Improvement of heat-tolerance by training I. Evaluation of effects of long-distance running and march training on heat-tolerance

in order to verify the heat-tolerance effect, two trainings, 90 min marching with load (WBGT 24. 6～35.6℃) and 10 km running (WBGT 25.0～31.1℃) were performed in laboratory and field under hot climate.Ten to twelve times (days) of training were carried out

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Clinical Preceptor’s Role in the Development of Nursing Training Based on Professional and Competency Frameworks in Two Health Care Facilities of Bujumbura

Background: The aim of clinical preceptors is to support the development of expertise related to the preceptorship of groups of trainees among nurses in clinical settings by the acquisition and use of theoretical knowledge, know-how and know-that. The support of students remains a major problem in hospitals, because the requirements of the preceptors according to the standards are not considered. The lack of guidelines on nursing preceptorships, theoretical application based on the professional curriculum, and professional expertise were the main problems assessed in the two Health Care (HUCK, VNC) in this study. The purpose of this study is to assess the knowledge of nurses and learners during their preceptorship practices and to contribute to the direction of evidence-based preceptorship. Method: A descriptive cross-sectional study design was used in this study during the 3-month period. A sample of 121 nurses as well as 56 learners were selected from 381 nurses and 80 learners using Alain Bouchard’s formula. A questionnaire developed according to the guidelines of Ernestine Wiedenbach’s theory of care, was distributed. The data were analyzed using the Microsoft Excel and the software program version 16 (SPSS-16). Results: The current study found that the majority of nurses do not know the importance of the clinical tutor. The results state that students experience clinical practice problems, thus clinical preceptorship is required. Nurses showed that there are different barriers often encountered during their practices. The overall nurse preceptorship process is not optimal and the average of 97.6% of nurses does not have expertise in coaching interns in clinical settings. Conclusion: Although that nurses have some experience at work, they express their weakness based on a low level of education, a lack of knowledge and trained professionals on the job, and clinical preceptorship guidelines.

Virtual reality:The bridge between medical education and clinical practice

After perusing the paper by Kim et al,I discovered that this is an interesting manuscript and a successful study.Virtual reality(VR)is an emerging and promising technology employed in the domain of medical practice and medical education over the past decade.In the era of big data,VR is constantly progressing in the fields of medical education and clinical diagnosis and treatment.As a novel scientific and technological tool,VR not only overcomes multiple limitations of the traditional medical teaching mode but also reduces the reliance on personnel and equipment.VR can simulate the real clinical situation,stimulate the enthusiasm of young doctors and nurses for clinical study,and simultaneously safeguard and promote medical safety and doctor-patient harmony.Favorable outcomes have been attained in clinical teaching and diagnosis and treatment activities.While enhancing the training conditions of medical cosmetics and elevating the level of clinical practice and teaching,the risks resulting from improper clinical diagnosis and treatment have been circumvented.All of this is evident and comprehensible.

Analysis of the Feedback on Teacher Training in an Affiliated Hospital in Shaanxi Province

Objective:This article aims to deeply analyze the feedback on teacher training in an affiliated hospital,so as to clarify the current needs and situation of teacher training and provide a scientific basis for further optimizing the teacher training system.Methods:The current situation and needs of teacher training in the affiliated hospital were collected by designing and distributing Tomato Form questionnaires on the DingTalk platform.The questionnaire adopted a percent-point system,all of which were indeterminate multiple-choice questions.Results:The average age of the clinical teachers participating in the survey was 40.44±7.85 years old,with an average teaching length of 4–10 years.The results showed that 60.20%of teachers think that the amount of teacher training in an affiliated hospital is sufficient;91.10%of teachers think that the factors affecting training conflict with working hours;97.96%of teachers believe that the training time has an impact on the training effect;81.63%of teachers prefer online training;51.53%of teachers tend to arrange training time on working days;33.16%of teachers tend to train once a month;17.78%of teachers prefer to receive training on clinical theoretical courses and practical teaching norms and skills content.Conclusion:Based on the above survey results,we propose to build a comprehensive management mechanism for teacher training,including improving the access,training,and assessment mechanism for clinical teachers,and adjusting and optimizing the training program according to actual needs.At the same time,an effective communication platform should be built to promote the deep integration of teaching and practice and enhance social recognition,so as to comprehensively improve the teaching quality and medical service of the hospital.

