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 traditional Chinese medicine culture and characteristic communityculture： a review

The broad and profound Chinese medicine culture is an important part of Chinese traditional culture, which nourishes the vigorous development of modern Chinese medicine. At present, traditional Chinese medicine （TCM） culture faces challenges and opportunities. As the inheritor of Chinese medicine culture, we bear the burden of inheriting and carrying forward TCM culture. Distinctive community culture is mainly playing value guidance and education transmission function in the process of residents identifying with the culture of Chinese medicine. Therefore, building a distinctive community culture under the guidance of the essence of TCM can effectively inherit and develop TCM culture.

Effect of traditional Chinese medicine and traditional health care sports on the development of modem community sports

After thousands of years of history, traditional Chinese medicine and traditional health care sports survive the fittest in the screening of the natural law, breeding, enduring Cheung, and reflects the inherent vitality. Investigation thoroughly on the effect of traditional Chinese medicine and traditional health care sports for the development of modem community sports is to examine and understand its meaning and value from a higher level, to better inherit and carry forward the excellent traditional culture of China and thus to explore meeting point of traditional Chinese medicine and traditional health sports and modem sports. It also ensures the community to establish a healthy concept, improve the cultural quality, strengthen the moral cultivation, rouse the national spirit, increase life interest and form the modem community culture. In short, by the national education of traditional Chinese medicine and traditional protection movement, there is a unique advantage other cultures are incomparable.

Community nurses＇ knowledge need toward traditional chinese medicine and related factors in China： A cross-sectional survey

Purpose：The aim of the study was to examine the knowledge need toward Traditional Chinese Medicine （TCM） in nurses who worked in Community Health Centers, and to explore the related factors in the current situation of China. Subject and setting： Participants worked in five community health centres across Chaoyang Beijing, and each com- munity health centre includes 4-7 health stations. A questionnaire survey was administered to 218 registered commu- nity nurses using cluster sampling. The investigation was conducted after obtaining informed consent from each par- ticipant. Design： A descriptive cross-sectional design was used to gather data in this study. Instruments： The survey tool was a 5-point Likert-type questionnaire designed by experts in TCM and related fields, which had good face va- lidity and internal consistency. Results： The nursing technology of TCM scored highest score in our research （42.87±5.74）. Next came disease prevention in TCM （21.02±2.67）. The lowest mean score was for the usage of Chinese herbal medicine （15.03±2.77）. The significant related factors for nurses＇ knowledge need towards TCM were educa- tional background （P 〈 0.05）, working unit （P 〈 0.01）, ＂on-the-job training on TCM＂ （P 〈 0.01） and ＂have studied lit- erature on Chinese medicine＂ （P 〈 0.05）. Conclusion： This results suggest nurses working in community care would like to learn more about TCM. Improving community nurses＇ understanding and learning of TCM can promote the application and promotion of TCM nursing technology in the community. Therefore, we could adopt targeted education for community nurses, in order to meet their knowledge needs, and to promote the application of traditional Chinese medicine knowledge to the community.

Detection of consensuses and treatment principles of diabetic nephropathy in traditional Chinese medicine: A new approach

Objective:To propose and test a new approach based on community detection in the field of social computing for uncovering consensuses and treatment principles in traditional Chinese medicine(TCM).Methods:Three Chinese databases(CNKI,VIP,andWan Fang Data)were searched for published articles on TCM treatment of diabetic nephropathy(DN)from their inception until September 31,2014.Zheng classification and herbdatawereextractedfromincluded articlesand usedto construct a Zheng classification and treatment of diabetic nephropathy(DNZCT)network with nodes denoting Zhengs and herbs and edges denoting corresponding treating relationshipsamong them.Community detection was applied to the DNZCT and detected community structures were analyzed.Results:A network of 201 nodes and 743 edges were constructed and six communities were detected.Nodes clustered in the samecommunity captured the samesemantic topic;different communities had unique characteristics,and indicated different treatment principles.Large communities usually represented similar points of view or consensuses on common Zheng diagnoses and herb prescriptions;small communities might help to indicate unusual Zhengs and herbs.Conclusion:The results suggest that the community detection-based approach is useful and feasible for uncovering consensuses and treatment principles of DN treatment in TCM,and could be used to address other similar problems in TCM.

