Performance in the Fundamentals of Laparoscopic Surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?

Objective:To correlate the utility of the Fundamentals of Laparoscopic Surgery(FLS)manual skills program with the Objective Structured Assessment of Technical Skills(OSATS)global rating scale in evaluating operative performance.Methods:The Asian Urological Surgery Training and Educational Group(AUSTEG)Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training.Delegates’basic laparoscopic skills were assessed using three different training models(peg transfer,precision cutting,and intra-corporeal suturing).They also performed live porcine laparoscopic surgery at the same workshop.Live surgery skills were assessed by blinded faculty using the OSATS rating scale.Results:From March 2016 to March 2019,a total of 81 certified urologists participated in the course,with a median of 5 years of post-residency experience.Although differences in task time did not reach statistical significance,those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS tasks.However,they took longer to complete the precision cutting task than participants with less experience.Overall OSATS scores correlated weakly with all three FLS tasks(peg transfer time:r=0.331,r^(2)=0.110;precision cutting time:r=0.240,r^(2)=0.058;suturing with intracorporeal knot time:r=0.451,r^(2)=0.203).Conclusion:FLS task parameters did not correlate strongly with OSATS globing rating scale performance.Although FLS task models demonstrated strong validity,it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence,as evaluated by FLS and OSATS,respectively.

Theory and practice for assessing structural integrity and dynamical integrity of high-speed trains

Purpose–The safety and reliability of high-speed trains rely on the structural integrity of their components and the dynamic performance of the entire vehicle system.This paper aims to define and substantiate the assessment of the structural integrity and dynamical integrity of high-speed trains in both theory and practice.The key principles and approacheswill be proposed,and their applications to high-speed trains in Chinawill be presented.Design/methodology/approach–First,the structural integrity and dynamical integrity of high-speed trains are defined,and their relationship is introduced.Then,the principles for assessing the structural integrity of structural and dynamical components are presented and practical examples of gearboxes and dampers are provided.Finally,the principles and approaches for assessing the dynamical integrity of highspeed trains are presented and a novel operational assessment method is further presented.Findings–Vehicle system dynamics is the core of the proposed framework that provides the loads and vibrations on train components and the dynamic performance of the entire vehicle system.For assessing the structural integrity of structural components,an open-loop analysis considering both normal and abnormal vehicle conditions is needed.For assessing the structural integrity of dynamical components,a closed-loop analysis involving the influence of wear and degradation on vehicle system dynamics is needed.The analysis of vehicle system dynamics should follow the principles of complete objects,conditions and indices.Numerical,experimental and operational approaches should be combined to achieve effective assessments.Originality/value–The practical applications demonstrate that assessing the structural integrity and dynamical integrity of high-speed trains can support better control of critical defects,better lifespan management of train components and better maintenance decision-making for high-speed trains.

A longitudinal analysis of the U.S. Air Force Reserve Officers’ Training Corps physical fitness assessment

Background:The U.S.Air Force physical fitness assessment(PFA)is used to determine the overall fitness of their personnel.It is currently unknown to what extent the PFA scores of Reserve Officers’Training Corps(ROTC)cadets are affected by mandatory physical training.The purpose of this investigation was to longitudinally examine the PFAs of ROTC cadets over a four-year period,evaluate the results across class ranks,and evaluate the sensitivity of the classification of the tests.Methods:Air Force ROTC cadets performed the PFAs(abdominal circumference,1-min pushups,1-min sit-ups,and a 1.5-mile run)in both the spring(n=26)and fall(n=22)semesters.PFAs were compiled over a four-year period(Spring 2014–Fall 2017)and were performed in accordance with Air Force Instruction 36–2905.A oneway repeated measures ANOVA was performed separately for the fall and spring groups for each dependent variable across the 4 years.Additionally,a one-way between groups ANOVA was performed for each dependent variable during the time point(fall 2015;n=46)with the most recorded cadets for each class rank.Results:Longitudinal assessments revealed a main effect of time(P=0.010)on abdominal circumference;cadets had a smaller abdominal circumference in their freshman year than in their senior year.A main effect of time(P=0.006)was also observed on sit-up quantity;cadets performed more sit-ups in their junior year than in their freshman year.Examining between class ranks during the same year(between-subjects ANOVA)revealed a main effect of class rank on sit-up quantity(P=0.003);the freshmen completed fewer repetitions than the sophomores(P=0.018)and the juniors did(P=0.001).Conclusions:The results indicated that only the sit-up component showed differences between class ranks.These findings suggest that the Air Force PFA may not be sensitive enough to detect changes in physical fitness or distinguish between class ranks regarding physical performance,even after years of training.This limitation may be in part due to the limited duration of training incorporated by the ROTC program(2 h per week),which provided a maintenance effect rather than improvement in physical performance.We recommend that more attention be directed to the efficacy of physical training,the sensitivity of measures included in the PFA,or both.