Research on the Application of the OSCE Model in Vocational Nursing Comprehensive Practical Training

The objective of this study is to examine the application effect of the Objective Structured Clinical Examination(OSCE)model in the comprehensive practical training course for higher vocational nursing.Based on the evaluation dimensions of core nursing competencies,the OSCE framework was constructed with the clinical nursing work process as the main focus and supported by a nursing case database.A questionnaire survey revealed that over 80%of students in the experimental group were satisfied with the application of OSCE in the nursing comprehensive practical training course,and more than 90%believed that OSCE assessment enhanced their theoretical knowledge and practical skills.The OSCE was also considered helpful in transforming learned knowledge and skills into professional competencies.

How does high-intensity intermittent training affect recreational endurance runners? Acute and chronic adaptations: A systematic review

Objective: This systematic review aimed to critically analyze the literature to determine how high-intensity intermittent training(HIIT) affects recreational endurance runners in the short-and long-term.Methods: Electronic databases were searched for literature dating from January 2000 to October 2015. The search was conducted using the key words "high-intensity intermittent training" or "high-intensity interval exercise" or "interval running" or "sprint interval training" and "endurance runners" or "long distance runners". A systematic approach was used to evaluate the 783 articles identified for initial review. Studies were included if they investigated HIIT in recreational endurance runners. The methodological quality of the studies was evaluated using the Physiotherapy Evidence Database(PEDro) scale(for intervention studies) and the modified Downs and Black Quality Index(for cross-sectional studies).Results: Twenty-three studies met the inclusionary criteria for review. The results are presented in 2 parts: cross-sectional(n = 15) and intervention studies(n = 8). In the 15 cross-sectional studies selected, endurance runners performed at least 1 HIIT protocol, and the acute impact on physiological, neuromuscular, metabolic and/or biomechanical variables was assessed. Intervention studies lasted a minimum of 4 weeks, with 10 weeks being the longest intervention period, and included 2 to 4 HIIT sessions per week. Most of these studies combined HIIT sessions with continuous run(CR) sessions; 2 studies' subjects performed HIIT exclusively.Conclusion: HIIT-based running plans(2 to 3 HIIT sessions per week, combining HIIT and CR runs) show athletic performance improvements in endurance runners by improving maximal oxygen uptake and running economy along with muscular and metabolic adaptations. To maximize the adaptations to training, both HIIT and CR must be part of training programs for endurance runners.

Observation of early active training effects after the operation for lumber intervertebral disc herniation

Objective To explore the recent and distant effects of early active training after the operation for lumber intervertebral disc herniation.Method 79 patients after the operation for mono segmental lumber intervertebral disc herniation had been divided into early active training group and routine control group randomly, and accepted training, regular re-examination, and follow-up of 1～6 years respedtively.Results The early active training group had better recent and distant objective effect, and more patients (97.6%) were satisfied with the operational effects.Conclusions The early active training after the operation for lumber intervertebral disc herniation is positive significant for operational effects.

Clinical nutrition in the hepatogastroenterology curriculum

Gastroenterology(GE) used to be considered a subspecialty of internal medicine. Today, GE is generally recognized as a wide-ranging specialty incorporating capacities, such as hepatology, oncology and interventional endoscopy, necessitating GEexpert differentiation. Although the European Board of Gastroenterology and Hepatology has defined specific expertise areas in Advanced endoscopy, hepatology, digestive oncology and clinical nutrition, training for the latter topic is lacking in the current hepatogastroenterology(HGE) curriculum. Given its relevance for HGE practice, and being at the core of gastrointestinal functioning, there is an obvious need for training in nutrition and related issues including the treatment of disease-related malnutrition and obesity and its associated metabolic derangements. This document aims to be a starting point for the integration of nutritional expertise in the HGE curriculum, allowing a central role in the management of malnutrition and obesity. We suggest minimum endpoints for nutritional knowledge and expertise in the standard curriculum and recommend a focus period of training in nutrition issues in order to produce well-trained HGE specialists. This article provides a road map for the organization of such a training program. We would highly welcome the World Gastroenterology Organisation, the European Board of Gastroenterology and Hepatology, the American Gastroenterology Association and other(inter)national Gastroenterology societies support the necessary certifications for this item in the HGE-curriculum.

