Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p = 0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2 gm single dose) for the treatment of urethritis/cervicitis;compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2 gm single dose (p = 0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.

Knowledge, Attitude and Oral Hygiene Practices among Medical Practitioners in Delta State, Nigeria

Background: The knowledge of good oral hygiene is of paramount importance for the technical knowhow to keep one’s mouth clean and free from periodontal diseases. Thus, one’s attitude towards oral hygiene directly affects the oral health status. Aims: The study aimed at evaluating the knowledge, attitude and oral hygiene practices among medical practitioners in Delta State, Nigeria. The research also aimed at determining the effect of sex on knowledge, attitude and oral hygiene practices. Methodology: This study was an observational cross sectional study. Purposive sampling technique was employed. A total of a hundred and twenty-three health care providers were assessed with a structured questionnaire. Ethical approval was obtained from the Ethics and Research Committee in the Department of Human Anatomy and Cell Biology, Delta State University, Abraka, Nigeria. Data was analyzed using SPSS version 18.0 package. Descriptive statistics was analyzed using simple frequency percentages distribution and association between categorical variables and sex was done using a chi-square test. Significance was accepted at p Result: Findings from the study present 76.0% males and 24.0% females in the studied population. Five categories of health care providers were assessed, 63.0% of respondents were medical officers, 21.0% were consultants, and 10.0% were residents, while 6.0% were house officers. The results showed that 43.9% of the participants brushed their teeth once daily, 54.5% twice daily while 1.6% thrice daily. Respondents were asked the last time they visited a dentist. Out of the 123 participants, 37.4% never visited, 20.3% claimed six months ago, 13.0% visited a year ago, 10.6% two years ago and 19.40% visited more than two years ago. It also shows percentage distribution of variant types of last treatment, 19.5% had extraction, 10.6% had filling, and 33.3% had scaling and polishing while 36.6% had other types of dental treatment. The study revealed that the majority of the respondents (93.5%) had a positive attitude towards oral health. A total of 91.9% of the participants had knowledge of oral hygiene, while 8.1% had no idea of oral hygiene. More than half of the respondent (57.2%) agreed and strongly agreed that oral hygiene knowledge in medical schools was adequate while 35.0% disagreed and strongly disagreed. There was no significant association (p > 0.05) between frequency of daily teeth brushing, last dental visit, variant treatments and sex. Conclusion: Findings from this study showed that the majority of the participants had an adequate knowledge on proper oral hygiene care and they had a positive attitude towards oral health. Being health care providers, the adequate knowledge and positive attitude could have a positive impact on the patients.

《The Medical Republic》案例分享--亦教亦学：医学生可以让全科医生学到什么

澳大利亚的全科医生具有行业自律性,体现在其自行制定行业标准、自主进行资质考核及自主执业等方面,也体现在《The Medical Republic》这一共享平台上。Leon Piterman是医学学士,医学博士,教育学硕士,英国医生学会会员,澳大利亚全科医生学会会员,Monash University副校长、全科医学教授,从事全科医学临床服务近40年;研究兴趣为慢性病管理、心理健康、医学教育;曾获澳大利亚勋章,医学部医学教育奖,澳大利亚全科医生学会研究奖,香港全科医生学会研究奖等;获多项澳大利亚卫生和医学研究理事会等大型研究项目,发表科学文章和著作章节120余篇,是《全科医学中的精神病学》合作著者。Piterman教授建议我国的全科医生应培养"共和"思想,以为全科医学领域提供更多的平等交流机会。目前Piterman教授定期为《The Medical Republic》撰写文章,本刊深受"医学共和"思想的启发,特邀本刊编委Monash University杨辉教授对Piterman教授的文章进行编译,并进行连载刊登!本期Piterman教授为我们讲述了在临床带教中从实习医学生处学到新知识的经历,并认为临床带教教师和实习医学生之间可以互相影响、互相促进,教亦学,学亦教,教学相长,相得益彰!

