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1.
Andrew R. Hoellein MD Christopher A. Feddock MD Charles H. Griffith III MD MSPH John F. Wilson PhD Donald R. Barnett MD MSPH Pat F. Bass III MD MS T. Shawn Caudill MD MSPH 《Journal of general internal medicine》2004,19(5P2):562-565
Due to recent public debate and newly imposed resident work hour restrictions, we decided to investigate the relationship of resident call status to their ambulatory patients' satisfaction. Resident continuity clinic patients were asked to rate their level of satisfaction on a 10-point Likert-type scale. Using multiple regression approaches, these data were then assessed as a function of resident call status. We found that in 646 patient encounters, patient satisfaction scores were significantly less when the resident was postcall, 8.99 ± 1.8, than when not postcall, 9.31 ± 1.3. We herein discuss etiologies and implications of these findings for both patient care and medical education. 相似文献
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The quality of medical education during internship is a cause for concern. This paper describes a structured educational programme for interns that was based around learning modules, clinical attachments and bedside teaching. The programme was incorporated into the term rotation of interns within an Area Health Service, and evaluated. Learning modules were timetabled by a Programme Coordinator and interns were reminded to attend. Clinical attachments were organized by the interns from a list of willing supervisors. Attendance at timetabled learning modules averaged 67%, which was greater than the 27% attendance at clinical attachments. Both sessions received high ratings for quality and clinical relevance. This structured education programme was based upon adult learning methods and was both feasible and well received by interns. Intern training programmes need to be programmed into the working week to ensure attendance, and modified following evaluation by interns. Such programmes should be considered by all hospitals to which interns are allocated. 相似文献
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Summary: As curriculum planners in general medicine residency training programmes we were concerned about house officers' anecdotal reports that hospital work requirements often overshadow individual learning goals. After each of five rotations, we asked residents to identify the educational 'usefulness' of certain rotation components which can be included in three categories; team members, work-related activities and educational events. Of 165 surveys distributed, 127 (77%) were returned. Data were analysed by residency year and by all years combined. The mean overall perception of learning was 3.9 out of a possible 5 points suggesting that residents do find some learning value. Results suggest that different residency years vary as to the significance of specific educational components. The importance of faculty/resident relationships to residents' perceptions of learning value was highlighted in particular. 相似文献
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目的探讨以团队导向的教学方法(team-based learning,TBL)联合病例为导向的教学方法(case-based learning,CBL)+情景教学法在医学影像本科超声教学中的应用及效果。方法选取滨州医学院2014级影像医学专业本科生50人为研究对象,随机分为两组,分别采用传统教学法(对照组25人)及TBL联合CBL+情景教学法(试验组25人)进行教学,教学结束后对两组学员进行考核及问卷调查,进行比较。结果试验组理论考核、阅片考核、操作技能成绩均高于对照组(P<0.05)。试验组在团队协作能力、自主学习兴趣、检索文献能力、对专业知识理解及记忆、基本技能操作能力、逻辑思维能力方面均明显优于对照组(P<0.05)。结论TBL联合CBL+情景教学法较传统教学更有助于学生提高影像专业医学学习自主性,夯实基本理论,基本技能,同时,有利于提高学生团队协作等综合素质。 相似文献
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李倬倩 《中国继续医学教育》2015,(18)
医学院的学生实习阶段是学生在教育中将理论与实践、基础知识与临床应用联系到一起的重要环节,是训练如何掌握专业的临床诊疗与各种医疗器械的操作技能不可缺少的阶段,是临床教育中重要的组成部分,同时也是医院选拔人才的一种重要的手段。因此许多医院在实习生参加实习的过程中都会建立实习档案对实习生进行系统的评价,档案不仅能反应一个学生的学习情况,增加考核临床带教的功能,还能够为用人单位提供一定参考价值的依据。 相似文献
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Long-term effects of ethics education on the quality of care for patients who have do-not-resuscitate orders 总被引:1,自引:0,他引:1
Dr. Daniel P. Sulmasy OFM MD Peter B. Terry MD Ruth R. Faden PhD MPH David M. Levine MD MPH ScD 《Journal of general internal medicine》1994,9(11):622-626
Objective: To assess the long-term clinical impact of a broad-based ethics education program for medical houseofficers with specific
emphasis on appropriate care for patients who have do-not-resuscitate (DNR) orders.
Design: Prospective, with an initial randomized phase.
Setting: The medical service of a university teaching hospital.
Participants: Medical houseofficers and their inpatients.
Interventions: A pilot program in 1988, and a full program with a two-year curricular cycle from 1989 to 1991.
Measurements and main results: The authors measured compliance with specific standards of care by reviewing charts of patients who had DNR orders at baseline
(n=39, 1988), after the pilot phase (n=57, 1989), and at the end of the first curricular cycle (n=56, 1991), noticing who wrote the DNR order, whether the reasons for the order and appropriate consent were documented, and
whether there was documented attention to any of 11 concurrent care concerns (CCCs), such as spiritual needs, the appropriateness
of tube feedings or pressors, and adjustment of analgesic dose. The percentage of DNR orders written by houseofficers increased
from 26% in 1988 to 67% in 1991 (p<0.01). The percentage of charts documenting the rationale and consent for the DNR order
was consistently high. The percentage of charts documenting attention to any CCC increased from 68% in 1988 to 86% in 1991
(p<0.01). The mean number of CCCs addressed per DNR order increased from 1.34 in 1988 to 2.14 in 1991. The mean number of
CCCs addressed per DNR order for patients who had AIDS increased from 0.89 in 1988 to 2.25 in 1991 (p=0.03).
Conclusions: The quality of care for patients who had DNR orders, both overall and for those who had AIDS, improved over long-term observation
in the setting of an ethics education program for medical houseofficers. The results suggest that ethics education may alter
physician practices and improve patient care.
Presented in part at the annual meeting of the Society of General Internal Medicine, Arlington, Virginia, April 29, 1993.
Supported by a Charles E. Culpeper Foundation Medical Humanities Award to Dr. Sulmasy. Computational assistance was provided
by CLINFO system of the National Institutes of Health (RR00035). 相似文献