Changes in balance ability,power output,and stretch-shortening cycle utilisation after two high-intensity intermittent training protocols in endurance runners

Purpose：This study aimed to describe the acute effects of 2 different high-intensity intermittent trainings（HIITs） on postural control,countermovement jump（CMJ）,squat jump（SJ）,and stretch-shortening cycle（SSC） utilisation,and to compare the changes induced by both protocols in those variables in endurance runners.Methods：Eighteen recreationally trained endurance runners participated in this study and were tested on 2 occasions：10 runs of 400 m with 90 s recovery between running bouts（10×400 m）,and 40 runs of 100 m with 30 s recovery between runs（40 × 100 m）.Heart rate was monitored during both HIITs;blood lactate accumulation and rate of perceived exertion were recorded after both protocols.Vertical jump ability（CMJ and SJ） and SSC together with postural control were also controlled during both HIITs.Results：Repeated measures analysis revealed a significan improvement in CMJ and SJ during 10 × 400 m（p〈0.05）,whilst no significan changes were observed during 40×100 m.Indexes related to SSC did not experience significan changes during any of the protocols.As for postural control,no significan changes were observed in the 40×100 m protocol,whilst significan impairments were observed during the 10×400 m protocol（p〈0.05）.Conclusion：A protocol with a higher number of shorter runs（40×100 m） induced different changes in those neuromuscular parameters than those with fewer and longer runs（10×400 m）.Whereas the 40×100 m protocol did not cause any significan changes in vertical jump ability,postural control or SSC utilisation,the 10×400 m protocol impaired postural control and caused improvements in vertical jumping tests.

Analysis of Common Clinical Practice Teaching Methods in Medical Colleges and Universities

Clinical practice teaching is an important part of medical education.For medical students in colleges and universities,the teaching method is mostly single before the teaching reform.Innovative clinical practice teaching methods have been implemented in colleges and universities with the deepening of the teaching reform in recent years.

Analysis of the status of clinical pharmacist pilot training in Chinese hospitals

A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and the trainee providing hospitals are all very high,among which the satisfaction of the training hospital is the highest.According to the results of the questionnaire, the most important training mode in the training hospitals＇ opinion is different from that in the trainees＇ opinion.Trainees prefer more initiative,practical,and participatory training and hope to learn from the wards round process,while the training hospitals are more inclined to group discussion and teaching.It＇s necessary to increase the number of eligible training hospitals, to implement one on one mentoring strategy in hospital pharmacist training,and to increase active learning in the training program. The result of this research would help to build more effective and efficient pharmacist training programs in Chinese hospitals.

DxR Clinician教学在全科专业规培学员临床思维能力培养中的作用

于2022年1月31日至2023年2月28日,将同济大学附属同济医院的30名全科专业住院医师规范化培训学员以随机数字表法分为试验组和对照组,每组均为15人。试验组应用DxR Clinician(简称DxR)系统进行9次虚拟诊疗课程;对照组以CBL(基于病例的学习)病例讨论形式进行9次相应主题的讨论课。应用满意度调查表了解两组规培学员对各自授课方式的满意度情况,同时应用年度考核成绩评估教学效果。实践表明,应用DxR系统的教学形式有助于提高全科规培学员的临床思维能力和自主学习能力,值得在全科医师规范化培训中广泛推广。

Investigations and feedback on the training mode of professional master's degree of clinical pharmacy in Peking University and the preliminary exploration of Pharm. D. Education

In order to carry out the comprehensive reform of the professional master’s degree training mode of clinical pharmacy, we carried out interviews among 91 persons on the professional master’s degree of clinical pharmacy in Peking University School of Pharmaceutical Sciences and collected extensive feedback. We preliminaries explore the mode of Doctor of Pharmacy（Pharm. D.） Education, laying the foundation for Doctor’s education of professional clinical pharmacy in China. We conducted investigations and interviews among 91 clinical pharmacists and students of Peking University School of Pharmaceutical Sciences on the training of professional master’s degree and Pharm. D. education mode, which includes 67 postgraduates and 24 clinical pharmacists. Respondents put forward the problems of training mode and corresponding suggestions and opinions from different aspects during the investigation and interview. The results mainly divide into four aspects： curriculum setting, clinical practice, assessme nt system and teaching resources. Respondents put forward effective feedback on the above four aspects, which are beneficial to the comprehensive reform of the training mode of professional master degree in clinical pharmacy and preliminary exploration of Pharm. D. Education in China.

