Evaluation of Length of Hospital Stay Joining Educational Programs for Type 2 Diabetes Mellitus Patients: Can We Control Medical Costs in Japan?

Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.

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.

Effect of Medication Safety Education Program on Intensive Care Nurses’ Knowledge regarding Medication Errors

Background: Medication errors are the iceberg of patient safety in hospitals and leading cause of morbidity and mortality among patients. Objectives: The study aim was to evaluate the effect of an educational program of medication safety on the knowledge of critical care nurses regarding intravenous medication errors. Methods Design: There are one group pretest and posttest designs. Subject: A convenient sample of all registered nurses (52) works in Palestine Medical Complex. Data collection tools: A self-administered knowledge determination questionnaire consists of both qualitative and quantitative statements to measure level of knowledge, used as data collection tool in pre and post educational sessions, with educational booklet as intervention tool. Statistical analysis: Data were analyzed with Statistical Package for the Social Sciences Software Version 18. The results are presented as frequency & percentage as appropriate at alpha level of P < 0.05;inferential statistics were generated. Paired t-test was used to perform the comparisons. Results: There was statistically significant difference in the knowledge level for the intensive care unit’s nurses regarding the intravenous medication administration during pre and post education program. Statistical analysis showed that there was a statistically significant between age, educational degree, critical units/wards, years of nursing experience and previous medication administration education program of the nurses and their knowledge during different phases of program intervention. Conclusion: Educational program on medication safety improves the knowledge of critical care nurses regarding intravenous medication errors. This study recommends that medication errors should be periodically assessed by improving clinical guidelines of medication administration.

Eight-Year Medical Education Program:Retrospect and Prospect of the High-Level Medical Talent Training in China

Purpose:The 8-year medical education program(EYMEP)is China's path to training high-level medical talents.In retrospect,this study systematically reviewed the developmental process of China's EYMEP.The status quo and characteristics,and threats and challenges,were analyzed,along with the program’s prospects.Design/Approach/Methods:This study analyzed relevant textual materials and policy documents dating back to the time of hosting of China's EYMEP,as well as conducted various specific interviews and field trips.Findings:The exploration of China's high-level medical talent training has been conducted over a century.EYMEP can be divided into five periods:the Only Host Period,the Duplication Pilot Host Period,the Expansion Period,the Joint Exploration Period,and the In-Depth Promotion Period.Currently,there are 14 universities and institutes hosting the EYMEP approved by the Ministry of Education of the People's Republic of China.However,they differ greatly in training ideas and goals,enrollment processes,and training phases.China's EYMEP is faced with some external threats and internal challenges.In the future,China's EYMEP should consider five aspects.Originality/Value:In the new era of the reform and development of China's medical education,a systematic review of the development of EYMEP in China is of great significance to the promotion of high-level medical talent training in China.Meanwhile,the exploration course of China's highlevel medical talent training represented by the EYMEP may be an enlightenment for other countries,especially developing countries like China,in their training of high-level medical talents.

The"4+4"Medical Doctor(MD)Pilot Program at PUMC:Implementation,Performance,and Prospects

Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.

职教本科试点背景下思政课教师适应性提升策略研究——以四川省医药卫生类专业为例

本科层次职业教育(以下简称职教本科)试点是职业教育改革发展的新事物,对职业教育思想政治理论课(以下简称思政课)提出了新要求。文章以医药卫生类专业开展职教本科试点为例,探寻职教本科试点思政课产生的变化,通过研究发现职教本科试点思政教师存在课程开发、科学研究、指导帮助、信息化应用等能力不足的问题,进而提出思政教师要做学生终身学习的示范者、做课程开发的推动者、做教法变革的践行者、做数字化改造的建设者、做课程思政的指导者等对策,以提高他们对职教本科试点的适应性。

八年制临床医学教育质量的学生评价与分析

基于全国11所八年制临床医学教育培养单位的毕业生调查数据,从培养入口、培养过程和培养出口三个层面对我国八年制临床医学生的培养状况、就读体验和职业发展进行实证分析。结果表明,我国八年制临床医学教育存在培养目标定位不够明确、教学方法较为单一、部分课程质量不高、毕业生科研能力发展欠佳、工作负担较重、职业满意度不高等挑战。为了提高八年制临床医学教育培养质量,要进一步从强化学生学习动机、丰富教育教学方法、重视学生科研能力培养、提高课程质量、明确培养目标、做好学生职业生涯规划等方面不断加以完善和改进。

