Objective: The “six-step teaching method” is a teaching method, which is summarized based on practical experience. This study aimed to explore the effect of “six-step teaching method” in clinical teaching of ...Objective: The “six-step teaching method” is a teaching method, which is summarized based on practical experience. This study aimed to explore the effect of “six-step teaching method” in clinical teaching of obstetrics. Methods: A quasi-experimental study design was used, 30 nursing students who entered obstetrics practice from March 2022 to July 2022 were selected as the control group according to the order of time, and traditional teaching methods were adopted. From August to December 2022, 30 interns were selected as the experimental group, and the “six-step teaching method” was adopted. After 8 weeks of clinical practice, the assessment results and teaching effect satisfaction of the two groups were compared. Results: The scores of obstetrical specialty in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05);The evaluation of teaching methods, teaching quality, classroom atmosphere and individual observation ability, clinical thinking ability and nurse-patient communication ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P Conclusion: “six-step teaching method” can effectively master the professional knowledge of obstetrics, stimulate the clinical thinking ability of interns, and improve the teaching effect and satisfaction. .展开更多
Tramadol is a potent analgesic.However,the analgesia efficacy of tramadol,particularly its minimum effective dose(MED),is not clear.The aim of this study is to find MED of tramadol for postoperative analgesia in infan...Tramadol is a potent analgesic.However,the analgesia efficacy of tramadol,particularly its minimum effective dose(MED),is not clear.The aim of this study is to find MED of tramadol for postoperative analgesia in infants.The continual reassessment method(CRM)was performed to find MED.Infants undergoing surgeries were included in the 3 phases of this series.In each phase,24 participants were allocated a different tramadol dose.Pain intensity was measured by face,legs,activity,cry,consolability(FLACC)measurement at 3-hour intervals.Tramadol was considered ineffective if the FLACC score was higher than 4 in 10 at anytime.In phase 1,seven dose levels were used within the range 0.1-0.4 mg·kg^(-1)·h^(-1).Phase 1 was insufficient to identify the MED,and we increased the dose to 0.4-0.8 mg·kg^(-1)·h^(-1) in phase 2.Phase 2 was insufficient to identify the MED.In phase 3,local anesthetic wound infiltration was introduced,and the tramadol dose levels tested were the same as in phase 1.The successful analgesia probability of tramadol 0.4 mg·kg^(-1)·h^(-1) was 82.1%(95%CI,0.742-0.925)in phase 1.In phase 2,it was 84.7%(95%CI,0.789-0.991)with the dose 0.8 mg·kg^(-1)·h^(-1).Phase 1 and phase 2 were insufficient to identify the MED.In phase 3,the successful analgesia probability for dose 0.35 mg·kg^(-1)·h^(-1) was 96.7%(95%CI,0.853-0.997).We have demonstrated that tramadol provides insufficient analgesia for surgeries considered to cause moderate-to-severe postoperative pain in infants if used as the sole analgesic,and that local anesthetic wound infiltration enhances the efficacy of tramadol.展开更多
Objective To evaluate the safety and analgesic efficacy of patient controlled intravenous analgesia (PCIA) with tramadol, and to compare its benefits and risks with combined spinal-epidural analgesia (CSEA) + patient ...Objective To evaluate the safety and analgesic efficacy of patient controlled intravenous analgesia (PCIA) with tramadol, and to compare its benefits and risks with combined spinal-epidural analgesia (CSEA) + patient controlled epidural analgesia (PCEA).Methods Eighty American Society of Anesthesiologist (ASA) Ⅰ - Ⅱ at term parturients in active labor were randomly divided into 3 groups: the control group (n =30) received no analgesia; group A (n =30) received spinal administration with ropivacaine 2. 