我院在新生中实施"预防艾滋病健康教育处方"的近期效果评价

目的 :了解医学院校新生对艾滋病知识掌握的程度 ,探索在预防艾滋病健康教育中的有效途径。方法 :采用投影胶片讲解“预防艾滋病健康教育处方” ,在教育前后进行两次调查 ,对比研究教育前后调查结果。结果 :在教育前学生对艾滋病基本知识的认识存在很大误区 ,教育后 ,对艾滋病基本知识的认识有很大程度提高。结论 :讲解“预防艾滋病健康教育处方”是提高医学生艾滋病知识水平有效的途径。     

深圳市学生1982年与2003年生长发育指标比较

目的 了解21年来深圳特区小学生身高、体重的变化情况。方法 将2003年与1982年深圳特区4769名小学生身高、体重的资料进行对比分析。结果 2003年与1982年相比。7～12岁男女小学生身高的年增加率分别为4．36％～9．50％和4．89％～7．84％。体重的年增加率分别为21．72％～38．80％和15．47％～33．96％。结论2003年与1982年相比，同龄小学生的身高及体重有了明显的增加。     

海岛中学生心理卫生特点及相关因素分析

目的 了解海岛中学生的心理健康状况及其相关因素。方法 随机分层整群抽取海岛城镇2243名中学生，采用自制的一般情况问卷、90项症状清单及艾森克人格问卷进行测试，用SPSS软件包进行统计分析。结果 海岛城镇中学生中的非独生子女比独生子女、高中生比初中生、女生比男生、家庭居住在渔农村比居住在城镇的中学生心理健康水平要低。他们的心理障碍的发生率和SCL-90各项因子分与国内大陆某些地区的报道有所不同，本文中学生的个性特征与SCL-90各项因子分的相关分析表明海岛城镇中学生的心理健康状况与性格的内外倾向、掩饰作用呈负相关，与心理变态倾向、情绪稳定性呈正相关。本文男女生的心理障碍的发生率为16％～47％，以强迫症状为最显著。结论海岛中学生心理障碍的发生率较高，并且与大陆其它地区中学生心理健康状况有所不同。     

我国医学高校筹资、成本和效率评价--基本框架和概述

“中国高等医学院校筹资、成本分析和经济效益评价研究”是国家教育部高教司和卫生部科教司立项课题，共产出5篇论文。主要分析研究课题的基本框架，重点介绍研究背景、研究思路、研究目的、资料来源与调查方法，以及产生出的几篇论文的安排。     

A programme for treating chemically dependent medical students

Summary. The first American programme for chemically dependent medical students at the University of Tennessee, Memphis is described. The goals of the Aid for the Impaired Medical Student (AIMS) Program are to provide confidential treatment for chemically dependent medical students, to assure that recovering students are able to resume their education, and to protect patients and others from the harm that may be caused by impaired students. The Program is administered by the AIMS Council, consisting of medical professionals and elected student representatives. The Council oversees the management of cases, including investigation of students who may be impaired, intervention when chemical dependency is suspected, diagnostic evaluation, treatment and aftercare, and post-recovery advocacy for students. The Program's experience includes 18 cases of suspected chemical dependency, with four self-referrals and 14 students referred by third parties. Eleven students have been diagnosed as chemically dependent and have completed treatment programmes. Nine have maintained recovery and eight have graduated. One student subsequently relapsed and committed suicide. Obstacles in programme implementation have involved absence of perceived need, the view that chemically dependent students should be dismissed from school, and reluctance of students to report classmates. Resources have included highly respected student representatives, a supportive administration, assistance of the impaired physicians programme, and medical insurance and professional courtesy to defray costs. Although the number treated has been modest, the AIMS Program is an important vehicle for training students regarding chemical dependency and their professional obligations toward impaired colleagues.     

Introducing expert systems to medical students using esta, Expert System Teaching Aid

Medical students are allocated little curriculum time for exposure to expert systems. ESTA, a computer model of an expert system, was developed to make best use of this time. The nature of the students' interaction with ESTA is described, and their reactions to the expert system concepts and the place of expert systems in medicine are presented. A discussion of these reactions draws some conclusions about teaching expert systems in particular, and computers in general, in the basic medical course.     