DxR clinicians在三年级本科生问诊及临床思维训练方面的应用与探索

利用DxR clinicians软件对三年级本科生进行问诊及临床思维训练课程,学生普遍认为该课程有利于提高学生问诊思路及临床思维的培养,有利于临床岗位胜任力及医患沟通能力、职业道德培养,有利于提高学生分析问题、解决问题的能力。该软件应用可在其他年级教学、培训及考试中适当推广.

Medically Unexplained Symptoms (MUS): What Do Current Trainee Psychologists, Neurologists and Psychiatrists Believe?

Objectives: Medically unexplained symptoms (MUS) are common in all medical settings. These conditions remain controversial, aetiology remains poorly understood and treatments have been slow to develop. This study aimed to examine the beliefs held by psychologists and other professionals about MUS, which may impact upon clinical practice. Design: 375 clinical psychology trainees from 23UKtraining courses, 12 neurologists and 19 psychiatrists in training completed a weblink survey designed to elicit a range of beliefs about MUS cause and treatment. Results: All three groups viewed MUS as a common clinical problem. Use of terminology differed between groups. All three groups held a view that sexual abuse was a medium to high risk factor for developing MUS. Only a minority of psychologists and psychiatrists doubted that the human mind is capable of massive repression for past distressing events;and few psychologists, and no psychiatrists, doubted the traditional psychodynamic causal model of MUS. Neurologists were generally more skeptical. Only a minority of all three groups disagreed that hypnosis was a helpful way to uncover memories that people can not access. Around one third of each group believed that traumatic memories recovered in therapy were reliable. Dualistic thinking was prevalent among all three groups, but more so among psychiatrists. Conclusions: The data show that many professsionals hold beliefs about MUS for which, empirical support is lacking. These beliefs may impact on clinical practice. Whether such beliefs are deemed to be correct or incorrect, they should be acknowledged.

Impacts from the implementation of a Novel Clinical Pharmacist Training Program in Changsha,Hunan Province,China

The Ministry of Health and Family Planning of the People’s Republic of China issued a mandate to all hospitals to implement clinical pharmacy services by 2020.Implementation of clinical pharmacy services to provide pharmaceutical care is a priority.The Second Xiangya Hospital of Central South University in collaboration with the University of Alberta implemented a structured train-the-trainer program to train pharmacists to provide direct patient care in collaboration with physicians,to teach/mentor other pharmacists and students from Hunan province,and to conduct clinical pharmacy research.Following implementation of the program,the pharmacy department increased the number of clinical pharmacists,expanded the clinical pharmacy services,made changes to hospital policies,and received a financial award of five million renminbi(one million Canadian dollars)to support the department.

使用DxR Clinician软件对内科住院医师规范化培训临床思维能力评估初探

目的通过临床思维训练软件DxR Clinician的训练及考核,培养住院医师正确的临床思维。方法选择在杭州市第一人民医院经过临床轮转2年或2年以上的内科住院医师25人,采用DxR Clinician软件,选择软件平台内符合该院实际情况的内科5大亚专科病例进行为期5个周期的考核,对得分情况进行统计分析;在首次考核前和末次考核后进行相关问卷调查。结果该院住院医师临床思维能力评估不理想,尤其是正确决策方面(包括诊断表现、临床思维表现)欠佳;问卷调查结果显示,使用DxR Clinician软件考核后,住院医师对临床思维能力训练的重要性认知有所提高。结论使用DxR Clinician软件对住院医师进行临床思维能力的训练及考核能反映住院医师在正确决策(包括诊断表现和临床思维表现)存在不足,可结合该软件开发住院医师规范化培训新的教学模式。