利用结肠镜培训模拟器提高初学者操作认知力教学质量的初探

目前结肠镜检查是大肠癌确诊及早期治疗的诊疗方法,且传统的结肠镜培训应得以改进。本文介绍了本院结肠镜教学和初学者对结肠镜的使用及相应步骤,探讨了结肠镜培训模拟器对提高教学质量的益处。     

“主线教学-课题设计”为基础的课堂讨论法在免疫学教学中的应用

目的探索“主线教学一课题设计”为基础的课堂讨论法在免疫学教学中的作用。方法选择药学系2008级和2009级2届五年制学生进行新的教学方法的试点。教学方法包括主线教学、课题设计、课堂讨论和实验操作。通过问卷调查和考试成绩比较,分析评价教学效果。结果问卷调查结果显示,73．5％以上的实验班学生认为“主线教学一课题设计”为基础的课堂讨论法有助于激发学习热情及提高综合能力;经t检验,实验班与对照班学生平均成绩比较,差异有统计学意义（P=O．0028）。结论“主线教学一课题设计”为基础的课堂讨论法是免疫学教学的有效方式,值得进一步推广应用。     

《医学伦理学》临床教学模式研究及思考

探索研究采用学校一医院联合教学的模式,以学校《医学伦理学》教研室学科带头人为教学核心、以附属教学医院伦理委员会为依托,进行《医学伦理学》延伸临床实践教学。探索三种教学方式相结合：理论讲授——实际案例分析——多角色讨论（医生、患者组织、医学伦理工作者）,使教学更具实践性、可操作性。面对当下医院医疗环境不佳的困局,让医学伦理学及医学人文教育走进临床医院和其他医疗机构,显然要好于仅加强医院治安防范。     

康复医学专业本科生教育现状与探讨

培养康复医学专业高级人才是发展我国康复医学的当务之急。康复医学本科生教育是提高康复医学办学层次和康复医学教育的学术地位、培养高质量康复医学人才的重要环节。本文重点介绍康复医学专业本科生教育的现状、来源、培养目标定位、专业领域以及本科生教育应注意的问题及解决方法。     

混合菌种质量控制检验方法探讨

对混合菌种质量控制检验,结果其分别为出血性大肠埃希菌O157、恶臭假单胞菌和金黄色葡萄球菌。直接分离平板是分离细菌的有效方式,增菌液增菌意义不大。     

The art of public health nursing: using confession technè in the sexual health domain

AIM: This paper explores the sexual health interview from a critical perspective, and to demonstrate how the confession ritual involved in this interview is implicated in the construction of subjectivities (meaning identities) as well as in fostering self-surveillance (self-regulation). BACKGROUND: The concept of public health depends primarily on several surveillance tools that monitor both the incidence and prevalence rates of certain diseases. Within the subgroup of infectious diseases, sexually transmitted infections comprise a group that is closely monitored. As a result, surveillance techniques, including policing sexual practices, are part of the public health worker's mandate. METHOD: Using a Foucauldian perspective, we demonstrate that confession is a political technology in the sexual health domain. FINDINGS: As one group of frontline workers in the field of sexual health, nurses are responsible for data collection through methods such as interviewing clients. Nurses play an integral role in the sexual health experience of clients as well as in the construction of the client's subjectivity. We strongly believe that a Foucauldian perspective could be useful in explaining certain current client behavioural trends (for example, an avoidance by at-risk groups of interactions with nurses in sexual health clinics) being observed in sexual health clinics across the Western hemisphere. CONCLUSION: Clinicians need to be aware of the confessional nature of their questions and provide requested services rather than impose services that they determine to be important and relevant. By appreciating that the sexual health interview is an invasive and embarrassing sexual confession, healthcare providers and policy-makers may be better able to design and implement more user-oriented, population-sensitive sexual health services.     