Promoting the Development of Traditional Chinese Medicine in the New Century

Reviewing the past, traditional Chinese medicine (TCM) in the 20th century experienced vicissitude. Since the founding the People's Republic of China, especially for the past twenty years, traditional Chinese medicine undertaking, full of vigor and vitality, has made an unprecedented development in China. The legal status and scientific status of traditional Chinese medicine and pharmacology have already been established. The medical system of traditional Chinese medicine, which is composed of traditional Chinese medicine hospitals, ethnic minority medicine hospitals, integration of traditional and western medicine hospitals and comprehensive hospitals, is playing an important role in preventing, treating diseases and enhancing people's health level. The system of production and circulation for traditional Chinese medicine has basically guaranteed the people's demand for Chinese medicine, with the principles of producing medicinal materials as basis, taking Chinese medicine industry as pillar and Chinese medicine as link. Remarkable achievements have been scored in the research of TCM development as well as research of TCM basic theory and clinical treatment. A number of scientific and technological results have been transformed into productive forces. TCM education has formed a rational pattern based on inheriting traditional way of transmission from master to disciple as well as taking the university and college education as the main part. Minority medical science has been further explored and sorted out; the level of medical treatment, teaching and scientific research for ethnic minority medicines has been improved. As the contingent of integrated traditional and western medicine is growing steadily, medical treatment system, scientific research system and teaching system for integrated traditional and western medicine takes shape progressively. International exchange and cooperation on traditional Chinese medicine has been greatly promoted. Various forms of cooperative relations on the TCM medical treatment, teaching and scientific research have been established between China and many other countries and regions in the world. With the increasing influence of TCM in the world, the accomplishment of traditional Chinese medicine in the 20th century has attracted world attention.

On the maintenance and intervention of health in Hainan Island from the perspective of traditional Chinese medicine

The prevention and treatment of diseases in traditional Chinese medicine pay attention to the"due to people due to time and place".With its unique natural resources,climate and ecological environment,as well as its unique lifestyle,Hainan Island residents'health should have strong local characteristics.Through reviewing the literature,this paper finds that:the residents of Hainan Island have more Yin deficiency,qi deficiency and damp-heat deficiency;The pathogeny and disease syndrome of residents in Hainan Island are also different from other regions.Therefore,the maintenance and intervention of residents'health in Hainan Island has unique characteristics.

中药智慧药学服务的实践与技术分析

目的 分析中药智慧药房的发展现状,总结中药智慧药学服务实践经验,概述其技术要求和发展方向。方法 成都中医药大学附属医院自2018年1月启动智慧中药房项目,建立中药智慧药房,承担门诊中药饮片调剂、煎药、配送等药学服务业务。结果 截至2023年5月已完成中药饮片代煎配送557.2万副,2022年度共服务患者23.14万人次。服务环节更简单,无需等候取药,无需二次到院取药,服务效率高,改善了患者就医体验。结论 中药智慧药学服务发展迅速,未来将依托技术进步建立全程化智慧服务体系。

我国基层中医药服务现状及发展路径探讨

背景我国对基层中医药卫生服务的关注度持续提升,但是目前基层中医药卫生服务体系仍存在问题,制约了我国中医药事业的发展。目的分析我国基层中医药卫生服务体系现状,探索持续提升基层中医药服务能力的策略。方法于2022年12月,检索《中国卫生健康统计年鉴》《全国中医药统计编摘》及国家疾病预防控制局和国家心血管病中心官方网站获取数据,从卫生投入、服务产出、健康需要3个层面构建指标体系,结合秩和比法和WHO卫生系统绩效模块框架对基层中医药服务现状进行综合评价。结果卫生投入方面:2017—2021年,除乡镇卫生院外,其他能够提供中医药服务的基层医疗卫生机构数量均有所增加;社区卫生服务中心(站)、乡镇卫生院、门诊部中医类临床科室床位数呈现上升趋势,但门诊部中医类临床科室床位数占门诊部总床位数的比例有所下降;社区卫生服务中心(站)、乡镇卫生院、诊所中医类执业(助理)医师占比明显上升,而村卫生室的中医类执业(助理)医师占比保持稳定,门诊部的中医类执业(助理)医师占比逐年递减;近5年,基层医疗卫生机构财政投入的绝对数值稳步提高,而中医机构财政拨款波动减少。服务产出方面:尽管各类机构中医诊疗人次占机构总诊疗人次的比例按照一定增幅稳步增长(除中医类门诊部外),但仅村卫生室的中医诊疗量占比始终保持在30.0%以上;除乡镇卫生院外,其他基层医疗卫生机构的中医类执业(助理)医师人均担负年诊疗人次总体上呈下降趋势。根据综合评价结果,2017、2018、2021年处于资源分配适宜状态,而2019、2020年处于资源分配不均衡状态。结论目前,我国基层中医药卫生服务体系建设得到有效落实,但在有序推进的过程中也存在一些不足。基层中医药资源不足、服务与利用不均衡、中医药优势未充分发挥、人才培养机制不健全、财政投入少等问题制约中医药事业的发展。为推动基层医疗卫生机构持续提高中医药卫生服务能力,需要夯实政府职能,进一步弘扬中医药文化,建立激励机制以优化人才培养模式,加强中医药服务与医保政策紧密结合,建设以“信息一体化”为支撑的中医医联体。