基于社会网络分析法的广西农村订单定向医学生免费培养项目问题分析及优化策略

背景我国自2010年起开始实施农村订单定向医学生免费培养项目(以下简称该项目),该项目在完善基层卫生人才队伍建设、提升基层医疗卫生服务水平等方面发挥了重要作用。随着该项目的推进,虽然已取得了一定成效,但也存在诸多尚待解决的问题,而其中紧迫且重要的核心问题尚未明确。目的通过梳理存在的问题,为进一步推进该项目提供借鉴。方法于2023年5月,采用文献分析法检索中文数据库,梳理文献记载的该项目存在的问题;采用社会网络分析法对梳理得出的问题进行分析,运用优劣解距离法(TOPSIS法)对基于社会网络分析法计算得出的结果进行综合评价。结果对文献中有关问题进行整理统计。得出频次排名靠前的问题依次为定向医学生基层薪资待遇偏低(14次)、定向医学生基层职业发展空间有限(10次)、相关配套政策不完善(10次)、基层工作条件差(7次)、定向医学生学习积极性与主动性欠缺(7次);通过TOPSIS法对社会网络分析法计算得出的结果进行综合评价,排名前4位的问题依次为相关配套政策不完善(Ci=0.867)、定向医学生基层职业发展空间有限(Ci=0.800)、定向医学生基层薪资待遇偏低(Ci=0.786)和基层工作条件差(Ci=0.621)。结论广西壮族自治区农村订单定向医学生免费培养项目在推进过程中仍存在较大问题。建议从以下几个方面优化该项目以确保项目高质量发展:完善相关配套政策,强化监管与评估;畅通职业晋升渠道,建立长效激励机制;完善薪酬制度,提高待遇水平;改善基层工作环境,为基层工作提质增效。

阶梯式沟通技能课程对农村订单定向医学生医患沟通能力培养的作用研究

背景本科医学教育阶段是培养农村订单定向医学生沟通能力的起点,为毕业后教育阶段的沟通能力培训及之后的职业生涯中与患者及家属、同行、其他卫生行业人员有效沟通奠定了基础。探讨如何提高医学院校教育阶段医患沟通教育质量,并提升此阶段农村订单定向医学生医患沟通能力具有重要的现实意义。目的探讨阶梯式沟通技能课程对农村订单定向医学生医患沟通能力培养的作用。方法于2019年9月,选取广西医科大学2019级农村订单定向医学生259名建立队列1,选取同级临床医学专业本科生262名建立队列2。队列1学生于2019年9月—2022年1月接受长达5个学期的阶梯式沟通技能课程培训,两队列学生均于2021年9月—2022年1月学习《医患沟通学》课程。比较两个队列学生的《医患沟通学》课程期末考试成绩、过程性考核成绩,调查队列1学生对阶梯式沟通技能课程的教学效果评价和满意度。结果农村订单定向医学生的《医患沟通学》期末考试总分及案例分析题、论述题得分高于临床医学专业本科生,单项选择题得分低于临床医学专业本科生(P<0.05)。农村订单定向医学生的《医患沟通学》课程过程性考试总分及信息收集、信息给予、协商解决、非语言沟通技巧使用维度得分高于临床医学专业本科生(P<0.05);建立第一印象维度得分与临床医学专业本科生比较,差异无统计学意义(P>0.05)。大于80.0%的农村订单定向医学生对阶梯式沟通技能课程的教学内容、教学方法、教学师资、课程编排、教学效果感到很满意/满意,>60.0%的农村订单定向医学生对阶梯式沟通技能课程在提升学习兴趣、增强接触困难患者信心、提高共情能力、提高医患沟通能力、提高语言表达能力、提高解决问题能力、提高团队协作意识方面表示很有帮助/有帮助。结论阶梯式医患沟通技能课程可明显提高农村订单定向医学生本科医学教育阶段医患沟通教育效果,促进培养医患沟通能力及其他综合能力素养。阶梯式课程模式是医学院校教育中培养医学生医患沟通能力的有效手段,并为全科医学毕业后教育及继续教育阶段开展沟通能力培训提供有益参考。