基于Tri-training-SSAE半监督学习算法的电力系统暂态稳定评估

基于机器学习的暂态稳定评估方法主要采用监督学习方法,为了解决监督学习方法所需的有标签样本难以获取的问题,提出基于三体训练-稀疏堆叠自动编码器(Tri-training-SSAE)半监督学习算法的电力系统暂态稳定评估方法。构建基于堆叠稀疏自动编码器的暂态稳定评估模型;在传统的三体训练过程中加入伪标签样本置信度判断,以减小噪声数据对模型训练的影响;以堆叠稀疏自动编码器为基分类器构建三体训练-稀疏堆叠自动编码器模型,利用大量的无标签样本提高模型的泛化能力。通过IEEE 39节点系统与华东某省级电网进行分析验证,结果表明,所提方法在有标签样本数较少时具有更高的评估准确度。

Integrated assessment of sea water quality based on BP artificial neural network

In order to carry out an integrated assessment of sea water quality objectively, this paper based on the concept and principle of artificial neural network, generated appropriate training samples for BP artificial neural network model through the method of producing samples to the concentration of various pollution index of sea water quality from the viewpoint of threshold, established the BP artificial neural network model of sea water quality assessment using multi-layer neural network with error back-propagation algorithm. This model was used to assess water environment and obtain sea water quality categories of offshore area in Bohai Bay through calculating. The calculations shown that pollution index in river＇s wet season was higher than that in dry season from 2004 to 2007, and the pollution was particularly serious in 2005 and 2006, but a little better in 2007. The assessed results of cases shown that the model was reasonable in design and higher in generalization, meanwhile, it was common, objective and practical to sea water quality assessment.

Effect of Combined Low-frequency Repetitive Transcranial Magnetic Stimulation and Virtual Reality Training on Upper Limb Function in Subacute Stroke:a Double-blind Randomized Controlled Trail

The effect of combined low-frequency repetitive transcranial magnetic stimulation（LF r TMS） and virtual reality（VR） training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups： experimental and control. In experimental group, the patients received LF r TMS and VR training treatment, and those in control group received sham r TMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment（U-FMA） and wolf motor function test（WMFT）, and the secondary endpoint including modified Barthel index（MBI） and 36-item Short Form Health Survey Questionnaire（SF-36） were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study（55 in experimental group and 53 in control group respectively）. After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval（CI） 3.6 to 22.7, P〈0.01], WMFT scores（mean difference of 2.9, 95% CI 2.7 to 12.3, P〈0.01）, and MBI scores（mean difference 16.1, 95% CI 3.8 to 9.4, P〈0.05） were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF r TMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.

