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.

Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective:To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents.Methods:The study period was from May 2022 to May 2023.20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group(n=10)and the routine group(n=10)by using the random number lottery method.The participatory group practised participatory teaching methods,and the routine group practised routine teaching methods.The results of discharge assessment,teaching evaluation,and mini-Clinical Evaluation Exercise(mini-CEX)assessment were compared between the groups.Results:The theoretical assessment,operational assessment,and total scores of the participatory group were significantly higher than those of the routine group,and the difference was statistically significant(P<0.05).The teaching evaluation of independent learning,theoretical mastery,teamwork,clinical thinking,communication,and learning interest of the participatory group was significantly higher than that of the routine group,and the difference was statistically significant(P<0.05).The mini-CEX assessments of history inquiry,organizational effectiveness,professionalism,physical examination,clinical diagnosis,communication skills,and overall clinical competence of the participatory group were significantly better than those of the routine group,and the difference was statistically significant(P<0.05).The teaching satisfaction of the participatory group was significantly higher than that of the routine group,the difference was statistically significant(P<0.05).Conclusion:Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training,and the teaching satisfaction is improved.

Trains of Thought in Treating Infectious Atypical Pneumonia with Integrative Chinese and Western Medicine Approach

EDITORIAL Severe Acute Respiratory Syndrome(SARS)is a new intractable disease worldwide,itsonset is acute,its infectivity and mortality is high,the knowledge about its etiology and pathogenesis is in-sufficient,the experience on SARS treatment awaits accumulation.Following pilot experiences of applyingICWM in fighting SARS is most valuable with scientific significance.

Train of Thought and Strategy over Strengthening the Research of Treating Hypertension by Integrative Chinese and Western Medicine

The gradually ex—panding number of peo—pie suffering from hy—pertension and the trendof lowering of their ageindicate that one shouldpay more attention tothe illness and tOstrengthen preventionand treatment of it inorder tO elevate clinicaltherapeutic effect,so as

Construction of nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19 (mild and common) in Beijing based on Delphi method

Objective:The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)in Beijing,to provide reference for clinical nursing of patients with COVID‑19(mild and common).Methods:Through online communication meeting with nurses who are in the frontline of anti‑epidemic,clinical investigation,literature research,and expert demonstration meeting are carried out to prepare the draft of the standard,and the Delphi method is applied to determine the standard of integrated traditional Chinese and Western medicine care for patients with COVID‑19(mild and common)in Beijing.Results:The nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)was established,which included 5 first‑level indicators,14 second-level indicators and 60 third‑level indicators.After two rounds of Delphi method,the positive coefficients of experts were 96%and 83%,the authoritative coefficients of experts were 0.89 and 0.91,and the Kendall’s coefficient of concordance(W)of experts were 0.12,0.09,0.10,0.13(P<0.05)and 0.44,0.43,0.37,0.39(P<0.05).Conclusion:The standard of integrated traditional Chinese and Western medicine nursing for patients with COVID‑19(mild and common)in Beijing constructed by the Delphi method is scientific and practical,which provides a reference for clinical application of integrated traditional Chinese and Western medicine nursing to fight against COVID‑19 infection.

Preliminary Study on the Training Mode of Chinese Pharmacy Professionals Based on the National Standard of Teaching Quality

With the promulgation of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities, the state has made clear regulations on the standard for the cultivation of Chinese pharmacy talents. Based on their own actual conditions, major colleges and universities have implemented different talent training modes, including talent training modes of running talent classes, "2+1+1", "Chinese Medicine Research Practice Class", employment-oriented professional talent training mode, three-level three-type diversified talent training mode, and talent training mode oriented with adapting to the characteristics of ethnic regions. Various talent training modes have different training objectives, and corresponding training programs are formulated to meet the requirements of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities. In addition, according to the notice on Solidly Promoting Labor Education into the "National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities" issued by the Department of Higher Education of the Ministry of Education, the introduction of labor education to the teaching of Chinese pharmacy majors will be a trend, and Chinese pharmacy professionals are required to achieve comprehensive and coordinated development of morality, intelligence, physique, beauty, and labor. How to integrate labor education with high quality and high efficiency into the training of Chinese pharmacy professionals is a problem that major universities will think about.