Path Selection of China’s Medical Reform Based on Empirical Measurement of Asymmetric Information

Based on the micro individual data from China Health and Nutrition Survey (CHNS) database and the development of China’s medical and health system reform since the reform and opening-up in 1978, this paper applies a two-tier stochastic frontier model to measure the degree of asymmetric information between physicians and patients in China’s medical service market and estimate the impact of bargaining on the final price of health care both holistically and annually. The empirical results show that: 1) The information mastered by physicians and patients have significant but opposing effects on the final medical service price. Physicians hold more information relative to patients and thus have stronger bargaining power. 2) Almost all patients will be forced to accept a medical price higher than the benchmark price by 16.52% on average by receiving excessive and expensive medical services, despite the differences in bargaining power between physicians and patients are highly heterogeneous. 3) The series of medical reforms in China had different impacts on medical care pricing efficiency. Especially, the early medical reforms could impose a positive impact on the efficiency of the medical market in the initial stage. I further propose that the path choice of China’s new round of medical reform should be as follows: It is necessary to insist on government-led efforts to protect the public welfare of medical services, and to introduce market mechanisms to mobilize social resources and improve the efficiency of the medical market. In addition, I point out that the establishment and improvement of the general practitioner system may reduce the degree of information asymmetry between physicians and patients, thus alleviating China's deteriorating physician-patient relationship.

Assessment of Knowledge, Attitudes and Practices (KAP) on Rheumatic Heart Disease among Senior Medical Students in Cameroon

Background: Rheumatic heart disease (RHD) is the commonest cause of valvular heart disease in low and middle-income countries (LMICs). The low cardiologist to patient ratio leaves a big challenge of RHD prevention and management to general practitioners in Cameroon. This makes it important to assess the aptitude of senior medical students who are doctors-to-be on RHD. This could thus give a base on which to increase awareness and decrease the burden of the disease. Therefore, we sort to evaluate the knowledge, attitudes, and practices (KAP) of senior medical students on rheumatic heart disease. General objective: To determine the level of knowledge, attitudes on rheumatic heart disease, and assess practices towards RHD and its prevention. Methodology: A cross-sectional study was conducted in four medical schools in Cameroon for a period of 3 months (from January 1st to April 1st, 2019). The senior medical students were recruited using a structured self-administered questionnaire and electronic forms. Data were entered into an excel spreadsheet and analysed with IBM SPSS version 25.0 for windows. The knowledge level was divided into tertiles (poor, moderate and good) while the attitudes and practices were divided into poor or good. Association to KAP was evaluated and Statistical significance was set at P < 0.05. Results: In total, 509 senior medical students (6th and 7th year) were recruited. The mean age was 24.6 (SD ± 1.7) with 53.2% of students in the 19 to 24 years-old range. There were more females (51.7%) and level 6 students (50.1%). Most of the students had moderate knowledge (58.2%), with good attitudes and practices on rheumatic heart disease and its prevention. One-quarter of the students had good knowledge, attitudes, and practices on rheumatic heart disease. Lecture on RHD, history of sore throat and study in faculty of health science (FHS) was associated with good knowledge, attitudes, and practices on RHD. Conclusion: Despite having most of the senior medical students (6th and 7th years) in Cameroon with moderate to good knowledge of RHD, only a third has an above-average knowledge. There is a modest knowledge of RHD that could be used as an important foundation upon which to build RHD educational programs to expand awareness and understanding. Every 1 in 4 senior medical students have good knowledge, attitude and practice on RHD.

我国院前医疗急救从业人员标准化意识调研

目的了解我国院前医疗急救从业人员标准化意识现状,为推动院前医疗急救标准化工作提供参考。方法自行设计调查问卷,于2023年1月-3月采用便利抽样方法对北京、河南、浙江、湖北、新疆5省市912名院前医疗急救从业人员的标准化意识进行调查,采用SPSS 20.0软件进行数据统计分析。结果院前医疗急救从业人员对标准化相关知识非常了解的比例均未超过20%,95.83%的从业人员认为标准化对推进院前医疗急救事业发展有作用,19.85%的从业人员参与过院前医疗急救标准起草工作,57.57%的从业人员愿意参与院前医疗急救标准制修订工作。结论我国院前医疗急救从业人员对院前医疗急救标准相关知识了解程度不高。有必要加强院前医疗急救相关标准、规范化知识的宣传、推广和普及,增强院前医疗急救从业人员的标准化意识,从而推进院前医疗急救事业持续发展。