5 mg and fentanyl 5μg, then with PCEA; group B (n = 20) received 1 mg/kg tramadol loading dose i. v.. PCIA with 0. 75% tramadol and it included: PCA dose 2 ml, lockout time 10 minutes, background infusion 2 ml/h, total dose no more than 400 mg. The intensity of pain was evaluated using Visual Analogue Scale (VAS).Results Both group A and B showed good pain relief. VAS pain scores were significantly decreased in group A and B compared with those in the control group (P<0. 01). In comparison with group B, the VAS pain scores decreased in group A (P<0. 05). The onset times of analgesia in group A were shorter than those in group B (P<0. 05). Apgar scores in group B were lower than those in group A (P<0. 05). The periods of second stage of labor in group A were longer than those in the control group and group B (P<0. 05). The cesarean delivery rate was significantly higher in the control group (16. 7%) than in group A (3. 3%) and group B (5. 0%), but it did not differ between group A and B. There were no significant differences in vital signs, fetal heart rate, degree of motor block, and uterine contractions among the 3 groups.Conclusions PCIA with tramadol is now a useful alternative when patients are not candidates for CSEA for labor, or do not want to have a neuraxial block anesthesia. However, sometimes it may not provide satisfactory analgesic effect.展开更多
目的研究线上实习带教时采用植入雨课堂智慧模式的教学法对产科实习教学效果的影响。方法回顾分析2022年5月—2023年2月在中山大学附属第三医院产科实习的五年制、八年制及内外全科医学士(bachelor of medicine and bachelor of surgery...目的研究线上实习带教时采用植入雨课堂智慧模式的教学法对产科实习教学效果的影响。方法回顾分析2022年5月—2023年2月在中山大学附属第三医院产科实习的五年制、八年制及内外全科医学士(bachelor of medicine and bachelor of surgery,MBBS)实习学生147名实习成绩,分为研究组65名,对照组82名。对照组开展正常的线下实习,研究组采用植入“雨课堂”智慧模式的新型教学方法开展线上实习。比较2组实习生的实习效果并对研究组实习生进行线上教学满意度调查。结果研究组实习生总成绩、平时成绩与对照组相比[五年制:(82.13±2.95)分vs.(83.03±3.44)分;八年制:(82.18±2.47)分vs.(83.52±3.13)分;MBBS:(81.82±2.41)分vs.(80.03±2.80)分],差异无统计学意义(P>0.05);研究组中五年制、八年制实习生理论考核成绩与对照组相比[五年制:(73.11±7.94)分vs.(73.82±8.50)分;八年制:(70.28±4.66)分vs.(69.03±6.56)分],差异无统计学意义(P>0.05),而研究组MBBS实习生理论考核成绩高于对照组[(74.89±5.40)分vs.(65.25±7.81)分],差异有统计学意义(P<0.05);研究组中实习生技能考核成绩均低于对照组[五年制:(78.89±4.76)分vs.(81.27±4.77)分;八年制:(80.78±3.42)分vs.(84.29±6.12)分;MBBS:(76.78±3.93)分vs.(80.38±1.77)分],差异有统计学意义(P<0.05)。研究组实习生对植入雨课堂智慧模式的教学法在产科线上实习带教中的满意度高,非常满意者占66.15%,无不满意者。结论植入雨课堂智慧模式的教学法在产科线上实习带教中的应用基本达到了产科实习的要求,虽然在临床技能培养上存在一定的局限性,但仍是一种可开展的线上实习教学法。展开更多
目的探究BOPPPS结合慕课(Massive Open Online Courses,MOOC)教学法在妇产科本科生临床教学中的应用。方法选取2022年1月—2023年6月在新疆医科大学第二附属医院妇产科实习的50名本科生,按随机数字表法分为研究组和对照组,每组25名。研...目的探究BOPPPS结合慕课(Massive Open Online Courses,MOOC)教学法在妇产科本科生临床教学中的应用。方法选取2022年1月—2023年6月在新疆医科大学第二附属医院妇产科实习的50名本科生,按随机数字表法分为研究组和对照组,每组25名。研究组采用BOPPPS结合MOOC教学,对照组采取常规教学。比较两组理论考核成绩、临床技能和教学方式认可程度评分。结果研究组理论考试成绩和临床技能考核成绩为(92.38±2.33)分、(90.11±3.12)分,高于对照组的(85.20±4.13)分、(86.85±6.45)分,差异有统计学意义(t=7.571、2.275,P均<0.05)。研究组教学方式认可程度评分均高于对照组,差异有统计学意义(P均<0.05)。结论BOPPPS结合MOOC教学法优于传统教学方式,可有效调动学习主动性,提高学生成绩。展开更多
目的探讨以成果为导向(Outcome Based Education,OBE)联合情景模拟教学法用于临床产科教学的价值。方法选择2023年1月—2024年1月于苏州市立医院产科实习的60名实习生为研究对象,经抽签法分为两组,对照组采取传统模式开展教学活动,观察...目的探讨以成果为导向(Outcome Based Education,OBE)联合情景模拟教学法用于临床产科教学的价值。方法选择2023年1月—2024年1月于苏州市立医院产科实习的60名实习生为研究对象,经抽签法分为两组,对照组采取传统模式开展教学活动,观察组采取OBE联合情景模拟教学法开展教学活动。对比两组实习生的理论知识、实践操作成绩,以及自主学习能力。结果观察组实习生的理论知识及实践操作成绩均高于对照组,差异有统计学意义(P均<0.05);观察组的自主学习能力高于对照组,差异有统计学意义(P均<0.05)。结论OBE联合情景模拟教学法用于产科教学活动效果明显,能够有效提高实习生的理论及实践成绩,提高学生自主学习能力。展开更多
文摘Objective: The “six-step teaching method” is a teaching method, which is summarized based on practical experience. This study aimed to explore the effect of “six-step teaching method” in clinical teaching of obstetrics. Methods: A quasi-experimental study design was used, 30 nursing students who entered obstetrics practice from March 2022 to July 2022 were selected as the control group according to the order of time, and traditional teaching methods were adopted. From August to December 2022, 30 interns were selected as the experimental group, and the “six-step teaching method” was adopted. After 8 weeks of clinical practice, the assessment results and teaching effect satisfaction of the two groups were compared. Results: The scores of obstetrical specialty in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05);The evaluation of teaching methods, teaching quality, classroom atmosphere and individual observation ability, clinical thinking ability and nurse-patient communication ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P Conclusion: “six-step teaching method” can effectively master the professional knowledge of obstetrics, stimulate the clinical thinking ability of interns, and improve the teaching effect and satisfaction. .
