Homogenization Construction of Three-Level Teaching Bases for General Practice Medicine Under the Internet+Model

With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually increasing.However,there are significant differences in clinical teaching management models and teaching levels among different bases.Most clinical teaching bases have incomplete teaching management systems,inadequate teaching management institutions,insufficient teaching personnel,and inadequate implementation of teaching rules and regulations.This article combines the construction practice of three-level clinical teaching base of the General Medicine College and the First Affiliated Hospital of Xi’an Medical University.We establish a standardized management system for the three-level clinical teaching base;implement a teaching supervision system and strengthen the monitoring of teaching quality;adopt multiple evaluations to test the effectiveness of clinical teaching implementation;explore the path of homogenization construction of teaching bases in terms of unified teacher training,promoting the development of teacher teaching abilities with equal quality and excellence,and providing a reference for improving the quality of medical talent training.

Preceptors'experiences in guiding nursing students to use research findings and to implement evidence-based practice

Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.

Discussion on Construction and Mechanism of Practice Bases for Professional Degree Postgraduates Based on the Integration of Production and Education in Local Universities

Under the background of emerging agricultural education,practice bases are an important place to train profession talented person that match social needs,so it is very important to build stable and long-term practice bases.At present,the main problems in the construction of practice bases for postgraduates in local colleges and universities are mainly focusing on construction and neglecting management,imperfect cooperation mechanism and lack of teaching management effectively.It is of great significance to build a long-term management mechanism to ensure the education quality of practice bases.Therefore,constructing the mode of"double integration and double promotion of production and education"with practice bases as the carrier and realizing the organic combination of industrial needs and postgraduate projects is an important idea for local colleges and universities to train professional degree postgraduates to"know agriculture,love agriculture,strengthen agriculture and promote agriculture",and it also provides a reference for the mechanism construction of postgraduate bases.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Application of Flipped Classroom Teaching Model Based on Micro-Course in Practical Training Teaching of Contact Lens Fitting Technology

Objective:This paper aims to study the application of flipped classroom teaching model based on micro-course in the practical training teaching of contact lens fitting technology.Methods:From September 21 to July 23,120 students majoring in ophthalmology and optometry were selected and randomly divided into groups.The control group adopted the traditional teaching mode,and the study group adopted the flipped classroom teaching mode based on micro-course.Teaching scores and the skills,observation and judgment,adaptability,and communication skills were compared between the groups.Results:Statistical comparison of teaching scores under different management methods showed that the clinical thinking score and practice work quality in the study group were higher than those of the control group,and the effect of the study group was better(P<0.05).The overall scores of skills,observation and judgment,adaptability,and communication skills of the study group were better than those in the control group,and the comprehensive ability scores in the two groups were significantly different(P<0.05).Conclusion:In practical training teaching of contact lens fitting technology,the application of flipped classroom teaching based on micro-course can improve the skill scores of personnel,and the overall effect is good.This can lay the foundation for advanced ophthalmology and optometry talents with profound theoretical knowledge and professional skills.

Construction and Practice of a Practical Teaching System for Normal Universities Based on Ability Cultivation

This study aims to explore the effect of project-based teaching methods on improving students’ abilities in normal universities. This study delves into the practice teaching system based on ability training implemented in normal universities, examining the application of this teaching model in teacher education and the potential challenges it may encounter. Our case study reveals that the Project-Based Learning (PBL) approach can effectively transform students from passive recipients of knowledge into active problem solvers, thereby enhancing their critical thinking, problem-solving, teamwork, and communication skills. However, challenges do exist, including ensuring active participation from all students, providing equal opportunities for each student to develop and showcase their abilities, and completing complex projects within a limited timeframe. Therefore, teachers may need to adjust their teaching strategies, and schools need to provide more resources and support. These adjustments can help the practice teaching system based on ability training better serve teacher education and offer students a higher-quality educational experience.

Experiment of Adopting the Learner Blog in CALL-based Practical English Writing Course

The learner blog is adopted in the instruction of CALL-based Practical English Writing course for A-level non-Eng lish major sophomores in our school in the spring this year.After examining how the program is implemented in detail,sugges tions are provided for future instructors in this related program.To ensure the program a good start,it is advisable for instructors to set aside a certain time to help each student to create a blog account in the beginning.Besides,it is requisite to provide stu dents with blogs titles with elaborate design and with the evaluation and further comment of the blog in the course of face-toface communication.Using of blogs in CALL-based Practical English Course is helpful in improving students'writing quality,in gearing up self-introspection for participants,in creating cooperative learning community,in fostering autonomous learning and cooperative learning,in building up communicative channels between students and instructors and among students themselves.

