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.

Construction of a Talent Cultivation Mode for Traditional Chinese Medicine Nursing Inheritance

Objective:To explore and build traditional Chinese medicine(TCM)nursing inheritance on the talent training scheme,the foundation for cultivating outstanding talents of TCM nursing inheritance.Methods:The modified Delphi method was used for conducting two rounds of consultation with 15 TCM nursing experts to formulate training plan.Results:The questionnaire recovery rates of two rounds of expert enquiry were 100.00%,with high experts enthusiasm,experts coefficients were 0.83 and 0.81,respectively.Kendall coordination coefficient were 0.26 and 0.30,respectively(P<0.01).After two rounds of expert consultation,the TCM nursing inheritance talent training scheme was finally formed,including 3 first-level indicators,7 second-level indicators and 24 third-level indicators.Conclusion:Construction of talent cultivating program of TCM nursing inheritance is scientific and feasible,with a certain reference value.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

Prescribing Chinese patent medicines without traditional Chinese medicine training is now banned in China

On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemicals and biological products)”(National Health Office Medical Letter [2019] No. 558)[1], where the third article stipulates:“Other types of physicians, after not less than one year of systematically studying Chinese medicine professional knowledge and passing the examination, in accordance with the basic principles of syndrome differentiation, can issue prescriptions for Chinese patent medicine”.

Visualization analysis of the international standard ISO/TC 249 for traditional Chinese medicine

Objective This study proposes to visually review the current situation and progress of standards sets by the International Organization for Standardization/Technical Committee on Traditional Chinese Medicine(ISO/TC 249). The review aims to explore the development strategies of the standards, which will exhibit the considerable impact on the economy, trade and exchanges, and cooperation in the area of traditional Chinese medicine(TCM).Methods ISO/TC 249 standards were searched on the ISO website, and their title, proposed time, current stage, scope, and classification were obtained for further summarization. Gephi was utilized to portray the co-occurrence network graph of the ISO/TC 249 standards subject.Results In ISO/TC 249, there were 116 standards, including 81 published standards and 35 developing standards by April 30, 2022. Two withdrawal standards were published after revision, which were not counted in the total standards. The number of published standards has been increasing since the first standard was published in 2014, whose title was “Sterile acupuncture needles for single use”. Among these standards, 17.24%(20/116) standards were in review, 56.03%(65/116) in publication, 3.45%(4/116) in approval, 5.17%(6/116) in enquiry,3.45%(4/116) in committee, and 14.66%(17/116) in preparation, respectively. With 116 standards, most of the research focused on the medicament, as its classification of the International Classification for Standards(ICS) showed the proportion reaching 49.54%. The network analysis data revealed that the top five most frequent words were “materials” “root” “requirements” “products” and “system”, after removing the noise data, such as prepositions,conjunctions, and pronouns. Additionally, the word “system” co-exists with the terms “computerized” “coding” “image” “tongue” and “analysis”;the word “requirement” co-exists with“manufacturing” “decoction” “process” and “materials”;whereas the word “devices” coexists with “pulse” “electric” “skin” and “measurement”.Conclusion With the increased diversification and complexity of problems, the development of standards is also oriented to multidisciplinary fields to cultivate the interdisciplinary talents, and especially the international standardization talents of compound TCM. Multi-angle analysis, formulation, and demonstration of standards, in line with industry needs in different disciplines, enhance the availability of standards and the ability to serve the industry.

Clinical Research of Traditional Chinese Medicine Fumigation and Washing Combined with Rehabilitation Training in the Treatment of Post-Apoplexy Shoulder-Hand Syndrome

Objective:To observe the clinical effect of traditional Chinese medicine fumigation and washing combined with routine rehabilitation training on post-stroke shoulder and hand syndrome(SHS).Comparing and analysing the effects of this treatment on the living ability of patients with post-stroke shoulder and hand syndrome.Methods:Fifty patients with post-stroke SHS who met the inclusion criteria were divided into observation group and control group by random number table method with 25 cases in each group.Both groups were given post-stroke secondary prophylactic drugs,while the control group was given routine rehabilitation training,20-30 minutes at a time,once a day,5 days a week,4 weeks as a course of treatment.On the basis of treatment in the control group,the observation group was combined with traditional Chinese medicine fumigation and washing,decocted with water to extract 3,000-4,000 ml juice,and added into the medicine bath bucket to soak the affected limb for 30-40 minutes,once a day,5 days a week,4 weeks as a course of treatment.The changes of upper limb edema degree,Numeric Rating Scale(NRS)score,Barthel index(MBI)and Fugl-Meyer Rating(FMA)scores before and after treatment were observed between the two groups,and the differences of clinical efficacy between the two groups were compared.Results:After treatment,the total effective rate in observation group was significantly better than that in control group(P<0.05).After treatment,the degree in upper limb edema in the two groups was significantly reduced(P<0.05),NRS score was decreased(P<0.05).Barthel index and FMA score were significantly increased(P<0.05),and the degree of upper limb edema and NRS score in the observation group were significantly lower than those in the control group(P<0.05).Barthel index and FMA score were significantly higher than those in the control group(P<0.05).Conclusion:The combination of traditional Chinese medicine fuming and washing with rehabilitation training has a better therapeutic effect on SHS,and the clinical efficacy of the former is more significant than that of single rehabilitation training.In clinical application,the former shows low cost,simple and easy operation,high acceptance by patients,and is conducive to promotion and use.