基于波士顿矩阵分析法的区域医院科技创新效率研究

目的通过客观评价了解区域医院科技创新效率,推动医院医学学科建设,为医院争创国家区域医疗中心的建设目标提供助力。方法基于医院科技量值指标体系,选取深圳市67家三级医院作为研究对象,分析医院科技创新发展情况,利用波士顿矩阵分析法反映医院科技创新效率。结果深圳市医院间科技创新效率有较大差距:6家医院以相对低的科技投入产生了较高的科技产出,科技创新效率最好;13家医院以较高的科技投入产生了较高的科技产出,具有较好的科技创新效率,科技产出仍可再提升;1家医院科技投入高而科技产出较低,具有较低的科技创新效率,在科技产出方面仍有较大提升空间;47家医院科技投入较低且科技产出也较低,在科技投入及科技产出两个维度仍需发力。结论应依据城市经济高质量发展水平,加强医院科技创新投入水平,引导产出高质量医学科技成果,提升医院科技创新效率。

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。

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。

考试焦虑障碍临床诊疗中国专家共识

考试焦虑障碍是一组与考试等评价性刺激相关的综合征,是考试带来的较为严重的心理问题之一。长期的考试焦虑容易引起紧张、恐惧、烦躁、抑郁等负性情绪,损害个体的工作记忆、注意等认知能力,严重的甚至会导致个体出现自杀意念。为进一步规范考试焦虑障碍的临床诊疗,在中华医学会心身医学分会考试焦虑协作组的组织下,由13名专家组成专家组,包括精神科医师和心理学专家,基于国内外文献和临床诊疗经验等制定本专家共识,以期从流行病学、病因、临床表现、评估、治疗等方面为临床医生提供科学、全面的指导。

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。

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。

深圳市公立中医医院医疗服务价格改革历程与思考

通过梳理深圳市公立中医医院医疗服务价格改革历程,分析优势与难点,提出动态调整中医药服务价格,定价应体现中医劳务价值和技术价值,完善医疗服务价格目录,建立中医医疗技术评定指标体系等建议,以助推中医药综合改革,优化深圳中医医疗服务价格改革模式。

疼痛专科护士中医疼痛管理培训知识体系的构建研究

目的构建疼痛专科护士中医疼痛管理培训知识体系,为中国疼痛护理人才中医疼痛管理培训提供参考。方法以核心能力理论为指导,通过文献研究和半结构式访谈构建中医疼痛管理培训知识体系初稿,2024年1月—2月采用德尔菲法对17名专家进行2轮函询。结果2轮函询的积极系数分别为100%和94.12%,权威系数均为0.899,肯德尔和谐系数为0.406~0.606(均p<0.001)。最终形成包括5个一级指标、12个二级指标和35个三级指标的疼痛专科护士中医疼痛管理培训知识体系。结论构建的疼痛专科护士中医疼痛管理培训知识体系具有科学性、可靠性,可为中国疼痛护理人才规范化、同质化的中医疼痛管理培训提供指导和借鉴。

基于Kano模型的三级中医院住院患者中医护理服务需求属性研究

[目的]分析三级中医院住院患者的中医护理服务需求属性,为提升三级中医院中医护理服务提出策略。[方法]基于Kano模型设计三级中医院住院患者中医护理服务需求调查问卷,对天津市某三级中医院469例住院患者进行调查,采用定量与定性的方法确定三级中医院住院患者中医护理服务需求属性分类及优先级排序。[结果]通过Kano模型和Better-Worse二维矩阵图进行需求分析,最终获得三级中医院住院患者中医护理服务必备属性需求14个,魅力属性需求9个,期望属性需求6个。[结论]三级中医院医院管理者应依据住院患者中医护理服务需求优先级顺序精准施策,保障必备型需求项目供应,加大期望型需求投入,同时发展创新魅力型需求,确保中医护理服务需求与供给高效匹配。

社区中医养生保健服务能力提升策略研究

社区卫生服务中心是提升中医药服务水平、满足多元化就医需求和推动中医药参与居民养生保健的重要载体。文章通过实地调查、实证分析的方法,在山东省烟台市、东营市开展社区中医养生保健服务能力的调查。发现居民对健康管理和中医养生保健服务的整体认知水平有待提升,但随着中医药特色服务与宣教的开展,居民对保健养生和慢性病治疗等服务的需求旺盛;社区卫生服务中心开展中医养生保健服务存在供需失衡的现象;居民对中医养生保健服务的满意度较高。文章从做好中医药文化宣传与推广、增加社区中医养生保健服务项目供给、培养中医养生保健服务技术技能人员等3个方面提出具体举措,为提升社区卫生服务中心中医养生保健服务能力提供参考建议。