significant differences were observable in the anthropometric parameters. The trained children in all groups had significantly higher exercise times on the cycle ergometer (P < 0.01, in young boysP < 0.05). The strength of their hands was lower in three trained groups: in younger boys (P < 0.05), in younger girls (P < 0.01) and in older girls (right handP < 0.01, left handP < 0.05). The urinary excretion of androsterone (P < 0.02), 11-ketopregnanetriol (P < 0.01) and pregnenetriol (P < 0.02) was decreased in the older trained girls; pregnenetriol was increased in younger boys (P < 0.05). Urinary excretion of cortisol metabolites was increased in trained boys [in younger boys: tetrahydrocorticosterone (P < 0.05) and 20-hydroxycortisol (P < 0.05); in older boys allotetrahydrocortisol (P < 0.02), cortisol (P < 0.05) and 20-hydroxycortisol (P < 0.05)]. There were no significant differences in the younger girls. In the trained older girls urinary excretion of cortisol metabolites was decreased: tetrahydrocortisone (P < 0.02), allotetrahydrocorticosterone (P < 0.01), tetrahydrocortisol (P < 0.05), -cortolone (P < 0.01), cortisol (P < 0.02), 6-hydroxycortisol (P < 0.01) and 20-hydroxycortisol (P < 0.05). A multivariate analysis of the data from the trained groups and sedentary, age-matched control groups showed that regular training has a significant effect on steroid excretion.     

骨应力性塑形改建的研究及其对新兵基础训练的指导意义

分组模拟训练的２８８只兔股骨标本病理观察及扭断试验结果表明,较大强度和时限训练的主导作用是加速骨塑形改建,增强抗骨折能力。分３组经３种方法训练的１８０只大鼠的胚骨上段病理切片及电镜观察表明,强化循环训练组的改建完成率（４１．７％）高于其它两组（２６．１％,２１．９％）,而应力性骨折发生率（１１．５％）则低于其它两组（２２．９％,１８．８％）。对１１２９名新兵１２周基础训练的前瞻性流行病学调查证实,下肢长管状骨经历约９周的应力性塑形改建期,训练的第２、７周出现的应力性骨折高发的双峰现象可随训练强度与时限的加大或减少,而提前或延迟出现。在训练中采用“强化循环训练法”将加速骨的塑形改建及降低应力性骨折发生率。     

The emergency medicine training needs of rural general practitioners

This study aimed to identify the emergency medicine training needs of rural general practitioners (GPs) in the catchment area of the Hunter Rural Division of General Practice. The GPs were surveyed using a questionnaire in which they were asked about their confidence levels in a number of specific emergency medicine skills, and about the areas of emergency medicine that they saw as priorities for upskilling. More than a third of GPs who were responsible for on-call work at the hospital indicated that they had low levels of confidence in a number of their emergency medicine skills, in particular skills relating to paediatric emergencies, cardiovascular emergencies, and respiratory emergencies. These emergency medicine domains were also seen as high priorities for upskilling by the majority of the respondents. The study shows that rural doctors need the opportunity to access emergency medicine training that provides upskilling not only in the management of clinical problems, but also in practical procedures.