健康中国2030战略背景下食品卫生与营养学专业培养方案之营养课程体系现况调查

目的:了解健康中国2030战略背景下各医学高校食品卫生与营养学专业培养方案中营养课程设置现状。方法:查找全国不同区域共32份营养专业培养方案进行整理分析,内容包括培养目标、课程设置、营养相关课程开设情况等。结果:全国开设食品卫生与营养学专业的本科高校共计32所,其中985高校2所(上海交通大学、四川大学),普通本科高校30所。毕业学分要求从152~280(193.4±34.6)学分不等,985高校和普通高校的理论课时总数和实验课时总数之比分别为(1.6±0.6)与(1.7±0.4),差异无统计学意义(P>0.05)。营养专业核心课程(营养与食品卫生学、临床营养学、人群营养学、公共营养学等)的总学时数254~716(456.3±52.7)不等。各高校间食品卫生与营养学专业的课程设置差异较大。选取的3所高校专业课程能涵盖注册营养师课程设置要求,但部分模块学时数较低,未达到注册营养师要求的最低标准。结论:高校设置食品卫生与营养学专业课程时应结合《健康中国行动(2019-2030年)》和《国民营养计划(2017-2030年)》,明确人才培养目标,加强新时代本科生营养理念的培养,建议从强化营养为先的观念、完善注册营养师课程体系、注重营养与临床融合发展和提升营养实践技能4个方面不断完善食品卫生与营养学专业人才培养方案。

“双创”背景下大型综合院校医学本科生科研项目导师队伍的特点分析

目的:探究师资力量与“双创”项目之间存在的关系。方法:回顾性分析2013年至2019年7年期间“双创”项目信息数据。结果:医疗岗指导教师数量增加,且不同医学领域的导师职称级别分布存在显著差异。结论:医疗岗指导教师呈增加的趋势。医学技术类等其他类型项目中,指导教师的岗位来源和职称级别都存在一定不足,未来需进一步关注。

新医科背景下以立德树人为导向的医学研究生培养方案的修订与实践——以重庆医科大学临床医学研究生培养方案修订为例

以重庆医科大学临床医学研究生人才培养方案改革为例,从修订原则、培养目标、培养环节、学位申请与授予及分流机制等方面入手,建立以落实立德树人为根本任务、以培养具有本校特色的创新型医学研究生为目标的人才培养方案修订机制,为培养高素质复合型医学人才提供参考。

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.

医学实验技术专业培养方案的修订与优化

目的通过对医学实验技术专业培养方案进行修订与优化,进一步提高该专业人才培养的质量和内涵。方法按照《普通高等学校本科专业类教学质量国家标准》和首都医科大学医学实验技术专业的培养经验,对其培养目标和课程设置进行了修订与优化。结果将该专业培养目标由原有的强调实验动物技术的专门人才调整为具备医学实验技术综合能力的复合型人才,删除了原培养目标中对于动物实验、实验动物培育与质量管理方面的要求。对应新的培养目标,增加了新的思政课程、与医学实验技术密切相关的专业课程,以及临床实习,减少了关于实验动物繁育、环境建设、外科手术及诊断相关的课程,完善了实验动物模型、病理解剖相关的课程。结论修订后的培养方案将有助于培养更全面的医学实验技术人才,进一步提高医学实验技术专业人才培养的质量,更好地满足科技创新新时期对该专业一专多能人才的需求。

Program & faculty evaluation

Graduate medical education(GME)has shifted its curricula from process-oriented approach to outcomes-oriented models.Program and faculty evaluation are methods by which educational curricula may adjust the teaching and learning environment to meet the needs and fills the gaps in GME.The measurement of educational outcomes is an essential for assessing teaching effectiveness in a shifting health care environment.In addition to trainee,program,and faculty evaluations,annual program review(APR)and evaluation and navigational changes made by the program education committee are essential to maintain effectiveness of an educational curriculum in a contemporary graduate medical training program.