以执业医师考试为导向的医学免疫学网络试题库建设与应用

医学免疫学是一门重要的医学基础课程,也是执业医师考试的考核内容。本文以执业医师考试为导向,采用考易网络题库与考试评价系统,从试题库的建设内容和题型方面进行医学免疫学网络试题库建设,目前试题库总题量达到2 400余题,逐步应用于开设医学免疫学课程的考试,并根据临床医学和预防医学专业学生考试成绩,采用难度、区分度、信度等指标评价试卷质量,分析课程教学效果。在试题库的建设和应用过程中,需要教师不断探讨研究,更新和完善试题库,将试题库建设成为动态高效的课程考核工具。该试题库建成后,既有利于提高执业医师考试的通过率,也有利于实行考教分离,为培养新时代具有岗位胜任能力的医学人才奠定基础。

基于结构性问题培养全科医生深度思考能力的方法研究

背景住院医师规范化培训的全科学员在各临床专科轮转时间短暂,学习内容宽泛,需要增强学习自主性。全科师资会面临不同背景学员,如5+3、转岗、专业硕士,或3+2助理全科、实习医生、公共卫生学员等,如何在培训中,使不同培训对象能各取所需,达到应有培训效果,需要认真研究。目的探索基于结构性问题的培训方式,提高学员学习主动性,培养其深度思考能力的作用。方法选取2020年江苏省全科/助理全科骨干师资培训班(骨干师资班)和基层卫生人才能力提升培训班(基层人才班)的学员作为研究对象。在每次学习活动结束,即刻组织学员讨论,要求依次回答“通过学习1.你学到了什么?2.还有哪些疑问?3.既往有什么相同或者类似的经验与大家分享?4.对今后工作的启发?”根据上述问题思路自行设计调查问卷调查培训学员对结构性问题培训方式的认同度,分为第1部分一般资料,包括性别、学历、职称、工作单位、岗位、工作年限、参与培训的项目等;第2部分是对“问题1、问题2、问题3、问题4和培训形式5”的解释性问题,5个维度共计20个条目,备选项是四等级,赋值为“1=非常同意,2=同意,3=不太同意,4=完全不同意”。结果培训对象对所有条目选择同意与非常同意的百分比均大于95%。不同性别、年龄、职称、岗位、工作年限培训学员等对结构性问题培训方法的认同程度比较,差异无统计学意义(P>0.05);不同学历、工作单位和培训项目培训学员对结构性问题培训方法的认同程度比较,差异有统计学意义(P<0.05)。相较于研究生及以上学历,本科培训对象对问题3、问题4的认同程度更高(P<0.05)。相较于三级医院,城市社区卫生服务中心(乡镇卫生院)和二级医院的培训对象对于问题1~4认同程度更高(P<0.05)。相较于骨干师资班,基层人才班的培训对象对于问题1~4及培训形式5认同程度更高(P<0.05)。结论培训实践中总结出的四个开放式问题,内容简单,含义递进,具有内在联系。运用结构性问题培训全科学员,形式灵活,能够激发被培训者的深度思考,该方法在基层卫生人才培训班获得更高的认可程度,表明适用于全科医生的培养。

基于能力培养导向临床实习轮转模式的应用意义

目的结合国家执业医师考试及全国大学生医学技术技能大赛的考试要求,探讨基于能力导向临床实习轮转模式改革的应用效果。方法选取实习的2017级临床医学“5+3”一体化儿科及临床专业实习生各90名,随机分为试验组和对照组,每组90人。试验组采用调整后实习轮转计划,对照组采用传统实习轮转计划,应用综合考评得分、个人综合能力、自我超越、职业抱负、教学满意度评分量表进行统计比较。结果试验组综合考评、个人综合能力、岗位胜任能力、自我超越、职业抱负、教学满意度明显高于对照组,差异有统计学意义(P<0.05)。结论实习模式改革有助于提高医学生的整体素质,改善医学生的学习环境,激发医学生的临床学习兴趣和主动性,增强医学生的临床实践能力,提高医学生的满意度,同时提升国家执业医师考试通过率以及为全国大学生医学技术技能大赛培养优秀赛手,值得继续深入探索和推广应用。

