Effect Analysis of WeChat Platform Combined with PBL Teaching Method for Standardized Training of Residents in Anesthesiology Department

Objective: To explore and analyze the effect of the WeChat platform combined with the PBL teaching method in the standardized training of anesthesia residents. Methods: 120 anesthesiology residents from January 2018 to the end of December 2019 were selected, and divided into a control group and an observation group of 60 each according to the time sequence of admission. The control group adopted the conventional teaching mode, and the observation group adopted the WeChat platform combined PBL teaching method. The scores of theoretical knowledge and anesthesia skills operation after training, the scores of the teaching interest survey, and the satisfaction with the teaching mode between the two groups were compared. Results: The scores of theoretical knowledge and anesthesia skills operation in the observation group were significantly higher than those in the control group, and the indicators of teaching interest in the observation group were also higher than those in the control group. The differences were statistically significant (P < 0.05). The satisfaction degree of the observation group was significantly higher than that of the control group, and the difference was also statistically significant (P < 0.05). Conclusion: The WeChat platform combined with the PBL teaching method is beneficial to improve the training effect of anesthesiology residents, stimulating autonomous learning ability, ensuring the effective practice of theoretical knowledge, and promoting them to move towards a higher standard of anesthesia skills.

Application Research of Fragmented Case Teaching in Standardized Training of Residents in Anesthesiology Department

Objective:To explore the effect of fragmented case teaching in the standardized training of residents in anesthesiology department.Methods:80 doctors who participated in the standardized training of residents in anesthesiology department from January 2021 to January 2022 were selected as the research objects,and the 80 doctors were divided into experimental groups according to the clinical teaching mode(n=40,implemented case fragmented teaching method)and the control group(n=40,traditional teaching method).The training lasted for 2 months,and the medical history collection,medical record analysis,practical operation ability,theoretical assessment results,and the degree of satisfaction towards the training of the two groups of doctors were compared.Results:After 2 months of training,the theoretical knowledge and operational ability of the doctors in the two groups have improved to a certain extent,but the medical history collection,medical record analysis,practical operation ability,theoretical assessment results and satisfaction of the doctors in the experimental group were significantly better than those in the control group(P<0.05).Conclusion:The effect of the fragmented case teaching method in the standardized training of anesthesiology residents is significantly better than the traditional teaching mode.The abilities of doctors have significantly improved after the training.Hence,the fragmented case teaching method is worthy of promotion in clinical practice.

Physician-Rated Utility of Procedure Videos for Teaching Procedures in the Emergency Department, Overall and during Emergency Department Crowding

Background: Real-time use of procedure videos as educational tools has not been studied. We sought to determine whether viewing a video of a medical procedure prior to procedure performance in the emergency department improves the quality of teaching of procedures, and whether videos are particularly beneficial during periods of emergency department crowding. Methods: In this single-centre, prospective, before and after study standardized data collection forms were completed by both trainees and supervising emergency physicians (EPs) at the end of each emergency department shift in the before (August 2008-March 2009) and after (August 2009-March 2010) phase. Online procedure videos were introduced on emergency department computers in the after phase. The primary outcome measure was EP rating of the quality of teaching provided (5-point Likert scale). The interaction between crowding and videos was also assessed, to determine whether videos provide a specific additional benefit during periods of emergency department crowding. Results: There were 1159 procedures performed by 192 trainees. Median procedures performed per shift was 1.0 (IQR 0 - 2.0). Mean EP rating of teaching provided was significantly higher in the group that viewed videos, at 4.2 versus 3.7 (p 0.001). In the adjusted analysis, EP ratings increased by 0.5 with a video (p 0.001), while the odds of a score of 5.0 were 2.2 times greater if a video was viewed (p = 0.03). The interaction of crowding and procedure videos was not significant (the use of videos increased the average score by 0.24 in times of crowding compared to times of non-crowding, p = 0.19). Conclusions: Use of procedural videos was associated with EP perception of improved quality of teaching provided around procedures. While EPs rated the quality of their teaching as improved overall, the effect of videos on teaching quality was the same in crowded settings as it was in non-crowded setting.

Analysis of Application of multimedia technology in the teaching of clinical pediatrics

Pediatrics belongs to highly professional important disciplines clinically. Because of abstract content of pediatrics, knowledge at odds and the lack of clinical practice, they pediatric pose serious challenges to the traditional teaching model. With the development of multimedia and network technology and the popularization of hardware facilities in higher vocational colleges, profound change took place in clinical pediatric teaching mode. Multimedia technology has become an important part of modern teaching methods. Through multimedia technology applications in pediatric vocational clinical teaching practice, the pediatric clinical teaching is optimized and classroom teaching improved, but also problems found in the application process of multimedia technology.