中医医院新入职本科护士培训考核评价指标的构建

目的 构建中医医院新入职本科护士培训考核评价指标。方法 通过文献研究、小组讨论,建立中医医院新入职本科护士培训考核评价指标初稿,选取来自7个省份的中华护理学会中医中西医结合护理分会的15名专家进行2轮专家咨询,确定考核评价内容及其权重。结果 2轮专家函询问卷的有效回收率均为100%,专家权威系数分别是0.962、0.980,肯德尔协调系数分别是0.220、0.268(均P<0.05),最终形成的中医医院新入职本科护士培训考核评价指标包括5项一级指标、24项二级指标和77项三级指标。结论 构建的中医医院新入职本科护士培训考核评价指标具有较高的可靠性和科学性,可为中医医院管理者及培训者选拔人才提供参考。

基于柯式模型评估中医住院医师规范化培训效果的研究

目的运用柯式模型评估中医住院医师规范化培训(以下简称“住培”)的效果,分析影响因素并提出有效措施,为完善中医住培管理体系提供依据。方法随机抽取2021年已结业的521名住院医师、30名带教老师、30名护士长进行问卷调查和访谈,从反应层、学习层、行为层、成果层四个层面进行统计分析。结果反应层:住院医师对住培相关政策内容的认知度偏低,对住培内容、培训师资、培训考核满意度较高,总体满意度也较高,但是对培训保障及设施、培训方式满意度较低。学习层:住院医师认为有效的方式是跟随上级医师查房和基本技能操作实践,且各类考核通过率较高。行为层:住院医师所有项目培训后评分均高于培训前,差异有统计学意义(P<0.05)。成果层:住院医师患者投诉率为0,事故率为0,执业医师考试通过率为98.85%(515/521),结业考核通过率为91.75%(478/521)。结论中医住院医师规范化培训取得了较好效果,住院医师各项行为能力显著提升。应继续加强政策宣教,提高薪资水平,制定合理的轮转计划,重视人文关怀,培养良好的团队精神。

双轨合一模式下超声医学专业学位硕士研究生科研能力培养问题探讨

超声医学专业学位硕士研究生(简称专硕)与住院医师规范化的“双轨合一”培养是我国医学教育的必然趋势,大大地提高了培养成效,学生的临床能力得到了显著提升,然而在较为繁重的临床学习任务中极易导致科研能力培养的不足,通过探讨“双轨合一”培养后专硕在科研能力培养面临的问题和挑战,并以问题为导向提出相应的对策和建议,为进一步做好专硕培养提供参考。

提高中医住院医师针灸技能的临床带教模式探索

目的在中医住院医师规范化培训(简称住培)大纲中要求所有住院医师均要到针灸科进行轮转学习,如何提高住院医师尤其是非针灸科住院医师在针灸科的培养质量,提高他们对针灸基本技术的兴趣和掌握程度,湖南中医药大学第一附属医院进行了积极的实践与探索。方法根据国家、省内文件精神,结合该院实际,从加强层级管理、强化师资建设、重视入科宣教、完善教学计划和注重全程考核等方面进行施教与管理。结果该院针灸推拿康复科住培通过构建管理-师资-培训-考核综合模式,全面提升住培质量,效果显著。结论积极探索有效的临床带教模式,有利于提升住培质量,对于提高中医住院医师针灸技能具有重要意义。

在综合医院中医规培中加强中医经典教学的探索

中医住院医师规范化培训(以下简称“规培”)是中国住院知师培训的重要组成部分,同时也是医教协同深化中医学人才培养改革的关键环节,更是加强中医临床人才队伍建设的有效途径和加快构建具有中国特色医学人才培养体系的重要举措。中医经典理论是中医学术的灵魂,是数千年来中医实践的经验结晶,是培养中医临床思维,提升中医临床技能的重要途径。此文分析综合医院中医规培教学中经典教学的不足,提出相应对策,探讨加强中医规培经典教学、培养学员中医临床思维的方法。