Integration and Development of Traditional Artistic Accomplishments in the Construction of Practice Teaching Bases of Universities and Colleges

Learning, inheritance and development of undergraduates' traditional artistic accomplishments is of realistic signifi cance in the modern society, integration of traditional artistic accomplishments in practice teaching will broaden the channels of modern undergraduates acquiring traditional artistic accomplishments. Learning traditional artistic accomplishments should be the colorful and vivid practice class on and off campus, moreover, students' recognition of traditional artistic accomplishments should be strengthened, and their understanding about traditional arts should be deepened. Full utilization of social resources of traditional arts helps learn the connotations of traditional artistic accomplishments, so that traditional artistic accomplishments will realize its theoretical and practical signifi cance in the rapidly-developing modern society.

Study on the Long-term Mechanism of Building Innovative Practice Bases for Full-time Civil Engineering Postgraduate Training

In order to implement the quality of full-time professional degree postgraduate education cultivation,the necessity of building an innovative base for cultivating professional degree postgraduates in civil engineering is discussed.Based on the problems ofthe integrated cultivation mode of industry-university-research,the effective mechanism for cultivating an innovative practice base for professional degree postgraduates in civil engineering is elaborated from the construction of the cultivation mode,system construction,daily management,and improvement of the rights and responsibilities of both parties,which provides guiding significance for better realizing the need to adapt to the development of high-level talents in society.

Research and Practice of the Construction Mode of the Practical Training Base for Agriculture and Forestry

In response to bottlenecks and dilemmas faced by institutions for agricultural and forestry practical training base construction, and based on Agriculture practical training base of Langfang Polytechnic Institute, this article illustrates the effective exploration and practice of the mode and ways for the construction of the practical training base,which provides some useful experience for the construction of the training base in agricultural and forestry institutions.

The eligibility criteria,training content,and scope of practice for prescriptive authority for midwives:a modified Delphi study

Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.

Subtle skills: Using objective structured clinical examinations to assess gastroenterology fellow performance in system based practice milestones

BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the immediate feedback was "very useful." One hundred percent of the fellows stated they would incorporate OSCE learning into their clinical practice.CONCLUSION OSCEs may be used for standardized evaluation of SBP milestones. Trainees scored lower on SBP milestones than other more concrete milestones. Training programs should consider OSCEs for assessment of SBP.

New Concepts and Evidence Based Practice in Physiotherapy：Examples from Stroke Rehabilitation

Objective:The purpose of this paper is to give an overview of new concepts and evidence based physiotherapy practice in stroke rehabilitation in the acute,post acute and chronic stage of stroke. Background:Historically physiotherapy has developed through the years from a focus on health,beauty,and equilibrium between spiritual,moral and physical powers,to a client centered service to people and populations to develop,to maintain and to restore maximum movement and functional ability throughout the lifespan. Still the health perspective is strong and divided into first,second and third prophylaxis. New concepts like Evidence Based Medicine,Evidence Based Practice,International Classification of Function and research within neurophysiology have had a deep impact on physiotherapy services,practice and education. The highest levels of documentation are Meta analyses and Randomised Controlled Trials,and today many of the physiotherapy methods used in rehabilitation of neurological conditions are tried out in different trials,bringing up-to date knowledge into practice. This paper focuses on rehabilitation of persons with stroke and physiotherapy methods in particular. Result:Physiotherapy in the acute stage improves motor function and enhances mobility. Rehabilitative efforts within the first few weeks as opposed to later favors better recovery. Type of physiotherapy in the acute stage is task oriented training with a focus on intensity and variability. Post acute therapy-based rehabilitation services targeted towards stroke patients living at home appear to improve independence in personal activities of daily living. In the chronic stage there is good evidence that aerobic exercise is beneficial for improving aerobic capacity in people with mild and moderate stroke. Progressive resistance strength training programmes reduce musculoskeletal impairment after stroke,without increasing tone or spasticity.

Application of consequence-based design criteria in regions of moderate seismicity

Current design criteria and prineiples of earthquake engineering design are reviewed,including safety factors, probabilistic approach,and two-level and muhi-level functional design ideas.The modern multi-functional idea is discussed in greater details.When designing a structure,its resistance to and the intensity of the earthquake action are considered. The consequence of failure of the structure is considered only through a rough and empirical factor of importance,ranging usually from 1.0 to 1.5.This paper suggests a method of'consequence-based design,'which considers the consequences of malfunctioning instead of simply an importance factor.The main argument for this method is that damage to a structure located in different types of societies may have very different consequences,which are depeudant on its value and usefulness to the society and the seismicity in the region.