Application of a Combination of Two Teaching Methods in Pediatric Teaching

Pediatrics is one of the clinical professional courses that is highly practical.The traditional single teaching method is inconducive to stimulating students’interest in learning,resulting in a poor classroom teaching effect.To change the traditional single teaching model and promote and improve the development of pediatric teaching,according to the level of pediatric teaching,colleges can consider combining two teaching methods to carry out pediatric teaching.The main research in this paper is the combination of PBL(problem-based learning)teaching and CBS(case-based study)teaching.An overview of the two teaching methods is first given,and then the application significance of the combination of the two teaching methods is analyzed.Lastly,it explores the specific implementation of hybrid teaching methods in pediatric teaching.

Validation of different pediatric triage systems in the emergency department

BACKGROUND: Triage system in children seems to be more challenging compared to adults because of their different response to physiological and psychosocial stressors. This study aimed to determine the best triage system in the pediatric emergency department.METHODS: This was a prospective observational study. This study was divided into two phases. The fi rst phase determined the inter-rater reliability of fi ve triage systems: Manchester Triage System(MTS), Emergency Severity Index(ESI) version 4, Pediatric Canadian Triage and Acuity Scale(CTAS), Australasian Triage Scale(ATS), and Ramathibodi Triage System(RTS) by triage nurses and pediatric residents. In the second phase, to analyze the validity of each triage system, patients were categorized as two groups, i.e., high acuity patients(triage level 1, 2) and low acuity patients(triage level 3, 4, and 5). Then we compared the triage acuity with actual admission.RESULTS: In phase I, RTS illustrated almost perfect inter-rater reliability with kappa of 1.0(P<0.01). ESI and CTAS illustrated good inter-rater reliability with kappa of 0.8–0.9(P<0.01). Meanwhile, ATS and MTS illustrated moderate to good inter-rater reliability with kappa of 0.5–0.7(P<0.01). In phase II, we included 1 041 participants with average age of 4.7±4.2 years, of which 55% were male and 45% were female. In addition 32% of the participants had underlying diseases, and 123(11.8%) patients were admitted. We found that ESI illustrated the most appropriate predicting ability for admission with sensitivity of 52%, specifi city of 81%, and AUC 0.78(95%CI 0.74–0.81).CONCLUSION: RTS illustrated almost perfect inter-rater reliability. Meanwhile, ESI and CTAS illustrated good inter-rater reliability. Finally, ESI illustrated the appropriate validity for triage system.

The mortality of patients in a pediatric emergency department at a tertiary medical center in China: An observational study

BACKGROUND: The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department(PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the mortality.METHODS: The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive statistics.RESULTS: Altogether 466 919 patients visited the PED during the period and 43 925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years(median, 5 months). The time from admission to death ranged from 0 to 216 hours(median, 1.5 hours). There were 92(40%) patients who died within 24 hours after admission and 104(45.2%) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth asphyxia.CONCLUSIONS: In our center, 40% of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.

Exploration of the Barriers and Education Needs of Non-Pediatric Hospital Emergency Department Providers in Pediatric Trauma Care

Study Objective: Nine million children are seen in emergency departments each year for traumatic injuries. Eighty percent of these children will be cared for in non-children’s hospital settings. We sought to understand the barriers and opportunities for optimal pediatric trauma care in non-pediatric emergency departments and to define practice-specific educational needs. Methods: This qualitative study consisted of focus groups from rural, regional and urban non-pediatric emergency department sites discussing pediatric trauma care. Groups were homogenous for the provider role and included 8 physician groups and 9 non-physician groups. Focus groups were led by a trained moderator using a discussion guide composed of open-ended questions which covered various topics of pediatric trauma care. Focus groups were audio-taped and later transcribed and the data were analyzed for major themes and key concepts. Results: A total of 107 providers participated in the focus groups (32 physicians and 75 non-physicians). Barriers to provide optimal pediatric trauma care expressed by providers included the lack of pediatric trauma experience, inadequate pediatric trauma training and the lack of confidence with assessment of the pediatric trauma patient. All providers across all types of hospitals indicated a need and interest in training focused on pediatric trauma, but topics covered, and skills needed varied by type of facility. Conclusions: Community emergency room providers indicated a need for pediatric trauma education. Specifically, hands-on training with high-fidelity simulation was identified as the most useful type of training to gain the skills and confidence needed to manage pediatric trauma patients in their emergency departments.