Analysis and Study on the Effect of PNF Stretching and Resistance Training on the Rehabilitation of Superior Chiasma Syndrome

In this paper,18 subjects with superior chiasma syndrome were analyzed and studied according to the inducement and correction method of superior chiasma syndrome by questionnaire survey,literature review and experimental research.To explore the effect of bad posture on the posture of patients,and to explore the effect of PNF stretching,anti-resistance training and manual loosening on the rehabilitation of patients with superior chiasma.Methods:the subjects were divided into three experimental groups,A,B and C,for 6 weeks,4 times a week for resistance training and PNF stretching training.It has been proved that the population with chest ambushes for a long time will cause the imbalance of muscle strength of shoulder,neck and chest,abnormal physiological curvature of cervical vertebrae and thoracic vertebrae,and induce chronic injury of shoulder and neck muscles and soft tissue,which will lead to symptoms of superior chiasma syndrome.According to the designed rehabilitation training experiment,PNF stretching training and anti-resistance training were carried out for the shoulder and neck muscles which caused superior chiasma syndrome,and the rehabilitation effect was very significant,which was obviously better than that of PNF stretching or resistance training alone.Therefore,PNF stretching and resistance training should be fully combined in rehabilitation training to improve the posture problem in order to achieve twice the result with half the effort.

Education Training Improvement of Built Environment and Energy Application Engineering in Line with the ABET Criteria

Built Environment and Energy Application Engineering(BEEAE),namely Heating,Ventilating,Air Conditioning and Refrigerating(HVAC&R),is one of the international accreditation programs.Its knowledge system of professional theory and professional education in accredited engineering academic programs must meet the requirements of the relevant international engineering certification.In view of professional engineers and technicians training of BEEAE,the professional training programs and the knowledge system are compared and explored in line with the international certification criteria.This study compares the items and requirements of different international certification criteria,and summarizes the experienced methods of education training.The undergraduate education and training programs are then improved in accordance with the requirements from international certification criteria.The BEEAE education training schemes should combine the knowledge system of the national professional guidance standards with the items from international certification criteria.

An Informative System Based on the Skill Gap Analysis to Planning Training Courses

By using the skill gap analysis we propose a new quantitative method to plan training courses. By comparing the differences between the competences needed to cover a position and the ones possessed, it is possible to find the cases that need to be trained. According to different situations we propose some algorithms to plan courses and to find the subjects that require to be trained.

Examining teachers' perceptions and practice of formative assessment in Chinese ESL classrooms

自2001年课程改革以来,中小学英语课堂形成性评价受到了教育管理者、研究者和实践者的广泛支持,但对于教师是如何理解和实施形成性评价的这一问题,还需要研究。本研究通过问卷调查方式探究中学英语教师对形成性评价的认识及其实施现状:(1)从六个维度(评价主体、评价构念、评价工具、评价时间、反馈、终结性评价与形成性评价之间的关系)了解教师对形成性评价的认识;(2)从五个方面(学习目标、反馈、终结性评价的形成性使用、不同学习阶段的形成性评价、自我和同伴评价)揭示教师形成性评价的实践特征。基于这些特征,本文为形成性评价教师培训提出了建议。

Communication Skills Training for Residents: Which Variables Predict Learning of Skills?

Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

Background: Life-threatening bleeding is a major cause of trauma-related deaths. Stop the Bleed—Active bleeding control (ABC) program in Hyderabad recently showed that lay first responders can be effectively trained. However, the willingness of high school students to train in bleeding control is unknown. We report Stop the Bleed training needs assessment from high schools in India and estimate the potential multiplier effect. Methods: A cross-sectional survey was conducted from 12 randomly selected schools in Hyderabad. The study was to understand current knowledge, skills and willingness to get trained and respond to life-threatening bleeding from injuries. 107 Participants (35 Teachers and 72 students) were purposively selected for telephonic interviews with a structured questionnaire. Results: Response rate was 93% overall. 80% of participants have never been trained in bleeding control. 84% reported willingness to be trained, train others and help bleeding victims. All the teachers reported that stop the bleed training would be useful in high schools. 70.6% of teachers recommended that training could start from middle school (10 to 15 years), 47% preferred the online training mode. Only 20% of participants had prior training in lifesaving first aid and 32% did not know the number of emergency medical services (EMS). Each trained participant has the potential to train 3 to 4 people at the household level and perhaps more at the community level. Conclusion: The surveyed schools in Hyderabad do not have the knowledge, skills, or training curriculum in Stop the Bleed. Students and teachers are willing to be trained and train others, with great potential for a “multiplier-effect” in the community.

