Motivation in medical education and patient communication. The EGPRN meeting in Zurich,Switzerland, October 2010

Abstract

The European General Practice Research Network held an international research meeting on ‘Motivation in medical education and patient communication’ in Zürich, Switzerland, in October 2010. The two authors were keynote speakers, who introduced the theme from different angles and summarized and reflected on individual papers presented at the conference. The theme of the conference underlined the importance of communication in general practice and of motivation in medical education in particular. There were a variety of papers each addressing in its own way the topic of this meeting. We conclude that it is still uncommon to use psychological theories on motivation in research on motivation and patient communication in general practice/family medicine. Motivation and readiness to change are essential concepts in experimental health services research. Research designs increasingly follow the Framework for the Evaluation of Complex Interventions in Health Care as suggested by the British Medical Research Council. However, there are also difficulties related to classical experimental designs that have to be critically discussed.     

Achieving vocational training goals during six months in an Italian general practice

Background: General practice training in Europe is still an unresolved issue. Italy has developed a formation course similar to specialty schools, awarding a certificate of attendance at the end of a 3-year period. Its training goals are defined mainly as work hours in medical facilities, including two semesters at two general practices.

Objectives: To evaluate if a registrar, during a semester in a general practice, has access to a case spectrum consistent enough to achieve the training goals, both ‘methodological’ (work organization targets) and ‘specific’ (targets of opportunity).

Methods: During a six-month period, every patient contact qualified for tutoring was recorded. For each visit, access mode and priority, patient name, age, patient reason for encounter (RFE), diagnosis, referrals, prescribed laboratory tests and treatment were recorded. Data was evaluated as in other Italian medical specialties; i.e. compared to target numbers.

Results: A total of 1 828 contacts and 2 437 RFE in 122 work days were recorded. There were 1 007 and 613 contacts with and without appointment respectively, 88 ‘family contacts,’ 44 scheduled check-ups, 11 phone contacts, and 65 nurse interventions. Of all contacts, 9.8% were indirect. In six months, we had at least one contact with 792 patients out of 1 500 (52.8%). Main RFE resulted from respiratory and musculoskeletal symptoms while most frequent diagnoses belonged to musculoskeletal, cardiovascular and respiratory fields.

Conclusions: A six months training period can be sufficient for representing a general practitioner's work organization and primary care epidemiology. However, deficiencies were observed.     

加强医学生“敬畏生命”伦理教育的内容及路径选择

随着现代医学的迅速发展,医疗卫生行业的特殊性越来越凸显,这种凸显的特殊性加大了公众对医务工作者“敬畏生命”伦理意识的强烈诉求.论文以“敬畏生命”的伦理意蕴为切入点,具体阐述了加强医学生“敬畏生命”伦理教育的基本内容,力求探索一条多渠道、立体化、全方位的教育路径.     

一起由医疗纠纷引起的吊销《医疗机构执业许可证》行政处罚案例分析

作者通过对一起由医疗纠纷引起的吊销《医疗机构执业许可证》行政处罚案例的分析,指出医疗卫生执法监督员面临棘手的医疗纠纷案件时,既需要善于学习和运用医疗专业知识,又需要善于应用行政证据规则,合理、有效地收集和运用证据,最终成功办案,维护社会公平。     

深圳市医疗广告监督情况分析及对策探讨

目的通过分析深圳市医疗广告监督工作的情况,为进一步规范医疗广告提供经验和依据。方法描述分析2010～2011年深圳市发布医疗广告的医疗机构的性质、数量、比例及广告的发布媒介情况。定性分析医疗广告监管的相关文献、专家交流资料和卫生监督工作情况。用Office软件包对数据进行预处理和统计分析。结论通过采取对医疗机构违法发布医疗广告的情况进行通报、行政处罚、约谈医疗机构法人代表、负责人等一系列措施后,深圳市医疗广告违法率呈现大幅下降的趋势。促进深圳市医疗广告的健康发展,必须在加强医疗广告卫生监督综合执法力度和长效机制建设的同时,积极完善医疗保障和医疗广告相关法制体系,实现医疗资源合理分配,引导患者理性就医,加强医疗机构依法执业意识,倡导媒体自律和社会公德,提高群众维权和识别虚假广告能力,才能有效规范医疗广告市场。     

肺功能测定的临床应用

本文通过论述肺功能检测的意义,重点阐述了肺功能在呼吸内科及外科等临床上的应用,使大家充分了解在临床上应该如何应用肺功能,以及应用肺功能的临床应用范围。     

医学影像专业课程改革之我见

医学影像学科的迅猛发展对医学影像人才的培养提出了越来越高的要求,医学影像课程改革势在必行,作者认为医学影像专业在课程设置上应加强两个"结合",突出一个"特色",注重两个"需要",以利培养出具有本专业特色的基础扎实、知识面宽及业务能力强的医学影像专门人才.     

医疗器械检测和校准实验室设备信息化管理的设计与开发

目的:研发实验室信息管理系统仪器设备数据库,实现检测与校准仪器的信息化管理。方法:在研究国家标准GB/T27025-2008检测和校准实验室能力的通用要求的基础上,运用编程语言Delphi7.0和微软SQL Server 2000开发后台数据库,分析其中涉及实验室设备管理、量值溯源等要素。结果:获取到所需要的数据字段和程序流程,完成功能模块数据库的集成。结论:在符合国家标准质量体系要求的前提下,建立检测和校准实验室仪器设备信息化管理的基础架构。     

腺苷脱氨酶的临床价值及其应用进展

腺苷脱氨酶（ADA）在某些疾病的早期诊断、治疗以及发病机制的研究中越来越受到关注。血清ADA活性是反映肝损伤的敏感指标,浆膜腔积液中ADA的测定在良恶性鉴别诊断上有重要价值。脑脊液ADA检测还可作为中枢神经系统疾病诊断和鉴别诊断的重要指标。近年研究表明ADA在结核病、糖尿病、恶性血液疾病、自身免疫性疾病的诊断及预后中也有重要价值。     

骨碎补外用对环磷酰胺致小鼠斑秃模型的影响

[目的]考察骨碎补外用对环磷酰胺致C57BL/6小鼠斑秃模型的影响。[方法]采用环磷酰胺腹腔注射建立C57BL/6小鼠斑秃模型,观察骨碎补外用对小鼠毛囊组织学变化和血清细胞间黏附蛋白(ICAM-1)、内皮细胞-白细胞黏附分子-1(ELAM-1)水平的影响。[结果]骨碎补外用能使实验性斑秃模型小鼠血清ICAM-1和ELAM-1水平降低,毛囊数增多(P<0.05或P<0.01)。[结论]骨碎补外用能够抑制毛囊进入退行期,对斑秃模型小鼠具有治疗作用。