A Culturally-Sensitive Model for CME Distance Learning Demonstratesa Way Forward： Kenya＇s Experience with ACME-IT （Advancing Continuing Medical Education Through Information Technology）

A distance learning Continuing Medical Education （CME） project based on live interactive presentations and a group participatory model demonstrated that important strides can be made in the quality of CME available to health care professionals in African rural settings. Implementers choose a communication model consistent with the fundamental orality of Kenyan and other sub-Saharan African countries. The project involved four hospitals and one training institution in rural Kenya. The testing of learners and focus group discussions with learners, facilitators and presenters indicated that the project＇s methodologies, that strove to be culturally and work place friendly, contributed to gains in knowledge, competencies including case management, the continuity of patient care, team work, staff morale and other issues of expressed importance to the hospital healthcare work force and hospital administrators. The learning system, known as Advancing Continuing Medical Education through Information Technology （ACME-IT）, was implemented by the Kenyan Ministry of Medical Services, EC Associates and the US-funded Aphia2 Western initiative implemented by PATH. The findings of this pilot suggests that the ACME-IT methodology that set up learning centers at the participating institutions is a promising viable alternative to the traditional and relatively expensive workshop training that characterizes much of CME in lower and middle income countries.

Continuing professional development:progress beyond continuing medical education

Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.

A Survey on the Continuing Education Status and Demand of Nurses in Chongqing Grass-Root Medical Institutions

Background: With the increased aging of population, the continuous increase in the morbidity of chronic diseases, and the issuance of universal two-child policy, the grass-root medical teams become more and more important. Objective: To investigate the continuing education status and demand of nurses in the grass-root medical institutions and thus provide a reference for optimizing the continuing education plan. Methods: From October 2018 to May 2019, a survey of 270 nurses from 28 grass-root medical institutions in Tongliang District of Chongqing was performed using a self-designed questionnaire. Results: In the grass-root medical institutions, the major continuing education pattern of nurses was hospital training and distance education;the continuing education focused on new basic theoretical knowledge and new nursing techniques, and its satisfaction was 67.8%. About 20.6% questionnaire answerers never had received continuing nursing education. As shown by one-way analysis of variance (ANOVA) and binary logistic regression analysis, the following factors were associated with the continuing education participation in the past three years: work unit, organizational affiliation, age, professional title and hospital policies. There were 93.0% questionnaire answerers reflecting that it was necessary to participate in the continuing education and wishing the conformance between the pattern and contents of continuing nursing education and the actual implementation status. Conclusion: The continuing education demand of nurses in the grass-root medical institutions is basic but diverse, and the organizations shall provide effective policy support for continuing education and make the diversified training plan by combining Internet technology, so as to realize the maximization of continuing education participation and keep improving the overall service quality of gross-root nurses.

Current State of Affairs with Regard to Continuing Medical Education for Technicians in Radiology in Francophone West Africa

Background: This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. Materials and methods: This opinion survey was administered to radiology technicians in French-speaking West Africa from 1st June to 31st October 2020, i.e. over a period of 5 months concerning their level of CME and their need for CME. Results: Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). Conclusion: The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa;however, it remains a luxury for them, due to its scarcity and its high cost.

Objective Assessment in Continual Medical Education (CME) Medical Objective Assessment in System Control

Existing examinations in postgraduate education and continuing medical education (CME) are not perfect. Modern assessment does not reflect disadvantages of older responders, for whom more time for reply is needed. Specialists with wide clinical experience may choose more than one correct answer in alternative questions. Reduced ability to remember in older people restricts examination without additional sources of information. We offer an individualised system for testing doctors. It provides personalised choice of examination questions using multiple choice questions with weight characteristics and absence of distractors, interactive cooperation in case of negative answers and the final decision of an expert in relation to the person tested. A special algorithm is proposed for typical questions that combines the advantages of known approaches to testing. The questioning system is complex for the creators of tests, but is more convenient and objective than existing ones for medical doctors.

Building towards Expertise in CME （Continuous Medical Education）： Suggestions for a New Paradigm

To build towards expertise, one has to accept to modify his way of practicing, including： （1） a need to reflect on and about the action; （2） a continuous concern about our competence to practice; （3） tireless effort to combine metacognition and mental practice in a trans-disciplinary approach; （4） adding research with neuroscience, understanding neuroplasticity, modulation and artificial intelligence. Usual practice actually does not include a continuous concern for CME （continued medical education） and is intermittent at best. This new paradigm constitutes the basis of our approach. Expertise starting in 2015 is described as an asymptotic curve unable to be obtained with usual practice and intermittent education. We suggest a new way of conceiving CME combining practice, reflection on action and in-situ simulation laboratory near work. We are describing TEE （technology-enhanced education） coupled with certain neuro-enhancers to achieve a break in the asymptotic curve of expertise. This is in reality a new conception of CME in medicine.