Application of Standardized Measures in Clinical Teaching of Medical Imaging Department

Objective:To explore the application of standardized measures in clinical teaching of medical imaging department.Methods:Forty-eight medical interns in Department of Medical Imaging of our hospital from February 2018 to May 2019 were selected as research objects.They were divided into 2 groups according to random number table method,with 24 cases in each group.Routine education management was performed in clinical teaching for control group,standardized measure management was performed in clinical teaching for observational group.Performance assessment before and after intervention was compared between two groups of medical students.Results:Before intervention,there was no significant difference in assessment result between two groups of medical students(P>0.05).Assessment result after intervention was higher than before intervention in two groups of medical students.Observational group was higher than control group,the difference was statistically significant(P<0.05).Conclusions:Implementation of standardized measures in clinical teaching of medical imaging department could significantly improve assessment result of medical students,and its application can be considered in clinical teaching.

The Application of Research Study in Higher Vocational Medical College Teaching

The research study is a new learning mode emerging in recent years, which can cultivate students＇ many aspects of ability. In the higher vocational colleges, obstetrics and gynecology department is a subject of strong theory and practice, which has a higher requirement for students＇ autonomous learning and ability to independently solve and analyze the problems. And it applies to the higher vocational obstetrics and gynecology subject teaching, which conforms to the refornl and development of clinical teaching in obstetrics and gynecology, and it is good for cultivating the medical talents suitable for social need with high quality and strong practice ability.

Evaluation of Predictors of Suicidal Re-Attempt in Pediatric Patients in the Emergency Department

Background: Suicidal attempt in children is a serious public health problem. A proper identification of features of suicide-related behavior may help physicians to develop an accurate approach. The aim of this study was to clarify the characteristics of children with poisoning due to suicidal attempt and to determine the risk factors of suicidal re-attempt in the Emergency Department (ED) via a simple questionnaire. Methods: We collected medical data of patients under 18 years who were admitted to our ED with intoxication due to suicidal attempt, retrospectively. General characteristics of patients were evaluated. Patients were divided into 2 groups as 1) High risk: patients with repetitive suicide attempt;2) Low risk: patients with first time suicidal attempt. Results: A total of 57 patients were included in this study. The mean age was 15.91 ± 0.97. Majority of the patients were female (73.7%). Analgesics were the most frequent abused drugs with a ratio of 51.1%. It is determined that the most important variables affecting the risk of suicidal re-attempt are “idea about the suicide” and “purpose”. It was determined that patients with an idea of repetitive suicide (I will try again) and whose purpose was to die (I wish I have died) were in the most risky group with a history of previous suicidal attempt. Conclusion: This study suggests that answers of the pediatric patients to some question have a potential to predict the high risk patients. The risk of suicidal re-attempt may be predicted by the answers given to these questions: 1) What is your idea about suicide? 2) What was your purpose?

Application of emergency severity index in pediatric emergency department

BACKGROUND： The purpose of triage is to identify patients needing immediate resuscitation, toassign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures asappropriate. This study aimed to use emergency severity index （ESI） in a pediatric emergency room.METHODS： From July 2006 to August 2010, a total of 21 904 patients visited the InternationalDepartment of Beijing Children＇s Hospital. The ESI was measured by nurses and physicians, andcompared using SPSS.RESULTS： Nurses of the hospital took approximately 2 minutes for triage. The results of triagemade by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This findingindicated that the nurses are able to identify severe pediatric cases.CONCLUSION： In pediatric emergency rooms, ESI is a suitable tool for identifying severecases and then immediate interventions can be performed accordingly.

Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia

BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in children,recommending aminopenicillins as the first-line therapy.Poor guideline compliance with 10%–50%of patients admitted to the hospital receiving narrow-spectrum antibiotics has been reported.A new clinical practice guideline(CPG)was implemented in our emergency department(ED)for uncomplicated CAP.The aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG implementation.METHODS:Prior to CPG-implementation,an anonymous case-based survey was distributed to evaluate knowledge of the current PIDS/IDSA guideline.A retrospective chart review of patients treated in the ED for CAP from January 2015 to February 2017 was performed to assess prescribing patterns for intravenous(IV)antibiotics in the ED at Children’s National Health System pre-and post-CPG implementation.RESULTS:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of choice.However,only 41.2%of patients admitted to the hospital with uncomplicated CAP pre-CPG received ampicillin(P<0.01).There was no statistically signifi cant increase in ampicillin prescribing post-CPG(P=0.40).CONCLUSIONS:Providers in the ED are aware of the PIDS/IDSA guideline regarding the first-line therapy for uncomplicated CAP;however,this knowledge does not translate into clinical practice.Implementation of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.