内科专业住院医师规范化培训指导医师线上DOPS培训的效果研究

目的探讨线上工作坊模式对内科专业住院医师规范化培训(简称住培)指导医师临床操作技能直接观察评估(direct observation of procedural skills,DOPS)师资培训的应用效果。方法选取2022年11月参加广东省内科专业住培普通师资培训班的45名指导医师为研究对象,采用线上分组讨论与教学视频评价反馈相结合的线上工作坊模式进行DOPS师资培训,采用问卷自评的方式评价指导医师对DOPS的掌握程度,并通过问卷调查了解培训前后指导医师对线上DOPS的培训需求与满意度。结果培训前仅17.8%的指导医师使用过DOPS量表;指导医师在培训后对DOPS的掌握程度明显高于培训前[(3.71±0.69)分比(2.29±0.87)分,P<0.01];且95.6%及以上的指导医师表示能够理解“DOPS评分项目的均质化制定方法”和“形成性反馈技巧”;100.0%的指导医师表示在今后住培教学中愿意尝试使用DOPS。课程的整体满意度评分为(8.40±1.70)分。结论线上工作坊模式对内科专业住培指导医师DOPS师资培训的短期效果满意,可进一步在住培形成性评价师资培训中推广应用。

OKR在检验医学住院医师规范化培训中的应用探讨

随着检验医学的高速发展,临床实验室得到了新的诠释,检验科不再仅限于执行标本收集、检验分析、结果报告等技术性工作,而应转变为一个能够为疾病诊疗提供实验室诊断信息的重要诊断科室。其需要积极主动参与到临床疾病的预防、诊断、治疗、预后评估等医疗活动中。检验医师作为一支新兴的医疗队伍应运而生,其角色不仅仅是技术执行者,更应充当实验室与临床医疗间的桥梁。在这个背景下,如何更好地进行检验住院医师规范化培训成为亟待解决的重要问题。本文通过对检验住院医师规范化培训内容的分析,探讨了目标与关键成果法(objectives and key results,OKR)在住培中的应用价值和意义。这一方法旨在明确培训的具体目标,并通过关键成果的达成来评估培训的有效性。借助OKR,不仅可以更加精准地设定检验医师培训的目标,而且可以在培训过程中更好地衡量和监控实际的学习成果,能够促进检验医学专业的规范化发展,培养更具综合素养和专业技能的医学人才。

特色临床巡诊课堂在检验医学科住院医师规范化培训中的实践探索

随着国内住院医师规范化培训(简称住培)体系的建立,以及检验医学科自身发展的需要,检验医师的规范化培训逐渐受到重视,如何开展检验医师的规范化临床巡诊教学已成为检验科亟待解决的重要问题。该文对武汉大学中南医院自2020年以来检验医学科住院医师规范化临床巡诊课堂教学的实施与体会加以总结和分析,以期为今后检验医学科专业基地进一步完善制度、改进措施提供指导和帮助。

全科住院医师规范化培训师资开展教学门诊的意愿及影响因素研究

背景全科住院医师规范化培训(以下简称住培)师资开展规范的教学门诊是培养合格全科医生的关键环节,2021年7月中国医师协会组织专家修订了《全科专业住院医师规范化培训全科教学门诊规范(试行)》,全国各全科住培基地均参照此规范开展教学门诊。然而现阶段各住培基地教学门诊的实施仍处于探索阶段,且重视程度不足,教学门诊质量不高、开展形式不规范现象普遍存在。目的了解全科住培师资开展教学门诊的意愿和影响因素,并分析开展教学门诊的难点与困惑,提出思考与建议。方法于2021年10月—2023年11月,以参加广东省省级全科住培普通师资培训班、骨干师资培训班的全科住培师资为调查对象(n=1003)。采用自行设计的问卷对纳入师资进行调查,内容涉及师资的基本情况、工作情况及全科教学门诊带教情况。通过“问卷星”平台制作电子问卷,并实现问卷的线上发放和回收。结果全科师资的平均年龄为(40.7±14.1)岁,724名(72.18%)师资所在机构开设了全科教学门诊,792名(78.96%)有带教意愿,710名(70.79%)无带教经验,904名(90.13%)自评带教能力为60~89分,583名(58.13%)未接受过全科教学门诊师资培训,462名(46.06%)期望以多种类型培训相结合的形式开展师资培训,分别有417名(41.58%)和309名(30.81%)认为全科教学门诊的教学难点是指导全科住院医师在全科门诊独立接诊患者和分层教学,377名(37.59%)认为最难实现的教学目的是指导全科住院医师掌握全科临床思维、提高其临床决策能力,216名(21.54%)认为全科住院医师最需要的培训内容是问诊技巧,456名(45.46%)认为所在机构未开展/不愿意开展教学门诊的原因为缺乏时间。多因素Logistic回归分析结果显示,所在机构开设全科教学门诊情况、带教经验、自评带教能力、接受全科教学门诊师资培训情况是全科师资教学门诊带教意愿的影响因素(P<0.05)。结论大部分全科住培师资愿意开展全科教学门诊,但存在带教经验、带教培训、带教能力不足等困难。建议优化和规范全科教学门诊、加强全科教学门诊师资的全科理念培训、强化带教激励措施、完善住培师资监督和反馈机制,以提升全科教学门诊质量。