人工智能辅助教学在医学影像规范化培训中的应用及探索

医学影像住院医师规范化培训(简称住培)课程内容复杂、培养周期有限,传统的教育模式存在培训时间长、难以真正掌握到基本技能、无法得到实时反馈且教学质量难以同质化等问题。人工智能技术能够为医学影像教育提供新的思路,为教学过程的个性化、交互性奠定技术基础,推进人工智能辅助下的以学生为主体的智能交互教学模式,对快速培养高素质的影像科医生具有积极意义。通过结合当前医学影像住培教学特点,对人工智能辅助医学影像教学新模式做出一个初步的构想,可为快速培养高素质影像科医生提供参考。

基于建构主义理论的教考联动模式在内科护理学教学中的应用

目的探讨基于建构主义理论的教考联动模式在内科护理学教学中的应用效果。方法将2020级2个护理本科班护生随机分为研究组和对照组各60人。对照组采用传统授课模式;研究组采用基于建构主义理论的教考联动模式,即依据建构主义理论,建立抛锚式基于案例的学习情景病例库,采用随机进入式课堂情景教学和小组支架式自主命题相融合的形式进行教学。1个学期后比较两组护生的评判性思维能力、自主学习能力和期末考试成绩。结果研究组护生评判性思维能力、自主学习能力及期末考试中的病例分析题、附加题及卷面总分显著高于对照组(均P<0.05)。结论基于建构主义理论教考联动模式能有效提升本科护生的评判性思维能力、自主学习能力,提升教学效果。

校史教育融入临床教学,建设协和特色课程思政:以内科学糖尿病教学为例

目的 探讨将协和校史融入糖尿病课程教学,建设协和特色课程思政。方法 以北京协和医学院临床医学“4+4”试点班学生为研究对象,采用糖尿病专业课程结合相关思政课程(包括胰岛素发展史,吴宪教授及林可胜教授的生平和贡献,池芝盛、潘孝仁、向红丁教授对糖尿病防治所作的贡献)进行教学,以问卷星形式线上收集学生在教学前后对于思政教学内容的了解程度及在教学后对于思政教学效果的评价并进行统计学分析。结果 纳入北京协和医学院临床医学“4+4”试点班学生共62名(2020级32名、2021级30名)。回收问卷共58份(2020级30份、2021级28份),回收率为93.5%(58/62)。教学前55.2%~100%的学生对于所有思政课程内容均不了解,教学后大致了解或比较熟悉课程内容的学生比例为100%,了解程度显著优于教学前(P<0.001)。82.8%的学生认为思政教学增加了学习兴趣,86.2%的学生对整体教学效果满意,89.7%的学生认为思政教学增加了对北京协和医学院校史的了解,77.6%的学生认为思政教学增加了对医学科学精神的理解,82.8%的学生认为思政教学增加了对专业报国爱国精神的理解,72.4%的学生认为思政教学增加了社会责任感。结论 将协和校史融入临床医学专业教学中,是协和医学教育的独特优势,有利于学生对专业知识的理解,接受正确的价值观、方法论、人文素养等方面熏陶,培养求真、务实的医学科学精神。

深化临床医学教育改革培养造就服务健康中国需求的卓越医师

本文围绕如何培养造就服务健康中国需求的卓越医师,从卓越医生教育培养计划着手,以临床医学专业学位教育和临床医学八年制培养改革为例,夯实高校附属医院医学人才培养主阵地,分析卓越医师培养和卓越医师科学家培养有效途径。

高校临床医学专业医学生有关医学人文教学的探索

目的:调查八年制医学生对思政人文教学的看法以及对目前现状的建议。方法:对上海交通大学医学院八年制临床医学专业的102名学生进行相关内容的问卷调查,了解其对思政人文课程的看法。结果:有47.1%的学生对于思政人文课程表示支持、认为是有必要的,有88.2%的学生表示相比传统的教学模式,新媒体渠道教学的学习效果更好并有助于学习。结论:八年制医学生对医学人文课程的热情和认知度较高,在学习过程中可以利用多媒体材料,将人文通识教育与医学教育结合。