医学研究生实验能力的培养方法

培养学生的实验能力是医学研究生教育的重要工作之一。通过多年的实践我们已摸索出一些行之有效的方法,主要包括4个循序渐进的训练阶段,即基础训练、巩固强化、熟练深化和扩展提高阶段。通过这4个阶段的训练,应培养出学生严谨认真、客观求实的工作作风,初步建立定量概念和无菌概念,具备独立从事实验研究的能力。研究生教育中通过对学生实验能力较为系统的培训,为其在医学科学领域的发展奠定良好的基础。     

Building Interdisciplinary Research Models Through Interactive Education

Background

Critical interdisciplinary research skills include effective communication with diverse disciplines and cultivating collaborative relationships. Acquiring these skills during graduate education may foster future interdisciplinary research quality and productivity.

Objective

The project aim was to develop and evaluate an interactive Toolbox workshop approach within an interprofessional graduate level course to enhance student learning and skill in interdisciplinary research. We sought to examine the student experience of integrating the Toolbox workshop in modular format over the duration of a 14‐week course.

Methods

The Toolbox Health Sciences Instrument includes six modules that were introduced in a 110‐minute dialogue session during the first class and then integrated into the course in a series of six individual workshops in three phases over the course of the semester.

Results

Seventeen students participated; the majority were nursing students. Three measures were used to assess project outcomes: pre–post intervention Toolbox survey, competency self‐assessment, and a postcourse survey. All measures indicated the objectives were met by a change in survey responses, improved competencies, and favorable experience of the Toolbox modular intervention.

Conclusion

Our experience indicates that incorporating this Toolbox modular approach into research curricula can enhance individual level scientific capacity, future interdisciplinary research project success, and ultimately impact on practice and policy.     

浅论产学研联合培养中药学研究生的策略与实践经验

产学研合作教育是充分利用学校与企业、科研院所等多种不同教学环境和教学资源以及在人才培养方面的各自优势,将以课堂传授知识为主的学校教育与直接获取实际经验、实践能力为主的生产、科研实践有机结合的教育形式[1-2].企业、科研院所的发展,需要高校的人才和科研技术;高校的发展,可以借助企业、科研院所的研究平台.     

Residents’ and standardized patients’ perspectives on empathy: Issues of agreement

Objective

We investigated correlations between residents’ scores on the Jefferson Scale of Empathy (JSE), residents’ perceptions of their empathy during standardized-patient encounters, and the perceptions of standardized patients.

Methods

Participants were 214 first-year residents in internal medicine or family medicine from 13 residency programs taking standardized patient-based clinical skills assessment in 2011. We analyzed correlations between residents’ JSE scores; standardized patients’ perspectives on residents’ empathy during OSCE encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy; and residents’ perspectives on their own empathy, using a modified version of this scale.

Results

Residents’ JSE scores correlated with their perceptions of their own empathy during encounters but correlated poorly with patients’ assessments of resident empathy.

Conclusion

The poor correlation between residents’ and standardized patients’ assessments of residents’ empathy raises questions about residents’ abilities to gauge the effectiveness of their empathic communications. The study also points to a lack of congruence between the assessment of empathy by standardized patients and residents as receivers and conveyors of empathy, respectively.

Practice implications

This study adds to the literature on empathy as a teachable skill set and raises questions about use of OSCEs to assess trainee empathy.     

Self‐perceived preparedness for dental practice amongst graduates of The University of Hong Kong’s integrated PBL dental curriculum