Clinical Study on the Effects of Different Infusion Solutions on Colloid Osmotic Pressure During Major Abdominal Surgery and Perioperative Albumin in Elderly Patients

Objective:To explore the effects of different infusion schemes on colloid osmotic pressure during major abdominal surgery and perioperative albumin in elderly patients.Methods:140 elderly patients of 65-80 years old undergoing major abdominal surgery were divided into 4 groups according to the method of random number table,and different proportions of crystals and colloids were given to different groups(group A:full crystal,group B:crystal-colloid ratio 1:1,group C:crystal-colloid ratio 2:1,Group D:crystalcolloid ratio 1:2).The plasma colloid osmotic pressure and level of albumin during perioperative period were monitored.Simultaneously observe the arterial blood pH,blood glucose,extubating time of endotracheal tube,postoperative feeding time,et al.Results:The total amount of liquid infusion in the group of whole crystal was 3056ml(3056±253),which was significantly more than other groups(P<0.01).At the same time,the colloid osmotic pressure decreased by 11.9 mmHg(11.9±2.8),which was more obviously decreased than that of the other groups(B group3.9±1.3,C group 1.5±0.3,D group 4.7±2.1).The difference was a statistically significant(P<0.01).On the next day after surgery,the level of albumin decreased by an average of 4.3 g/L(4.5±1.9)compared with that in group B before surgery,and group C decreased by 2.9 g/L(2.9±1.2)in average,which was significantly different(P<0.05)from group A 10.2 g/L(10.2±1.8).There was no statistically significant difference between group A and group D(P>0.05).And the other indexes were not significantly different between the two groups.Conclusion:This study found that different infusion solutions with different crystal-colloid ratios had an effect on perioperative colloid osmotic pressure and level of albumin.

Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in Mizan-Tepi University Teaching Hospital,South West Ethiopia,2022

Objective:Despite trials and programs for the prevention of childhood mortality due to pneumonia,Ethiopia is among the top five countries with the highest number of deaths due to pneumonia.Although the prevalence of pneumonia has increased in the abovementioned trials,little is known about the recovery time from severe pneumonia and its predictors in the study area.Therefore,this study aimed to assess the time to recovery from severe pneumonia and its predictors among pediatric patients admitted to Mizan-Tepi University Teaching Hospital,Ethiopia,in 2022.Methods:A total of 591 children admitted for severe pneumonia were selected using simple random sampling.Data were entered into Epi-data version 4.4.2.1 and expor ted to STATA version 14 for analysis,and the assumptions of Cox propor tional hazard models and goodness of fit were assessed through Shoenfeld residual and Cox-Snell residual,respectively.Bivariate and multivariable Cox regression models were used to identify the predictors of mor tality.Results:This study revealed that 91.54%(95%confidence interval[CI]:89.00–93.53)of participants recovered with an incidence rate of 24.10(95%CI:22.15–26.21)per 100 person-day–observations.The hmedian recovery time of children was 4 days(95%CI:2–6).Children who were not exclusively breastfed(AHR=1.3;95%CI:1.03–1.66),who had a history of inability to suck/feed(AHR=0.81;95%CI:0.65–0.99)were independent predictors of the time to recovery.Conclusions:Children with severe pneumonia who had not exclusively breastfed and who had a history of inability to suck/feed were independent predictors of time to recovery.Therefore,all stakeholders and concerned health care providers should focus more on early diagnosis and management and hasten early recovery based on the identified factors.

Application of Scenario Simulation Method in Pediatric Clinical Nursing Teaching

Purpose Analysis of Situational Teaching Method Applied in Pediatric Clinical Nursing Teaching.Method The 120 nursing students who studied in our University from 2015 to 2017 were selected as the study subjects and divided into routine group and experimental group.General teaching methods were adopted for the routine group,and the experimental group took a scenario simulation teaching method on this basis.Results The satisfaction of the teaching methods between the experimental group and the routine group were 93.33% and 81.67% respectively,P<0.05;The theoretical and practical results of the experimental group were better than the routine group,P<0.05.Conclusion The application of the situational teaching method in pediatric clinical nursing teaching has a significant effect and can effectively arouse students’interest in learning.