Eight years'' experience with a structured clinical examination

A structured clinical examination has been an integral component of the final-year examinations conducted by the Departments of Medicine and Surgery at the University of Adelaide for the last 8 years. It has been used as an alternative to the traditional clinical examination. This paper describes the results of ongoing student and examiner surveys carried out to determine their views and satisfaction with this new approach. It also briefly discusses the feasibility of introducing such an examination into a conventional medical school environment. The surveys showed a remarkable level of acceptance and support by both students and examiners. This positive reaction has been maintained over the 8-year period. The main reasons seem to be its perceived relevance and fairness. Students also appear to be directing their learning in a direction thought desirable by teachers. No significant problems have been encountered with the practical implementation of the method.     

Quantitative assessment of diagnostic ability

This paper describes variables critical to diagnostic thinking that are based on research by Bordage and Grant & Marsden on the diagnostic thinking of medical students and experienced doctors. The purpose of the study is to use their findings to develop an inventory of diagnostic thinking. A 56-item diagnostic thinking inventory was initially developed; each item contains a stem followed by a 6-point, semantic differential scale. The inventory is designed to measure two aspects of diagnostic thinking: the degree of flexibility in thinking and the degree of knowledge structure in memory. The specific goal of the study is to determine which items discriminate best between weaker and stronger diagnosticians and to reduce the inventory to only those items which significantly contribute to the overall score. Thirty subjects from nine groups, each representing a distinct phase of medical education and clinical practice, participated, namely first- and third-year clinical medical students, house officers, senior house officers, registrars, senior registrars, consultants, trainees in general practice, and general practitioners, all from the UK (n = 270). Discrimination indices were calculated for each item. The revised version of the inventory contains 41 items. All the subjects found the exercise meaningful and the resulting scores showed variance and discrimination. The inventory will eventually be used to assess individual student's and clinician's diagnostic thinking and to plan ways of improving their diagnostic thinking.     

Adverse learning strategy: the Adelaide Diagnostic Learning Inventory and its subscale replicability in a medical student population

The Adelaide Diagnostic Learning Inventory (ADLIMS) is a measure of learning styles and learning pathologies that was designed to investigate the impact of traditional approaches to learning versus problem-based learning and to identify students whose approach to learning tasks predicted poor academic performance. In this study, some important psychometric properties of the ADLIMS were examined, including its factor structure. In this study, factor replicability across samples was argued to provide a more robust and psychologically meaningful factor solution than that which can be obtained using traditional mathematical criteria. The results of the factor analysis did not confirm the presence of the four factor solution earlier reported for the ADLIMS, but did identify three clear factors that had very high replicability. An inspection of the items comprising these three factors showed that factor 1 tapped subjective distress related to poor study habits, lack of motivation to study, and distraction from social activities. Factor 2 tapped distress arising from high achievement expectations that were hampered by superficial or disorganized study habits that did not enable the student to grasp the relationships between concepts and ideas. Factor 3 tapped positive feelings and a sense of satisfaction associated with a problem-based approach to the learning of new study material. Although the internal reliability of the ADLIMS subscales met the requirements of a measure to be used in general research such as in the investigation of correlates among groups of medical students, they did not meet the higher requirements of a measure to be used to identify or predict individuals with pathological learning styles.     

Self-directed learning in anatomy: incorporation of case-based studies into a conventional medical curriculum

This paper reports an attempt to develop self-directed learning skills in second-year medical students by introducing case-based projects into the gross anatomy course at a long-established medical school. The programme and students' responses to a questionnaire completed at the end of the year are presented. Information on the various resources used by students to find information is given. The performance of students in the case-based components of the course has been evaluated and also in the more traditional end-of-year written examination. The data confirm that students have recognized that the projects were about obtaining a deeper understanding of the anatomy, and the programme appears to have promoted the use and study of library texts.