Assessment and Analysis of Carrying Capacity of 350 km/h EMUs Operating on Beijing-Shanghai Highspeed Railway

This paper makes an analysis of the impact on the structure of the corridortype train working diagram by increasing the 350 km/h train pairs of Beijing-Shanghai High-speed Railway(HSR).According to the requirements of operation speed diversity,the multi-station receiving characteristics of cross-line trains and different train stopping schemes,this paper proposes a scheme of adding 350 km/h train pairs via computer analysis of carrying capability mode.The scheme is divided into three stages:(1)Initial stage:It is planned to increase trains running at 350 km/h,with 15~26 pairs of trains put into operation;(2)Rapid increase stage:27~142 pairs of 350 km/h trains are put into operation;(3)Full replacement stage:143~195 pairs of 350 km/h trains are put into operation,during which the number of cross-line trains under operation is controlled,the number of cross-line trains in each section is determined,the operation and connection scheme of cross-line trains is adjusted and the train stopping scheme is optimized.The results of this study were used for the adjustment of the train working diagram in the third quarter of June 25,2021 to increase the number of 350 km/h train pairs from 19 to 30 on Beijing-Shanghai HSR.350 km/h trains are evenly arranged during 7:00—19:00 on the train working diagram and 300 km/h trains are arranged by making full use of every time and space,to improve the travelling speed on Beijing-Shanghai HSR as a whole.

全科医学师资质量评价体系建设研究进展

保障全科医学师资质量不仅是培养合格全科医生的重要基础,而且关系到全科医学与其他专业学科之间的关联,是提高全科医学地位、促进全科医学发展的重要保证。本文通过查阅国内外全科医生培训、全科医学师资培训的相关网站及文献,对全科医学师资的角色和功能、准入标准、质量评价标准、认证标准进行总结,并对我国全科医学师资质量评价及认证指标体系的发展进行展望,提示未来应构建适应中国国情的全科医学师资质量评价及认定指标体系,成立权威的全科医学师资专业委员会,制定全科医学师资的准入、评价和考核标准,建立系统完善的全科医学师资培训管理制度,在各省筛选出1~2家优秀全科医学师资培训基地,建立一支相对固定、优质的全科医学师资队伍,这将为我国全科医学师资培养的持续质量改进提供有益借鉴。

视频喉镜结合综合困难气道训练考核系统在急诊规范化培训住院医师气管插管培训中的应用研究

目的探讨视频喉镜结合综合困难气道训练考核系统在急诊规范化培训住院医师气管插管培训中的应用效果。方法选择2022年1月—2023年6月在首都医科大学宣武医院急诊科轮转的住院医师58人,随机分为对照组(n=28)和试验组(n=30)。对照组应用直接喉镜结合综合困难气道训练考核系统进行气管插管技能培训,试验组应用视频喉镜结合综合困难气道训练考核系统进行气管插管技能培训。培训结束后对两组住院医师进行气管插管技能考核,内容包括正常气道和困难气道的气管插管,分别比较两组住院医师气管插管时间、一次性插管成功率、喉镜对门齿的压力、气管插管位置正确率的区别。另外,分别对两组住院医师进行教学满意度问卷调查。结果普通气道气管插管中,试验组与对照组喉镜对门齿的压力和气管插管位置正确率的差异无统计学意义(P>0.05);一次性插管成功率试验组大于对照组,气管插管时间试验组小于对照组(均P<0.05)。在困难气道气管插管中,试验组的一次性插管成功率和气管插管位置正确率大于对照组(P<0.05),插管时间和喉镜对门齿的压力明显小于对照组(P<0.05)。调查问卷自评显示,试验组对气管插管自信心和学习兴趣大于对照组(P<0.05),满意度和技能评分两组差异无统计学意义(P>0.05)。结论应用视频喉镜结合综合困难气道训练考核系统对急诊规范化培训住院医师进行气管插管培训可以提高气管插管成功率,减少对门齿的损伤,提高住院医师的学习兴趣。