文摘Tramadol is a potent analgesic.However,the analgesia efficacy of tramadol,particularly its minimum effective dose(MED),is not clear.The aim of this study is to find MED of tramadol for postoperative analgesia in infants.The continual reassessment method(CRM)was performed to find MED.Infants undergoing surgeries were included in the 3 phases of this series.In each phase,24 participants were allocated a different tramadol dose.Pain intensity was measured by face,legs,activity,cry,consolability(FLACC)measurement at 3-hour intervals.Tramadol was considered ineffective if the FLACC score was higher than 4 in 10 at anytime.In phase 1,seven dose levels were used within the range 0.1-0.4 mg·kg^(-1)·h^(-1).Phase 1 was insufficient to identify the MED,and we increased the dose to 0.4-0.8 mg·kg^(-1)·h^(-1) in phase 2.Phase 2 was insufficient to identify the MED.In phase 3,local anesthetic wound infiltration was introduced,and the tramadol dose levels tested were the same as in phase 1.The successful analgesia probability of tramadol 0.4 mg·kg^(-1)·h^(-1) was 82.1%(95%CI,0.742-0.925)in phase 1.In phase 2,it was 84.7%(95%CI,0.789-0.991)with the dose 0.8 mg·kg^(-1)·h^(-1).Phase 1 and phase 2 were insufficient to identify the MED.In phase 3,the successful analgesia probability for dose 0.35 mg·kg^(-1)·h^(-1) was 96.7%(95%CI,0.853-0.997).We have demonstrated that tramadol provides insufficient analgesia for surgeries considered to cause moderate-to-severe postoperative pain in infants if used as the sole analgesic,and that local anesthetic wound infiltration enhances the efficacy of tramadol.
文摘Objective To evaluate the safety and analgesic efficacy of patient controlled intravenous analgesia (PCIA) with tramadol, and to compare its benefits and risks with combined spinal-epidural analgesia (CSEA) + patient controlled epidural analgesia (PCEA).Methods Eighty American Society of Anesthesiologist (ASA) Ⅰ - Ⅱ at term parturients in active labor were randomly divided into 3 groups: the control group (n =30) received no analgesia; group A (n =30) received spinal administration with ropivacaine 2. 5 mg and fentanyl 5μg, then with PCEA; group B (n = 20) received 1 mg/kg tramadol loading dose i. v.. PCIA with 0. 75% tramadol and it included: PCA dose 2 ml, lockout time 10 minutes, background infusion 2 ml/h, total dose no more than 400 mg. The intensity of pain was evaluated using Visual Analogue Scale (VAS).Results Both group A and B showed good pain relief. VAS pain scores were significantly decreased in group A and B compared with those in the control group (P<0. 01). In comparison with group B, the VAS pain scores decreased in group A (P<0. 05). The onset times of analgesia in group A were shorter than those in group B (P<0. 05). Apgar scores in group B were lower than those in group A (P<0. 05). The periods of second stage of labor in group A were longer than those in the control group and group B (P<0. 05). The cesarean delivery rate was significantly higher in the control group (16. 7%) than in group A (3. 3%) and group B (5. 0%), but it did not differ between group A and B. There were no significant differences in vital signs, fetal heart rate, degree of motor block, and uterine contractions among the 3 groups.Conclusions PCIA with tramadol is now a useful alternative when patients are not candidates for CSEA for labor, or do not want to have a neuraxial block anesthesia. However, sometimes it may not provide satisfactory analgesic effect.