'Best practice' in focus group research: making sense of different views

AIM: The aim of this paper is to identify the broad epistemological debates which underpin conflicting statements on 'rigour' and 'good practice' in qualitative research; to relate divergences in statements of 'good practice' in focus group design made by the pre-eminent commentators on focus group methodology to these broader epistemological debates; and to stimulate further reflection on the range of possible uses for focus groups in health services research. Considerations of the analysis of focus group data are beyond the scope of this paper. DISCUSSION: Focus groups are a popular form of qualitative data collection, and may be defined as a particular form of group interview intended to exploit group dynamics. While qualitative research may be broadly characterized as concerned with exploring people's lived experiences and perspectives in context, it is a heterogeneous field incorporating many theoretical traditions. Consequently, qualitative researchers may be informed by a wide range of assumptions about the nature of knowledge (epistemology). These assumptions, whether implicit or explicit, have important consequences for claims about rigour and 'good practice' in data collection. Thus, while there is broad agreement over the general form of focus groups, statements of 'good practice' in terms of its application are varied. A close reading of texts by the two pre-eminent commentators on the practical application of focus groups identifies differences in 'best practice' focus group design related to their respective epistemological assumptions, and differences principally related to sampling techniques, composition of groups, the perceived role of group interaction and the nature of inference. CONCLUSION: Explicit consideration of the epistemological basis of divergent statements of 'best practice' in focus group design forces health services researchers to balance the demands of theory with the practicalities of conducting focus group research within complex host organisations; and encourages readers to apply appraisal criteria appropriate to the stated intentions of researchers.     

Exploring knowledge work and leadership in online midwifery communication

Aim. This paper reports a study to answer the following question: if given a user‐friendly online system, that enabled communication across the practice community, would midwives function as knowledge workers? Background. Globally, the demand for quality‐led and innovative service delivery requires that nurses and midwives shift from being ‘information workers’, or passive receivers of managerial and organizational decisions, to become ‘knowledge workers’ who are able to create, lead and communicate service innovation and practice development. New communication technologies may offer a means for healthcare professionals to interact as knowledge workers and develop supportive communities of practice. Methods. An online discussion forum was implemented as a low‐cost technological intervention, deploying existing hardware and a standard hospital intranet. The evaluation of the forum was constructed as case‐study organizational research. The totality of online communication, both traffic and content, was analysed over a 3‐month period (193 messages downloaded 2003/2004), and 15 in‐depth interviews were undertaken with forum users. Findings. Given simple, facilitative, innovative technology, supported by a positive working culture and guided by effective leadership, midwives could function as ‘knowledge workers’, critically reflecting upon their practice and translating knowledge into action designed to achieve change in practice. Participation occurred across all staff grades, and midwives were predominantly supportive and facilitative towards the contributions made by colleagues. Conclusion. Midwives may be well placed to exemplify the ‘ideal’ characteristics of the knowledge worker being demanded of modern healthcare professionals. The deployment of online interactive technologies as part of strategic vision to enhance knowledge work among healthcare professionals should be given attention within health systems.     

远程会诊专家管理模式的实践探讨

目的：探讨远程会诊专家全方位的管理新模式,建立长效管理机制,不断提高远程会诊质量。方法：构建远程会诊专家库动态管理、专家制度管理、评价考核管理、人文管理、经济激励等模式,打造高素质的远程会诊专家队伍。结果：充分调动了专家参与远程会诊的积极性,有效提升远程会诊质量。结论：使用全方位的专家管理模式,对提高远程会诊质量具有重要意义。     

各家老年病学说临床思考

各医家、各流派间的交融碰撞乃是中医学传统继承中的要点,该文从金元四大家及明清各家著述中具有代表性的治疗老年病学术思想与医疗经验入手,分别对刘完素、李东垣、张子和、朱丹溪、张景岳、赵献可、李中梓、虞搏、胡慎柔、喻嘉言做了探讨,全文皆以笔者的临床实践加以佐证。