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Ideological and Political Exploration of Academic Continuing Education Professional Diploma in Medical Imaging

In alignment with the 20th National Congress of the Communist Party of China’s commitment to establish a healthier nation,the focus on healthcare strategically prioritizes human well-being.This necessitates redefining medical service delivery.Consequently,the training of medical students and continuing education is Challenged.In recent years,the notion of incorporating“ideological and political education within the curriculum”is becoming more explicit,especially within university talent training.This paper,exploring the unique attributes of professional medical imaging student training and continuing education,proposes the innovative model of“3+4+2”ideological and political education at the First Affiliated Hospital of Dalian Medical University.It introduces a new system of“school-family-society”tripartite co-education,a new mechanism of“party committee-functional departments-teaching and research office-teachers”four-level linkage,and a novel approach of“party branch-teaching and research office”dual-wheel drive,integrating value shaping,knowledge imparting,and ability cultivation.The goal is to nurture Party talents and educate patriots,thereby enhancing the effectiveness of“comprehensive education”and bolstering the construction of new medical sciences.

Interpretation of proposed measures for continuing nursing education

1 Introduction With the development of modern medicine,the growth of the social demand for nursing,and the gradual improvement of the concept and connotation of lifelong nursing education,continuing nursing education(CNE),as a key form of lifelong nursing education,has received wide attention and played an important role worldwide.CNE is a kind of lifelong education of nursing science on the basis of continuing

Cross-sectional study of the educational background and trauma knowledge of trainees in the “China trauma care training” program

Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.

Management of Adult Growth Hormone Deficiency at Peking Union Medical College Hospital:A Survey among Physicians

Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.

Process evaluation of E-learning in continuing medical education:evidence from the China-Gates Foundation Tuberculosis Control Program

Background:E-learning is a growing phenomenon which provides a unique opportunity to address the challenges in continuing medical education(CME).The China-Gates Foundation Tuberculosis(TB)Control Program implemented online training forTB health workers in three provinces of China.We aim to evaluate the implementation of E-learning CME programs,analyse the barriers and facilitators during the implementation process,and to provide policy recommendations.

The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China

Background:Given the context of rapid technological cha nge and COIVD-19 pan demies,E-lear ning may provide a unique opportunity for addressing the challenges in traditional face-to-face continuing medical education(CME).However,the effectiveness of E-learning in CME interventions remains unclear.This study aims to evaluate whether E-learning training program can improve TB health personnel's knowledge and behaviour in China.

A comparison of ophthalmic education in China and America

Training qualified ophthalmic professional is crucial for any eye care system worldwide.Education of modern western Ophthalmology in China started late but develops rapidly.This review focused on ophthalmic education in China and US,describing details of the programs and analyzing the differences.This summary may provide useful information for practitioners of medical education from both countries and help improve the present training designs.

The Impact of a Real-Life Inflammatory Bowel Disease Education Course for Brazilian Physicians from the Perspective of Its Participants

Background: Physicians must acquire the necessary skills to provide Inflammatory Bowel Disease (IBD) patients with state-of-the-art clinical care, aiming to improve patient’s quality of life and disease outcomes. Purpose: To describe the queries and experiences of doctors enrolled in an IBD education course and to evaluate the impact of the course. Methods: A retrospective study included 100 physicians, of which 78 attended the course. A questionnaire was applied evaluating how the course had an impact on their IBD-knowledge. The 20-hour-course consisted of practical “real-life” activities and theoretical discussions. Results: The majority of doctors’ expertise was in gastroenterology (53%) and coloproctology (44%). A significant portion had no experience with biological therapy for ulcerative colitis (19.4%) or Crohn’s disease (5.05%). The main topics doctors wanted to discuss were biological therapy (93%), new drugs (74%) and differential diagnosis (64%). A considerable number of physicians did not feel confident at prescribing biological therapy before the course (44.4%), a percentage that decreased to 8.5% after the course (p < 0.0001). The impact of the course was considered high (grades 9 and 10) by most of the participants (78.2%). Discussion: The ideal course should have a practical and theoretical component, as well as the support of an experienced multidisciplinary team. A real-life practical-theoretical IBD course proved a success at increasing IBD knowledge.