人工智能赋能全科医生继续教育改革的研究

我国的全科医学继续教育在大力发展中取得了一定成效,但与国际平均水平仍有差距。应用人工智能(artificial intelligence,AI)为全科医生的继续教育带来了新的机遇和可能。人工智能为载体的教育培训模式能够提高基层全科医生的诊疗水平,并为解决现有问题提供新的答案。通过人工智能,全科医生可以更便捷地获取专业知识和最新医学进展,提升专业水平和技能。应用该教育培训模式可以提高医疗系统的效率,改善医疗资源分配不均衡。制定政策和规范,建立健全的继续教育体系,确保全科医生继续教育有效运行和发展。全科医生继续教育同时面临挑战,如保证教育内容质量和可靠性,适应新兴技术和需求等。借助互联网+和人工智能的发展,我国全科医生继续教育有新的机遇和发展空间,能进一步提升全科医生的专业素养和技能水平,为全科医学培训进步做出贡献。

农村订单定向医学毕业生工作场所患者源暴力、职业倦怠与离职意向的关系研究

背景农村订单定向医学生免费培养项目是缓解农村地区基层医生匮乏、提升基层医疗卫生队伍整体素质和技术水平的重要举措。目前,完成“5+3”培养模式的农村订单定向医学毕业生(以下简称定向毕业生)逐步履约进入基层工作,其基层工作现状及服务期满后留任意愿受到高度关注。目的探讨职业倦怠和工作场所患者源暴力对离职意向的影响,为稳定全科医生队伍提供政策建议。方法于2021年12月—2022年2月,采用分层整群抽样方法抽取9个省份,在各省卫生健康委科教处的协助下向定向毕业生开展电子问卷调查。定向毕业生的职业倦怠采用职业倦怠量表-服务行业版(MBI-HSS)评估,工作场所患者源暴力涉及语言暴力和躯体暴力,离职意向的测量问题为“服务期满后,您是否愿意继续服务基层?”。采用多因素Logistic回归分析定向毕业生的职业倦怠和工作场所患者源暴力对离职意向的影响。结果3615份定向毕业生的问卷被有效回收。87.77%(3173/3615)的定向毕业生服务期满后不愿意/不确定是否留任。17.46%(631/3615)的定向毕业生遭受过躯体暴力,60.33%(2181/3615)的毕业生遭受过语言暴力。定向毕业生的职业倦怠检出率为55.82%(2018/3615),其中,60.80%(2198/3615)的定向毕业生处于中度/重度情感耗竭,去个性化和个人低成就感的占比分别为67.55%(2442/3615)和83.76%(3028/3615)。多因素Logistic回归分析结果显示,在控制了性别、职称、个人月收入等社会经济学因素后,处于职业倦怠的定向毕业生有4.92倍[95%CI(3.87~6.25)]的风险离职,1.92倍[95%CI(1.50~2.46)]的风险不确定是否留任(P<0.05);遭受语言暴力和躯体暴力的定向毕业生分别有1.46倍[95%CI(1.12~1.91)]和0.38倍[95%CI(0.27~0.52)]的风险会在服务期满后离职(P<0.05)。结论目前,定向毕业生的离职意向较高,预计服务期满后基层全科人才流失较多。职业倦怠是离职意向的核心影响因素,我国定向毕业生职业倦怠状况不容乐观,应从多个层面加强对工作的调节,缓解员工负面情绪,从而稳定全科医生队伍。