文摘目的研究线上实习带教时采用植入雨课堂智慧模式的教学法对产科实习教学效果的影响。方法回顾分析2022年5月—2023年2月在中山大学附属第三医院产科实习的五年制、八年制及内外全科医学士(bachelor of medicine and bachelor of surgery,MBBS)实习学生147名实习成绩,分为研究组65名,对照组82名。对照组开展正常的线下实习,研究组采用植入“雨课堂”智慧模式的新型教学方法开展线上实习。比较2组实习生的实习效果并对研究组实习生进行线上教学满意度调查。结果研究组实习生总成绩、平时成绩与对照组相比[五年制:(82.13±2.95)分vs.(83.03±3.44)分;八年制:(82.18±2.47)分vs.(83.52±3.13)分;MBBS:(81.82±2.41)分vs.(80.03±2.80)分],差异无统计学意义(P>0.05);研究组中五年制、八年制实习生理论考核成绩与对照组相比[五年制:(73.11±7.94)分vs.(73.82±8.50)分;八年制:(70.28±4.66)分vs.(69.03±6.56)分],差异无统计学意义(P>0.05),而研究组MBBS实习生理论考核成绩高于对照组[(74.89±5.40)分vs.(65.25±7.81)分],差异有统计学意义(P<0.05);研究组中实习生技能考核成绩均低于对照组[五年制:(78.89±4.76)分vs.(81.27±4.77)分;八年制:(80.78±3.42)分vs.(84.29±6.12)分;MBBS:(76.78±3.93)分vs.(80.38±1.77)分],差异有统计学意义(P<0.05)。研究组实习生对植入雨课堂智慧模式的教学法在产科线上实习带教中的满意度高,非常满意者占66.15%,无不满意者。结论植入雨课堂智慧模式的教学法在产科线上实习带教中的应用基本达到了产科实习的要求,虽然在临床技能培养上存在一定的局限性,但仍是一种可开展的线上实习教学法。
文摘目的探究BOPPPS结合慕课(Massive Open Online Courses,MOOC)教学法在妇产科本科生临床教学中的应用。方法选取2022年1月—2023年6月在新疆医科大学第二附属医院妇产科实习的50名本科生,按随机数字表法分为研究组和对照组,每组25名。研究组采用BOPPPS结合MOOC教学,对照组采取常规教学。比较两组理论考核成绩、临床技能和教学方式认可程度评分。结果研究组理论考试成绩和临床技能考核成绩为(92.38±2.33)分、(90.11±3.12)分,高于对照组的(85.20±4.13)分、(86.85±6.45)分,差异有统计学意义(t=7.571、2.275,P均<0.05)。研究组教学方式认可程度评分均高于对照组,差异有统计学意义(P均<0.05)。结论BOPPPS结合MOOC教学法优于传统教学方式,可有效调动学习主动性,提高学生成绩。
文摘目的探讨以成果为导向(Outcome Based Education,OBE)联合情景模拟教学法用于临床产科教学的价值。方法选择2023年1月—2024年1月于苏州市立医院产科实习的60名实习生为研究对象,经抽签法分为两组,对照组采取传统模式开展教学活动,观察组采取OBE联合情景模拟教学法开展教学活动。对比两组实习生的理论知识、实践操作成绩,以及自主学习能力。结果观察组实习生的理论知识及实践操作成绩均高于对照组,差异有统计学意义(P均<0.05);观察组的自主学习能力高于对照组,差异有统计学意义(P均<0.05)。结论OBE联合情景模拟教学法用于产科教学活动效果明显,能够有效提高实习生的理论及实践成绩,提高学生自主学习能力。
