Supporting new graduate registered nurse transition for safety: A literature review update

BackgroundReports suggest higher incidence of medical errors occur during times of transition for new practitioners, in part due to general staff disruption in the health services and inexperience of those entering the workplace. NGRNs experience a range of challenges on transition to professional practice and their transition experience will impact their ability to provide high quality patient care.AimThe aim of this review was to critically appraise the contemporary literature concerning the transition of new graduate registered nurses (NGRNs) and their patient safety knowledge and practices.DesignA scoping review of research literature.MethodsThe review used key terms and Boolean operators to search literature from 2015 to September 2018. A search of CINAHL, PsycINFO, Scopus and Medline databases and a manual search of references conducted to identify any other literature not previously detected.FindingsThis review acknowledges NGRNs have varied experiences during initial transition to practice. Transition programs are valuable for the structure and support provided during the first 12-months of practice. Ward culture influences safety practices while disparity between readiness and expectations remains.DiscussionPractical and emotional support necessary to help new nurses successfully navigate the turbulent early months of transition to clinical practice will ultimately enhance NGRNs’ clinical safety.ConclusionsNew graduate nurses require a supportive culture to translate knowledge and skills into safe practice and alleviate stressors. There remains little literature regarding patient safety knowledge and practices of new graduate registered nurses.     

A commentary on the practice of integrated medical curriculum in the interdisciplinary field of medical engineering

Shanghai University School of Medicine was a newly established medical college in 2018. It is founded on the national health development policies, international medical development trends and the close relationship between the advantages of new medical courses and medical artificial intelligence, it is dedicated to using intelligent medicine as the breakthrough point, training graduate students in two interdisciplinary medical engineering subjects as the priority, and implementing the integrated medical curriculum teaching reform. In this paper, we introduce the background of the integrated medical curriculum system at the Shanghai University School of Medicine, the horizontal and vertical integration of medical courses in interdisciplinary medical engineering subjects, the cross-integration of traditional integrated medical courses with other disciplines and specialties, and the transformation mode of medical science and technology innovation led by artificial intelligence under the support of three-dimensional curriculum integration, putting forward the prospect of the curriculum integration system and providing experiences and references for other medical schools.

KEY MESSAGES

• This paper introduces the necessity and feasibility of implementing integrated medical course teaching in a newly established medical college.
• This paper introduces the strategies and concrete measures we took to implement integrated medical course teaching.
• The analysis of examination papers and other evaluations revealed that the integrated medical teaching for graduate students with non-medical professional backgrounds is feasible.

     

我国普通外科专科医师规范化培训历史、现状和展望

上海市普通外科专科医师规范化培训自2013年开始试行至今已有9年,作为毕业后医学教育的重要组成部分,其核心培养目标、培训内容、培训模式通过学习欧美国家的先进经验并结合自身特点而逐步形成了国内的标准和体系,对于专培医师职业胜任力的培养具有深远的意义,尤其是其考核模式成为专科医师规范化培训考核极为有益的创举和探索,也为全国范围内推广实施起到了引领作用和示范效应。目前,仍然需要正视在专科医师规范化培训实施过程中出现的问题和带来的困惑,及时认识和突破这些瓶颈并补上持之以恒的短板,从而进一步推动我国毕业后医学教育继续向前迈进。     

Utility of a standardized sign-out card for new medical interns

Conscientious sign-out between medical interns is important for the continuity of care of hospitalized patients. We developed a standardized sign-out card that prompted the intern going off duty to transmit patient care information to the intern on call. The card was tested in a prospective, randomized, controlled trial in which one group of interns used the card, and another group did not. Any instance of poor sign-out was reported on a questionnaire completed by the intern who had been on call the previous night. The group using the sign-out cards reported poor sign-out on 8 nights (5.8% of questionnaires), and the control group reported it on 17 nights (14.9% of questionnaires, p=.016). The card was time-effective and inexpensive, resulted in more complete data recording, and possibly decreased the morbidity associated with poor sign-out. Presented at the Association of Program Directors in Internal Medicine annual meeting, Atlanta, Ga., March 22, 1995.     

护理学研究生教育的科学管理

介绍我国护理学学位授予情况和第二军医大学护理学研究生教育管理经验,并提出护理学研究生培养过程需解决的问题,为护理教育者及教育管理者提供参考。     

Injuries to emergency medicine residents on ems rotations

Objectives. To study the incidence and nature of injuries sustained by emergency medicine (EM) residents during EMS rotations, and steps taken at EM residency programs to increase resident safety during field activities. Methods. An eight-question survey form was mailed to all 114 U.S. EM residency directors, with a second mailing to nonresponders eight weeks after the initial mailing. Results. A total of 105 surveys were returned (92%). Six surveys were from new programs whose residents have not yet rotated on EMS. These were excluded from further analysis, leaving 99 programs. Of these, 91 (92%) reported no injuries. One EM resident died in a helicopter crash in 1985. Seven other injury events were reported: 1) facial lacerations, rib fractures, and a shoulder injury in an ambulance accident; 2) an open finger fracture (crushed by a backboard); 3) contusions and a concussion when an ambulance was struck by a fire engine; 4) a groin pull sustained while entering a helicopter; 5) bilateral metatarsal fractures in a fall; 6) rib fractures, a pneumothorax, and a concussion in an ambulance accident; and 7) “minor injuries” sustained in a crash while responding to a scene in a program-owned response vehicle. Actions taken at residency programs to reduce the risk of injury include the use of ballistic vests (four programs), requiring helmets on flights (five programs), and changing flight experience from mandatory to optional (two programs). Ten programs (10%) reported using ground scene safety lectures, and nine programs (15% of those offering flights) reported various types of flight safety instruction. Sixty-nine programs (70%) reported no formal field safety training or other active steps to increase resident safety on EMS rotations. Conclusions. Injuries sustained by EM residents during EMS rotations are uncommon but nontrivial, with several serious injuries and one fatality reported. The majority of EM residency programs have no formal safety training programs for EMS rotations.     

研究生医学实验动物学教学的实践与思考

医学实验动物学是一门新兴的学科，该课程注重理论与实践相结合，从而将教学延伸到研究生动物实验论文指导，并把课程教学工作与实验动物从业人员资格认可相衔接，丰富了实验动物从业人员资格认可的内容。     

关于举办医学专业研究生课程进修班的若干思考

通过多年从事同等学力人员申请硕士学位研究生培养的工作与实践,不断探索中国当代形势下的研究生课程进修班的管理及机制,并根据研究生课程进修班的特点探讨管理过程中出现的一系列问题,并针对相应的问题提出一些思考和建议。     

医科大学五年级学生心理状况的初步研究

采用精神症状自评量表（ＳＣＬ－９０）对医科大学１７３名五年级学生进行调查,结果表明医科大学毕业生在躯体化、强迫、抑郁、焦虑、敌对、偏执等因子分高于全国常模青年组（Ｐ〈０．０１）,男性强迫、人际敏感二项分高于女性（Ｐ〈０．０５）,应根据医科大学毕业生心理状况的特点进行心理辅导工作。