新安医家程樑《引经证医》学术思想探析

程樑是清代著名新安医家,沉于经典,勤于临床,将所思、所感系统整理、总结,于1873年著成《引经证医》。文章从该书医学理论体系构建的角度出发,探寻其学术思想,包括阴阳四时五行,构建哲学基础;独重脾胃,明确藏象核心;详论六气,阐发病因病机;形色脉参,形成综合诊断;内外同治,展现多元治疗等五个方面。《引经证医》论理明晰,以经典理论为指归,临证圆活,以审机施治为目标,是理论结合实际的尚佳范例,其学术思想值得后来者研究与学习。

加强医用气体从业人员的培训

医用气体系统是医院的生命支持系统。有的医用气体有高压、助燃、低温、易爆等物理特性。医用气体从业人员和工程技术人员应该懂得医用气体的特性和掌握操作技能,并能够处理安全隐患。本文阐述了从业人员上岗前进行专业知识培训的必要性。只有懂得医用气体的特性,方能更好地从事这项工作。

太忻一体化经济区医养旅游资源空间分布及利用模式

医养旅游资源是从区域性“旅医养资源融合”视角重新定义旅游资源,以当地居民作为旅游发展的最大受益者进行研究。借助GIS空间处理方法,结合最邻近指数、基尼系数、核密度分析法和规模度指数等方法分析太忻一体化经济区医养旅游资源空间分布特征及利用模式。研究表明太忻一体化经济区医养旅游资源空间分布特征有4方面:(1)医养旅游资源呈现“总体离散、局部集聚”的空间分布特征;(2)12个市区县内医养旅游资源分布具有不均衡性;(3)南部地区的医养旅游资源规模最大、最集中;(4)太忻一体化经济区的医养旅游资源空间分布的密集区域,即迎泽区、万柏林区、杏花岭区、尖草坪区,与其人口分布密集区域几乎一致。在对医养旅游资源空间分布进行分析的基础上提出以下利用思路:(1)主客共享的“旅医养融合”发展模式;(2)在产业融合发展基础上构建医养旅游产业集聚模式。通过研究为实现太忻一体化经济区空间优化和高质量发展提供理论依据。

我国农村订单定向医学生免费培养项目相关政策分析

农村基层卫生工作是我国卫生工作的重点。为在农村地区吸引和留住卫生人才,提高农村基层卫生服务能力,近年来,国家和各省市自治区针对农村订单定向医学生免费培养项目(简称订单定向项目)出台了多项政策。对我国订单定向项目相关政策内容进行梳理,并对订单定向项目的实施情况以及存在问题进行分析,进而提出政策建议。研究结果显示,订单定向项目相关政策逐步完善,有力缓解了基层卫生人才数量不足、专业能力有待提升的问题,同时,为贫困人口接受高质量教育做出了重要贡献。然而,当前我国订单定向项目缺少对基层从医志向和素质的考核机制,缺乏明确基层医疗卫生机构建设标准,相关激励政策不够完善,缺乏基层全科医生培养模式要求,后续相关政策应进一步完善。

医疗机构中药从业人员现状调查与优化策略

目的:分析72所不同等级医疗机构中药从业人员现状,为中药从业人员服务能力提升及管理部门制定相关政策提供参考。方法:以电子调研表的形式对72所不同类别、不同级别医疗机构中各部门中药从业人员基本情况进行调研,包括职称、学历、年龄及从业年限等,对收集数据进行分析。结果:各级医疗机构中药从业人员差距较大;三级医疗机构人力资源明显优于二级和乡镇医院;基层地区人均药师配备数量不足,学历、专业技能均相对较低;临方炮制、中药临床药学、中药科研等科室人员配比较低,受重视程度不够。结论:优化并合理配置中药人力资源,可更好地发挥中医药特色优势,提升中医药服务能力。