Seminar教学法在中医本科生临床实习教学中的应用效果

目的探讨Seminar教学法在中医本科生临床实习教学中的应用效果。方法选取2021年7月至2022年7月在天津中医药大学第一附属医院肝胆科实习的60名中医学专业本科生,按照随机数字表法将其分为对照组和试验组,各30人。对照组采用常规教学法,试验组在对照组教学模式基础上采取Seminar教学法。比较两组的应用效果。结果试验组的出科考核成绩高于对照组,差异具有统计学意义(P<0.05)。两组的出勤情况评分比较,差异无统计学意义(P>0.05);试验组的实习主动性、日常提问回答情况、临床书写病历完成度、查房参与情况评分及总分高于对照组,差异具有统计学意义(P<0.05)。结论Seminar教学法能够提升中医本科生的实习主动性、日常提问回答情况、临床书写病历完成度、查房参与情况评分以及出科考核成绩,教学效果良好,是对本科生临床实习带教方法的有益尝试。

MiniQuest教学模式在感染科实习医生教学中的应用

目的 探讨MiniQuest教学模式在感染科实习医生教学中的应用。方法 选择2020年9月—2021年6月本校60名感染科实习医生作为研究对象,按不同年级分为对照组(2020级)和干预组(2021级)两组,每组各30名。对照组采用传统教学方法,干预组采用MiniQuest教学方法。比较两组中文版评判性思维能力测量量表、自我效能量表、团队凝聚力测量问卷、教学效果评价问卷、考试成绩。结果 干预后,干预组实习医生的寻找真相、开放思想、分析能力、系统化能评判性思想的自信心、求知欲和认知成熟度及总分得分高于对照组,差异有统计学意义(P<0.05);干预后,干预组实习医生的自我效能评分明显高于对照组,差异有统计学意义(P<0.05);干预后,干预组实习医生的共乐群性、自律性、归属性、价值性及总分评分明显低于对照组,差异有统计学意义(P<0.05);干预组实习医生喜欢此种教学方式占90.00%,能掌握重点内容、能提高问题分析能力及能提高团结合作能力均占86.67%,能提高评判性思维能力和能提高自主学习能力均占83.33%,能提高操作技能占80.00%,能提高语言表达能力、能提高人际沟通能力及能提高学习兴趣均占76.67%;干预组实习医生的理论成绩和操作成绩均高于对照组,差异有统计学意义(P<0.05)。结论 MiniQuest教学模式能提高感染科实习医生评判性思维能力、自主学习能力、实习医生教育水平及核心竞争能力。

Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department

AIM To determine the prevalence of Chlamydia trachomatis(CT) and Neisseria gonorrhea(GC) in young men seeking care in the emergency department(ED) for non-sexually transmitted infection(STI) related symptoms.METHODS This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints. RESULTS Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18(quartiles 16-18, 19-21)]. Overall, 17(6.3%, 95%CI: 4%-10%) tested positive for CT and 0%(95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71%(95%CI: 65%-76%) and 2%(95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46%(95%CI: 43%-54%) and 13%(95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88%(95%CI: 64%-98%) were successfully followed up. CONCLUSION The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

Mini-CEX联合DOPS评分量表在推拿科住院医师规范化培训中的应用探索

目的采用迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)联合临床技能操作评分量表(direct observation of procedural skills,DOPS)的形成性评价,探讨其在推拿科住院医师规范化培训教学中的应用价值。方法选取2022年6月—2023年6月在安徽中医药大学第一附属医院推拿科进行住院医师规范化培训的60名住院医师规范化培训学员,由获得安徽中医药大学住院医师规范化培训师资证书的教师进行临床规范化教学。在每期住培学员入科后1周及出科前利用Mini-CEX和DOPS评分量表各测评1次,通过对考核成绩、教师和学员互评满意度进行数据分析,评价形成性评价的临床教学效果。结果Mini-CEX量表的出科前考核成绩与入科后考核成绩[(54.95±4.17)分vs.(53.93±3.65)分]比较,差异均有统计学意义(P<0.05)。DOPS评分量表的出科前考核成绩与入科后考核成绩[(87.00±8.32)分vs.(84.97±6.75)分]比较,差异均有统计学意义(P<0.05)。出科前考核教师对评估结果的满意度分值高于入科后,出科前考核住培学员对评估结果的满意度分值高于入科后,差异均有统计学意义(P<0.05)。结论Mini-CEX结合DOPS评分量表作为推拿科住院医师规范化培训的形成性评价工具效果良好。