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。

基于贝叶斯理论的中医内科BOPPPS教学模式探索

目的 探索基于贝叶斯理论的中医内科BOPPPS教学模式。方法 选取2020年3月至5月于黑龙江中医药大学佳木斯学院开设中医内科学课程班级213名学生,采用随机数字表法将其分为对照组107名、试验组106名。对照组行常规BOPPPS教学,试验组行贝叶斯理论优化的BOPPPS教学。比较两组学习前后思维能力、学习动机、学习投入度、专业技能及教学效果。结果 学习后,两组思维能力、学习动机、学习投入度得分高于学习前,且试验组高于对照组(P<0.05)。学习后,两组专业技能得分高于学习前,且试验组高于对照组,差异有统计学意义(P<0.05)。试验组学生自评和互评、学生对授课教师评价评分高于对照组,差异有统计学意义(P<0.05)。结论 基于贝叶斯理论的BOPPPS教学模式可提高中医内科教学效果,实践价值较高。

基于培养新型高阶中医药人才的中药炮制教学改革

在实现中华民族伟大复兴中国梦的大背景下,我国政府出台多项政策推动中医药发展,同时也对培养符合时代和社会需求的中医药人才提出更高的要求。中药炮制是中医药的重要特色,该课程在中药人才培养中具有重要的地位。文章以培养新型高阶中医药人才为教育目标,从教学理念、教学方法、评价体系3个方面对中药炮制教学进行了大胆的改革与实践。结果表明,在教学相长的同时,教学改革不仅大大增强了学生们的专业自信、文化自信,更激发了学生们改革创新的意识、对行业发展的思考和对民族复兴的责任感。

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。

高职临床医学专业人才培养模式改革与实践

目的讨论高职临床医学专业人才培养模式的改革策略,汇总实践成果,推广“1+1+1”高职临床医学专业人才培养模式。方法将2022年8月至2023年8月常德职业技术学院临床医学专业的两个随机自然班纳入研究,两个班学生人数均为40人,其中一个班接受传统的“2+1”人才培养模式,为对照组;另一个班接受经改革的“1+1+1”人才培养模式,为观察组。两种人才培养模式最大的区别在于大二时期(2022年8月至2023年8月),对照组医学生该学年在校进行理论学习,观察组医学生该学年在教学医院进行临床课的学习。比较两组医学生之间的专业课理论考试成绩和实践考试成绩差异,以及专项能力水平差异,最后评价两组对各自教学模式的满意度。结果(1)观察组专业课理论考试成绩、实践考试成绩均高于对照组,差异有统计学意义(P<0.05)。(2)教学前,两组的病历书写能力、临床思维能力、医患沟通能力、团队合作能力、自我正念能力评分比较,差异无统计学意义(P>0.05);教学后,观察组的病历书写能力、临床思维能力、医患沟通能力、团队合作能力、自我正念能力评分均高于对照组,差异有统计学意义(P<0.05)。(3)观察组对当下人才培养模式激发学习兴趣的满意度评分、对当下人才培养模式提高团队合作水平的满意度评分、对当下人才培养模式激发自身职业与就职信念的满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论“1+1+1”人才培养模式有助于更好地培养高职临床医学专业人才,提升整体教学品质。

基于PDCA循环持续改进的SPOC模式在中医学教学管理中的应用

新型冠状病毒肺炎(以下简称“新冠”)流行3年,对世界各行各业都产生了巨大影响。目前我国新冠疫情防控已取得重大战略成果,疫情总体得到有效控制,社会已经全面复工复学,疫情防控已经转变为常态化管理,但丝毫不能忽视反弹风险,仍然有部分地区出现本土感染病例。这也给疫情常态化防控下,高等医学院校中医学专业教学管理带来新的思考。高等医学院校教职员工、学生众多,为做到在严格疫情防控下减少聚集性中医相关课程教学,避免出现聚集性传播可能,在线教学成为目前主要的教学模式。文章探索了PDCA循环管理系统和小规模限制性在线课程(SPOC)模式在高等医学院校中医学专业教学管理中的应用,以期找到高效、适宜的中医学专业教学管理模式,提高中医学教学质量。