形成性评价在眼科住院医师规范化培训中的应用

眼科住院医师规范化培训是毕业后医学教育的重要组成部分,首都医科大学宣武医院眼科不断改进对住院医师的管理及教学方法,在住院医师规范化培训专题讲座、教学查房和病例讨论等教学活动中,引入形成性评价,以《眼科培训细则》及推荐教材为指导,确定学习及评价范围,将每月进行的教学活动内容形成理论知识测试卷,对研究对象进行闭卷考试。试卷评阅后逐一反馈给住院医师,同时对每道题完成情况进行分析,反馈给相关授课教师。通过一段时间的尝试,发现住院医师对教学活动中知识点的掌握情况明显提升。对参与的教师和住院医师进行问卷调查显示,均对此培养方式有较高的满意度。在眼科住院医师规范化培训教学活动理论授课中应用形成性评价,可以调动住院医师参加教学活动的积极性和主动性,提高专注度和自主学习的意愿,促进课后复习及相关文献书籍的学习,有助于理论知识的掌握,提高学习成绩。同时此法有助于教师及时调整授课内容和方法,提高教学效率,更好地达到教学目的。

应用临床教学五步法进行形成性评价提升住院医师医患沟通能力

目的研究应用临床教学五步法进行形成性评价提升住院医师医患沟通能力。方法采用自身对照的队列研究方法,由参与研究的指导医师对自愿纳入研究的住院医师进行5次关于医患沟通技能的形成性评价,每次均应用临床教学五步法进行反馈指导。对形成性评价前后住院医师的自评和他评结果进行对比分析。结果21名住院医师纳入研究。第5次形成性评价得分(90.00±2.47)分与第1次得分(61.24±9.86)分相比,差异有统计学意义(P<0.01)。18名住院医师完成自评问卷,结果提示,应用临床教学五步法进行形成性评价后,住院医师更注意在沟通前了解患方的社会文化背景,并据此拟定不同沟通策略。在沟通中,住院医师更注意观察患者的表情和语气的变化,主动询问患者的理解程度、治疗期望和意愿(P<0.05)。结论应用教学五步法进行形成性评价可有效提升住院医师医患沟通能力。

医学影像相关专业实习导师制的实践探讨

医学生实习导师制作为人才培养新模式,在临床实习教学中具有很多优势。大连医科大学附属第二医院放射科在多年的导师制实践中进行了不断的改革与完善。包括综合衡量导师与学生各项素质,从而甄选合格的实习导师,并进行导师与学生的双向选择,建立完整考核体系。并在教学过程中实现教学内容的标准化和对学生的个性化培养,规范导师群体考评奖惩制度等一系列管理制度的完善与发展。同时也在实施过程中发现导师教学未尽其职、学生积极性欠佳以及教学方式、内容受限等一系列的问题,导致教学成果不理想。当然,导师制的优势也在逐步展现,不仅使实习学生在学习、工作甚至科研创新等多方面收获良多,而且对参与其中的实习导师的教学与个人发展也意义颇深。随着导师制的发展,其存在的问题将不断完善,定会培养更多优秀的毕业生。

失语症研究的语言学转向

失语症研究的发展经历了由医学主导到心理学主导,再到语言学主导,再到目前多学科交叉的变化过程。目前,在世界范围内从语言学视角开展失语症研究的热潮正在形成,主要包括失语症言语特征、失语症患者语言能力评估以及失语症的康复训练。本文从这三个视角介绍中西方失语症研究的概况,论述失语症研究需要开展的工作,尤其是我国失语症研究需要开展的工作,为我国语言学学者从事失语症研究指明方向。

药学教育实践教学形成性评价有效性探索

重视实践教学和应用型人才培养质量是高等药学教育的发展规律。有效、科学的形成性评价可为药学教育实践教学学习过程提供持续动态测评与反馈,为药学教育优质人才培养提供有力保障。文章总结提升药学教育实践教学形成性评价有效性的实践路径,为构建良好的形成性评价体系和保障育人质量提供参考和研究基础。