Urgent Need of Continuing Medical Education:The Key for Patient Awareness of Labor Epidural Analgesia-A Survey of Chinese Perinatal Care Providers

Objective:This survey was designed to understand the misconceptions about labor epidurals.Methods:This voluntary and anonymous online survey on wenjuan.com was conducted from September 1st,2015 to January 1st,2016 via mainly WeChat groups dedicated to perinatal healthcare providers in China.The questionnaire included items inquiring the knowledge and opinions about labor epidural analgesia related to maternal complications,baby safety,and effect on laboring.Incomplete surveys were excluded from the data analysis.The data was presented as percentages and a Chi-square test or Fisher's exact test,as appreciate,was used to quantitatively compare the results.Results:A total of 1412 respondents completed surveys with 42.9%(606/1412)of them being anesthesiologists,35.1%(495/1412)being obstetricians,11.8%(167/1412)being midwives,3.7%(52/1412)being labor and delivery nurses,and 6.5%(92/1412)being hospital administrators and unspecified.The study revealed a lack of knowledge in labor pain control.Although 82.4%(1164/1412)of respondents were familiar with labor epidural analgesia,8.9%(126/1412)did not know how it works,and 1.1%(15/1412)never heard it in a multiple-choice question.The three main groups(anesthesiologists,obstetricians,and midwives/labor and delivery nurses)were chosen for comparisons.Opinions among these three groups concerning five questions in the three main concerns were evaluated using a statistical significance of P<0.05.Conclusion:The results in our survey indicated an urgent need of continuing medical education to multidisciplinary specialties to improve evidence-based medical practices as these misconceptions have existed for over 10 years in the medical professionals.Lack of public awareness fueled by misconceptions related to labor epidural analgesia may be associated with a lack of professional knowledge.Correct knowledge in professionals needs to be disseminated to the public in order to dispel possible misconceptions and rumors about labor epidural analgesia.This would not only enhance patient understanding of their care but also improve maternal,fetal,and neonatal outcomes.

麻醉科进修医师临床教学培训模式的探索研究

目的建立麻醉科进修医师临床教学培训模式,并评价其实施效果。方法选取2023年3—9月在北京协和医院麻醉科进修学习的25名医师为研究对象,在其进修期间实施“导师制⁃知识更新⁃临床实践”的临床教学培训模式。于进修学习前、后分别进行测试(包括基础知识、临床思维和沟通技巧),比较进修医师两次测试的答题成绩,评价培训模式的有效性。同时,收集进修医师对教学培训模式的满意度评价。结果进修学习前、后试卷的有效回收率分别为84%和100%;学员进修学习后的平均成绩显著高于进修学习前[(10.1±1.1)分比(5.6±1.8)分,P<0.01];92%的学员给予了积极反馈。结论“导师制⁃知识更新⁃临床实践”的临床教学培训模式可有效提升进修医师的基础知识、临床思维和沟通技巧,学员满意度较高,具有一定应用价值。

医学教育中科普教育的实践与思考

医生的继续教育是一个终身的过程,随着医学知识的不断更新,医生需要时刻保持学习的态度。由于医生身份的特殊性,医学培养的过程极为复杂。医学继续教育在此过程中起到承前启后的作用。传统的学校教育已无法满足医生对继续学习的需求,探讨医生继续教育的方式成为一个长期研究的话题。把医生培养成合格的临床工作者是医学教育追求的目标。在人们对健康的日益关注下,有必要对大众进行科普宣传。为了更有效地进行科普宣传,对医生进行科普教育是必要的。科普教育旨在教导医生将复杂难懂的医学知识以通俗易懂的语言呈现,帮助患者更清楚地了解疾病,积极配合医生的诊断和治疗。这不仅使大众受益于知识的学习,还能减少经济损失,有利于医患关系的和谐。通过科普的继续医学教育,可以避免过度宣传,以新颖且易懂的方式表达。在教学过程中,可以从名人的角度、疾病的季节性,以及常见的职业和生活场景中寻找话题。因此,将科普教育引入医学生的教育中,对于提升医学生的教学质量具有重要意义。

肌骨超声进修医师的教学实践探索

继续教育是提高超声医师亚专业技术能力的重要途径和手段,肌骨超声发展迅速,临床应用范围不断拓展,已成为临床多学科重要的影像学评估手段,但目前我国肌骨超声尚未得到普遍推广,很多基层医院的医师对肌骨超声一知半解。肌骨超声有自身的特殊性,集解剖、病理、临床及超声为一体,除对解剖结构进行诊断外,还涉及功能评估,因此教学难度大。进修学习是快速掌握肌骨超声的重要手段。文章结合多年肌骨进修医师的带教经验,将肌骨进修医师培训分4个阶段:相关理论知识学习、规范化操作学习、临床常见疾病学习和临床观摩及患者检查。文章分别总结了每一阶段的教学特点、侧重点和带教方法,兼顾基础知识、技能操作和临床思维培养,以更好地提升进修医师的继续教育质量。