Objectives: To determine how prepared for dental practice graduates from the integrated problem‐based learning (PBL) dental undergraduate curriculum at The University of Hong Kong (HKU) perceive themselves to be and to identify factors associated with self‐perceived preparedness. Materials and methods: A postal questionnaire was sent to five cohorts of dentists who had graduated from HKU’s integrated PBL curriculum between 2004 and 2008. Using a 4‐point Likert scale, the questionnaire assessed the self‐perceived level of preparedness in 59 competencies grouped in nine domains. Responses were dichotomised into ‘poorly prepared’ and ‘well prepared’. Results: The response rate was 66% (159/241). The mean proportion (± standard deviation) of respondents indicating well‐preparedness was 72.0 ± 15.1% overall, and for each domain was as follows: general patient management, 93.1 ± 12.1%; practice management, 81.0 ± 22.2%; periodontology and dental public health, 73.5 ± 19.3%; conservative dentistry, 92.5 ± 13.1%; oral rehabilitation, 62.8 ± 24.0%; orthodontics, 23.0 ± 32.9%; managing children and special‐needs patients, 64.8 ± 28.9%; oral and maxillofacial surgery, 52.2 ± 25.2%; and drug and emergency management, 84.7 ± 22.6%. The odds of self‐perceived well‐preparedness were increased for cohorts graduating in 2004 and 2005 and graduates working in a non‐solo dental practice. Conclusions: Dental graduates of HKU’s integrated PBL curriculum felt well prepared for the most fundamental aspects of dental practice. However, apparent deficiencies of training in orthodontics and oral and maxillofacial surgery will need to be addressed by continuing education, postgraduate training and planning for the new 6‐year undergraduate curriculum in 2012.     

Referrals to dietitians/nutritionists: A cross‐sectional analysis of Australian GP registrars’ clinical practice

Aim

The present study aimed to describe referral patterns of general practitioner (GP) registrars to dietitians/nutritionists. There is a paucity of research regarding GP referral patterns to dietitians/nutritionists. Limited data show increasing referrals from established GPs to dietitians/nutritionists. There are no data on GP registrar (trainee) referrals.

Methods

This was a cross‐sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing, multicentre, prospective cohort study of registrars, which documents 60 consecutive consultations of each registrar in each of the three six‐month GP training terms. The outcome factor in this analysis was a problem/diagnosis resulting in dietitian/nutritionist referral (2010–2015). Independent variables were related to registrar, patient, practice and consultation.

Results

A total of 1124 registrars contributed data from 145 708 consultations. Of 227 190 problems/diagnoses, 587 (0.26% (confidence interval: 0.23–0.29)) resulted in dietitian/nutritionist referral. The most common problems/diagnoses referred related to overweight/obesity (27.1%) and type 2 diabetes (21.1%). Of referrals to a dietitian/nutritionist, 60.8% were for a chronic disease, and 38.8% were related to a Chronic Disease Management plan. Dietitian/nutritionist referral was significantly associated with a number of independent variables reflecting continuity of care, patient complexity, chronic disease, health equity and registrar engagement.

Conclusions

Established patients with chronic disease and complex care needs are more likely than other patients to be referred by registrars to dietitians/nutritionists. Nutrition behaviours are a major risk factor in chronic disease, and we have found evidence for dietitian/nutritionist referrals representing one facet of engagement by registrars with patients’ complex care needs.     

Self‐rated preparedness of Australian prevocational hospital doctors for emergencies

Objective: To determine perceived preparedness of Australian hospital‐based prevocational doctors for resuscitation skills and management of emergencies, and to identify differences between doctors who perceive themselves well prepared and those who perceive themselves poorly prepared for emergencies, in demographics and exposure to desired learning methods. Methods: Questionnaire consisting of a mix of graded Likert scales and free‐text answers distributed to 36 Australian hospitals for secondary distribution to hospital medical officers. Results: From 2607 questionnaires posted, 470 (18.1%) were returned. Thirty‐one per cent (95% confidence interval [CI] 26–35%) felt well prepared for resuscitation and management of emergencies, 41% (CI 37–45%) felt adequately prepared and 28% (CI 24–32%) felt they were not well prepared. Those who felt well prepared reported that they had experienced more exposure to a range of educational methods, including consultant contact, supervisor feedback, clinical skills, high fidelity simulator sessions and unit meetings. Well‐prepared and poorly prepared doctors had similar opinions of the usefulness of various learning methods, but the poorly prepared group more frequently expressed a desire for increased exposure to contact with registrars and consultants, clinical skills sessions and hospital and unit meetings. There were no differences in gender, age or country of origin (Australia vs international medical graduates) between those who felt well or poorly prepared. Conclusions: Many prevocational hospital doctors feel inadequately prepared for the management of emergencies. Perceived preparedness is associated with more exposure to particular educational activities. Increasing exposure to learning of emergencies in undergraduate and prevocational years could reduce the number of junior doctors who feel poorly prepared for emergencies.