全科医生视角下影响社区医疗机构开展体医融合服务的质性研究

背景体医融合是推动社区居民健康的基础环节,也是助力社区医疗服务高质量发展的重要保障,而全科医生又是践行体医融合服务的落脚点与着力点,但目前缺乏基于全科医生视角的影响社区医疗机构开展体医融合服务的相关研究。目的研究全科医生对影响社区开展体医融合服务的理解和看法,旨在为社区更好地开展体医融合服务工作提供思路和参考。方法于2023年3—4月,通过目的抽样法,在湖南省株洲市选取5家社区卫生服务中心(站)的11名全科医生作为调查对象,利用“一对一”半结构化深度访谈的研究方法,借助内容分析软件Nvivo 12.0对访谈内容进行录音文本转录、分析单元形成、内容编码以及主题提炼。最后利用描述现象学分析法对访谈资料进行逻辑分析,掌握全科医生对影响社区开展体医融合服务的理解和看法,并归纳总结出访谈主题。结果影响社区开展体医融合服务的内容可归纳为4个主题和10个亚主题:体医融合服务环境亟待优化(场地供给不足、氛围滞后、宣传不足)、全科医生能力亟待提高(体医融合认知能力不足、开具运动处方能力缺乏)、社区卫生服务机构支持乏力(体医融合相关培训活动匮乏、经费划拨不足、人力资源短缺)、患者对体医融合服务认知不足(患者对体医融合疗效认知不足、患者对体医融合风险认知不够)。结论社区全科医生在体医融合服务能力方面还存在诸多不足,为了促进社区体医融合服务更好地发展,亟须优化社区体医融合服务环境;提高全科医生体医融合认知能力与开具运动处方能力;加强社区卫生服务机构支持保障力度;提升患者对体医融合服务的疗效和风险认知。

基于数据挖掘名老中医食管癌医案探讨虫类药物作用机制的研究进展

目的:通过数据挖掘分析名老中医诊治食管癌医案,发掘其中虫类药物的运用规律并对其作用机制进行探讨。方法:①以国家中医药管理局公布的第一批至第三批国医大师和第一批至第六批全国老中医药专家学术经验继承工作指导老师名单为依据,在河南中医药大学图书馆馆藏书目检索系统输入名老中医姓名,检索其著作、经验集,从中寻找其诊治食管癌的医案。②以名老中医姓名、“食管癌”“中医”“医案”“临床经验”为检索词,分别检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库自建库至今公开发表的食管癌诊治医案,提取医案详细信息,包括诊断、处方药物、虫类药物、证型,运用中医传承辅助平台对处方药物的四气五味、归经、用药频次、虫类药物频次、证型分布进行分析。结果:共纳入331个处方、344味药物,使用频次居前10位的分别为茯苓、黄芪、陈皮、白术、甘草、威灵仙、麦冬、白花蛇舌草、党参、砂仁。证候频次居前10位的依次为痰瘀互结、气阴两虚、痰气交阻、瘀毒互结、胃气上逆证、脾气虚证、脾肾两虚证、脾胃虚弱、气滞血瘀、痰湿内停。其中所涉虫类药物频次居前10位的分别为:壁虎、蜈蚣、全蝎、僵蚕、蜂房、穿山甲、土鳖虫、蟾皮、水蛭、乌梢蛇。

从国家执业医师资格考试角度浅谈课程教学改革

目的:以温州医科大学某年度执业医师资格考试成绩及影响因素为切入点,探讨医科院校教学改革方案。方法:某年度温州医科大学参加临床执业医师考试878人,公共卫生执业医师考试78人,口腔执业医师考试26人,对比分析执业医师资格考试其各科成绩与国家平均得分、平均掌握率等的差异;查阅参加执业医师资格考试考生在校期间相应各科成绩,分析本科阶段医学教育与国家执业医师资格考试成绩间的关联性。结果:临床执业医师资格考试,各科目成绩均高于全国平均分(P<0.05)。公共卫生执业医师资格考试除卫生统计学、妇幼保健学,口腔执业医师资格考试除口腔内科学、口腔预防、内科学、外科学与国家平均分无差别外,其他科目得分均高于全国平均分(P<0.05)。临床、公共卫生执业医师资格考试中基础知识、专业知识的成绩与在校期间多数相关科目成绩呈中、低度相关(P<0.05),医学人文知识以及口腔专业多数相关科目两类成绩间关联性不显著(P>0.05)。结论:应重视在校医学人文学科教育,提高医学生人文素养;注重过程性考核评价,重视理论与实践相结合、基于问题教学为有效的教学改革以提高课程教学质量。

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。