中医住院医师规范化培训的思考和建议

中医住院医师规范化培训是当代中医药医学生毕业后人才培养模式之一,是培养中医临床医师的必经之路。此文就中医住院医师规范化培训工作提出了思考和建议,包括强化师资培训、加强岗前培训、建立诊疗规范及应急预案、注重中医经典传承、建立考核评价体系、提高规培医师待遇等。完善中医住院医师规范化培训工作仍需要在实践中进一步探索和总结。

微信结合CBL在中医经典住培带教中的应用

目的探讨以微信为载体结合基于案例的学习(Case-based learning,CBL)在中医经典教学中的应用效果。方法于2020年9月—2021年7月,以2019年10月在北京中医药大学各临床医学院参加中医住院医师规范化培训的59名中医内科专业住院医师为研究对象,按随机数字表法分为实验组和对照组,实验组30名,对照组29名。实验组采用微信公众号平台联合CBL教学,对照组采用单纯CBL教学,分别讲解《黄帝内经》《伤寒论》《金匮要略》及《温病条辨》经典条文理解及方药运用,每门课程20学时,比较两组学习效果。结果实验组住院医师中医经典测试成绩显著优于对照组,差异有统计学意义(P<0.05)。两组住院医师对教学模式各方面的满意度差异均具有统计学意义(P<0.05)。结论在中医经典教学中,应用以微信为载体结合CBL的教学法能够提高住院医师综合能力,有助于培养住院医师中医临床思维。

超声科住院医师规范化培训教学活动设置及实践

超声医学理论与实践相结合的学科特点决定了超声科住院医师规范化培养(简称住培)模式的特殊性,临床知识的更新迭代、超声新技术的层出不穷要求超声科医师不仅要有扎实的理论基础、缜密的临床及影像诊断思维、较强的实践操作能力,又要有良好的自主学习能力和一定的科研思维。文章针对四川大学华西医院超声医学科住培教学活动的设置及实践进行探讨,通过设计分级分层临床理论教学课程、从模拟人到临床操作的技能教学实践、强化诊断报告书写指导、设置教学阅片和临床文献研读会等多种教学方式提升超声科住院医师临床岗位胜任能力及科研能力,以期培养更多优秀的、综合素质完善、具有较强自主学习能力和良好创新能力的高水平临床超声医学人才。

以岗位胜任力为导向的中医脑病住院医师规范化培训教学探析

以岗位胜任力为导向的理论和方法用于住院医师规范化培训,是提升临床医师专业素质和培养合格医疗人才的关键方法。如何运用有效的手段提升中医脑病住院医师规范化培训学员的岗位胜任力仍需要进一步探索与研究。本文基于脑病科住培医师培训实践,构建授课教学法(LBL)-案例教学法(CBL)-问题教学法(PBL)-研究教学法(RBL)“四轨并驱”的教学策略,提出以岗位胜任力为导向的中医脑病住培医师的培训方法,以期提高中医脑病专业住培医师的岗位胜任力,从而为临床锻炼出更为优秀的医疗队伍,使之更加符合新时代医疗工作的要求,也更好地提升中医住院医师的整体水平。

全息影像技术在外科住院医师规范化培训教学中的构建与应用

目的评价全息影像技术在外科住院医师规范化培训教学中的应用价值。方法选取2022年9月至2023年9月郑州大学第一附属医院外科住院医师规范化培训学员60名,按照随机数表法分成全息影像教学组和传统教学组,每组各30名,分别采取全息影像技术支持下教学模式和传统医学教学模式进行住院医师规范化培训教学。通过考试成绩及教学满意度调查比较两组在住院医师规范化培训教学效果方面的差异。结果两组的理论成绩和技能成绩分别为(84.19±4.85、88.07±5.61)分和(77.24±5.15、82.70±5.45)分,差异有统计学意义(P<0.05)。教学满意度评价分别为86.66%和100.00%。全息影像教学组在对理论知识的理解和掌握,学习主动性等方面的评价明显优于传统教学组。结论全息影像技术支持下的教学模式较传统教学模式更有益于提高住院医师规范化培训教学质量。