Inquiry Based on Evidence and its Practices in Two Healthcare Facilities of Bujumbura

Background: Inquiry evidence-based practice (IBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs. IBP and its practice in health care promote also many advantages, such as improvements of practices based on the attitudes and cognitive ideas. This study aims to assess the inquiry based on evidence (IBP) and its practices in two Health Care Facilities (HCFs) of Bujumbura to help the practitioners to understand its importance. Methods: A cross-sectional study design was used to analyze the importance of IBP and its practice in these two hospitals. The probability-sampling technique was used also to select 104 nurses from the Military Hospital of Kamenge and 55 nurses from the Van Norman Clinic. A questionnaire was used to collect data with two mains components, demographic data and knowledge and attitudes addressing the following parameters: evidence practice during inquiry, nursing theory, current analysis in nursing care oriented the evidence, prioritization of care, rational diagnostic, monitoring and assessment. Results: The findings from this study revealed a poor knowledge and attitude among participants towards Inquiry Based Practice. In all variables, participants were scoring less than 10%. However, majority of participants (76.5%) know the indicators of patients’ satisfaction with nursing interventions through survey-based practice and 74.1% argued to analyze their information collected. Conclusion: This study revealed a weak awareness on IBP and its importance during nursing practice among participants as for almost all variables, participants were scoring less than 10%, except for the indicators of patients’ satisfaction with nursing interventions through survey-based practice (76.5%). Therefore, in-service training and curriculum revision had been highlighted and recommended another to provide the best rational diagnosis and achieve the patient’s outcomes.

Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system

AIM To examine the practice pattern in Kaiser Permanente Southern California(KPSC), i.e., gastroenterology(GI)/surgery referrals and endoscopic ultrasound(EUS), for pancreatic cystic neoplasms(PCNs) after the regionwide dissemination of the PCN management algorithm.METHODS Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015(18 mo before and after the publication of the algorithm) in KPSC(integrated health system with 15 hospitals and 202 medical offices in Southern California) were identified.RESULTS2558(1157 pre-and 1401 post-algorithm) received a new diagnosis of PCN in the study period. There was no difference in the mean cyst size(pre-19.1 mm vs post-18.5 mm, P = 0.119). A smaller percentage of PCNs resulted in EUS after the implementation of the algorithm(pre-45.5% vs post-34.8%, P < 0.001). A smaller proportion of patients were referred for GI(pre-65.2% vs post-53.3%, P < 0.001) and surgery consultations(pre-24.8% vs post-16%, P < 0.001) for PCN after the implementation. There was no significant change in operations for PCNs. Cost of diagnostic care was reduced after the implementation by 24%, 18%, and 36% for EUS, GI, and surgery consultations, respectively, with total cost saving of 24%.CONCLUSION In the current healthcare climate, there is increased need to optimize resource utilization. Dissemination of an algorithm for PCN management in an integrated health system resulted in fewer EUS and GI/surgery referrals, likely by aiding the physicians ordering imaging studies in the decision making for the management of PCNs. This translated to cost saving of 24%, 18%, and 36% for EUS, GI, and surgical consultations, respectively, with total diagnostic cost saving of 24%.

Research on Landscape Planning and Design of Education Practice Base——A Case Study of Shengquan Education Practice Base in Feidong County of Hefei City of China

By taking landscape planning and design of Shengquan Educational Practice Base in Feidong County of Hefei City for example, the paper has analyzed its base condition, planning target of the construction of "the thought tank of Chinese culture", and landscape construction distinguished from modern and traditional agricultural sightseeing park. It has identified its position, and highlighted the combination of education and practice. Then, in the perspective of "one axis, two belts and four areas", its general layout has been illustrated, and the specific practice contents and plant landscape construction in the practice park and activity route have been introduced in detail. It has emphasized its characteristic dominant projects and established its brand, so as to achieve the win-win of education practice significance and economic benefit.

Practice and Thinking on the Construction of Agricultural Science and Education Cooperative Personnel Cultivation Base

Agricultural science and education cooperative personnel cultivation base is a new personnel cultivation platform built by the Ministry of Agriculture and the Ministry of Education relying on the national modern agricultural industry technology system,to strengthen the close connection between agricultural education and modern agricultural industry. The first batch of agricultural science and education cooperative personnel cultivation bases have been operating for 5 years. Taking Zhanjiang Litchi-Longan Agricultural Science and Education Cooperative Personnel Cultivation Base as an example,it introduced the achievements in the base construction from the perspective of construction cooperators,and discussed measures for improving the base operation.