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。

探讨基于核心指标集构建中医特色的射血分数保留心力衰竭1+N模式疗效评价体系

核心指标集是就某一特定研究领域达成的所有临床研究都应该测量和报告的最少的临床结局,核心指标集可以提高临床疗效评价的规范性和可比性,是循证医学发展的必然、是中医药临床疗效评价的重要抓手、是推动中医药疗效评价与国际接轨的关键。如何运用核心指标集实现临床疗效国际化、标准化的同时,又能遵循中医诊疗特点体现自身优势是中医临床疗效评价的难点。针对这一难点,项目组创新性地提出了1+N模式的射血分数保留心衰(heart failure with preserved ejection fraction, HFpEF)疗效评价体系,即通用的核心指标集“1”+个性化指标集“N”,以满足循证医学和中医学疗效评价的双重需求。本文初探HFpEF疗效评价构建模式,主张在规范化基础上体现多样化和个性化的研究目的需求。结合HFpEF临床疗效评价的现状,综合业内专家意见,探讨了HFpEF 1+N模式疗效评价构建中核心指标集“1”的取舍以及“N”体系的构建思路,以期最大程度的形成符合中医药特色的临床评价体系新范式,推动中医药国际化进程。

高校招生视域下中医院校护理本科人才培养策略研究

目的了解全国中医院校护理学类本科专业招生现状,为中医院校培养具有中医特色的护理人才提供参考。方法采用目的抽样法,选取全国24所中医院校2021-2022年公布的护理学类本科专业招生情况作为研究对象,通过文本分析法进行资料分析。结果专业设置和专业布点在校际区域间差异较大,专业目标和课程设置对中医特色逐渐彰显,针对拔尖人才培养聚力不够,招生模式传统单一,生源质量整体偏弱。结论高校可通过优化专业结构、调整招生策略、深化教学改革、强化培养特色等,提升中医院校护理本科人才培养质量。

互动启发式教学在中医科辨证施护能力培养中的应用

目的 探讨互动启发式教学在中医科辨证施护能力培养中的应用效果。方法 取三所医院中医科护士45名,按照随机数字表法分为对照组和观察组。对照组22名采用常规培训,观察组23名采用互动启发式教学,比较两组中医护理能力、中医辨证施护能力和考核成绩。结果 观察组的中医护理能力得分为(105.26±3.64)分,高于对照组的(92.37±4.08)分;辨证施护能力得分为(79.37±2.52)分,高于对照组的(72.06±2.71)分,且观察组的辨证施护理论得分、辨证施护实践技能得分均高于对照组,差异均有统计学意义(P<0.05)。结论 基于互动启发式教学的中医辨证施护能力培养,有利于提高护理人员中医知识、辨证施护能力的培训效果。

世界四大传统医学教育体系及对中医药教育的启示

中医药、古希腊医学、阿育吠陀和阿拉伯医学被认定为世界四大传统医学。梳理了四大传统医学的教育培训体系。对比发现:中医药重点关注师承关系,理论与实践结合;古希腊医学以强大的理论研究与实验观察为主要特点;阿育吠陀高度重视文化认同为主要特点;阿拉伯医学则高度重视文化交流与实践推广。建议推动中医药教育创新发展,强化实践教学,提升教学质量,加强国际交流与合作,提高国外公众接受度。

中医适宜技术联合盆底肌肉训练治疗产后压力性尿失禁临床观察

目的 对产后压力性尿失禁患者进行中医适宜技术干预治疗,并观察效果。方法 将60例患者随机分为治疗组和训练组,并对其进行相应治疗,观察2组1 h尿垫试验结果、Sandvik尿失禁指数和国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分改善情况,以及临床疗效。结果 治疗后,治疗组1 h尿垫试验结果、Sandvik尿失禁指数和ICI-Q-SF评分改善均优于训练组。治疗结束时,治疗组总有效率为86.7%(26/30),高于对照组的63.3%(19/30)(P<0.05)。6个月随访时治疗组总有效率86.7%(26/30)亦高于对照组的56.7%(17/30)(P<0.05)。结论 在产后女性中,压力性尿失禁的发生是值得关注的问题。将中医适宜技术与凯格尔训练联用干预产后压力性尿失禁达到巩固、延长疗效的目的。

基于应用型人才培养的中医外科学本科教学方法探讨

中医外科学是中医学的重要组成部分之一,具有很强的应用性、实践性。随着时代发展和社会要求,患者的医疗需求及对医疗质量的要求日渐提高。同时疾病治疗复杂化和疾病谱的改变,对广大中医药事业技术人员的专业素养提出更高的要求,培养符合中医药事业发展的应用型人才已是刻不容缓的任务。通过探讨不同的本科教学模式,突出中医外科特色教学,建立全面可行的应用型人才培养模式,培养新型应用型中医外科人才,为中医外科医疗事业提供人才保障。此文将从应用型人才培养目标、中医外科学教学现状、教学模式及考核体系等方面进行探讨,探索中医外科学本科应用型人才的培养模式,提升本科生医学知识储备、临床实践技能水平、人文素质及科研能力等综合能力,提高教学质量,培养合格人才。