Neurocritical Care Training for the Neurosurgery Resident

Introduction: Recent data has associated favorable outcomes in patients who were treated in a “semi-closed” intensive care unit and attended to by a devoted team of neurointensivists as opposed to the neurosurgeons. This has led many to question the need for dedicated critical care education in the neurosurgical residency training program. Our aim was to determine what current neurosurgery residents and program directors/chairman thoughts were on NCC education in neurosurgical resident training, and to discuss possible methods to allow for collaboration between the NCC team and the neurosurgeons. Methods: Surveys were sent out electronically to all residency programs. Thirty-nine responses from junior residents, 36 responses from senior/chief residents, and eight responses from program directors/chairman were obtained. Results: No statistical difference between the majority responses of the different level residents, and between program directors/chairman and combined resident responses. Conclusions: Clearly, neurosurgery residents of all levels and program directors/chairman value NCC education and see a valuable role for this knowledge in their future. Most residents however do not want to spend an additional year of fellowship training to become certified neurointensivists. We discuss the role of NCC education in residency training and possible solutions to allow collaboration between the NCC team and the neurosurgical team.

Post competency training in standardized training of resident physicians and integrated postgraduates

We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.

Application Effect of Remote Ultrasound Teaching in Standardized Residency Training

Objective:To explore the application effect of remote ultrasound teaching in the standardized training of residents.Methods:42 students who participated in the standardized residency training in the Department of Ultrasonography of our hospital from August 2022 to August 2023 were selected and divided into the control group(n=21)and the observation group(n=21)by using the random number table method.The control group was taught routinely,and the observation group was taught with remote ultrasound on the basis of the control group.The general data,teaching effect,ultrasound diagnostic compliance rate,and teaching satisfaction of the participants in the two groups were observed.Results:The baseline data of the two groups were not statistically significant(P>0.05);the theoretical and practical assessment scores of the observation group were significantly better than those of the control group(t=2.491,t=2.434,P=0.05);the ultrasound diagnostic compliance rate of the participants in the observation group was significantly higher than that of the control group(78.33%)(χ2=33.574,P=0.000<0.001);the overall satisfaction rate of students in the observation group(20/95.24%)was significantly higher than that of the control group(14/66.67%)(χ2=3.860,P=0.049<0.05).Conclusion:In standardized residency training,remote ultrasound teaching can effectively improve the comprehensive ability of students,enhance diagnostic accuracy,and improve students’teaching satisfaction.

Exploration of the Integration of Curriculum Ideology and Politics into the Educational Pathway of Standardized Training for General Practice Residents

In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.

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.

Daily activities and training experiences of urology residents during the coronavirus disease 2019 pandemic in Indonesia: A nationwide survey

Objective:To explore the impact of the coronavirus disease 2019(COVID-19)pandemic on the training experiences of urology residents in Indonesia.Methods:A cross-sectional study using a web-based questionnaire(SurveyMonkey)involved all registered urology residents in Indonesia.The questionnaire was structured in Bahasa Indonesia,composed of 28 questions,and divided into three sections:demographic characteristics,current daily activities,and opinions regarding training experiences during the COVID-19 outbreak.The survey was distributed to all respondents via chief of residents in each urology center from May 26,2020 to Jun 2,2020.Results:Of the total 247 registered urology residents,243 were eligible for the study.The response and completeness rate for this study were 243/243(100%).The median age of respondents was 30(range:24e38)years old,and 92.2%of them were male.Among them,6(2.5%)respondents were confirmed as COVID-19 positive.A decrease in residents’involvement in clinical and surgical activities was distinguishable in endourological and open procedures.Most educational activities were switched to web-based video conferences,while others opted for the in-person method.Smart learning methods,such as joining a national or international speaker webinar or watching a recorded video,were used by 93.8%and 80.7%of the respondents,respectively.The respondents thought that educational activities using web-based video conferences and smart learning methods were effective methods of learning.Overall,the respondents felt unsure whether training experiences during the COVID-19 pandemic were comparable to the respective period before.Conclusion:The COVID-19 pandemic negatively affected urology residents’training experiences.However,it also opened up new possibilities for incorporating new learning methodologies in the future.

基于模糊综合评判的住院医师规范化培训带教质量评价

带教质量直接影响住院医师规范化培训工作中最终输出人才的质量,对带教质量进行合理、有效的评价,是提升住院医师规范化培训质量、完善住院医师规范化培训制度的重要保证。针对住院医师规范化培训工作中带教质量评价因素的复杂性、模糊性以及定性指标难以量化的问题,提出一种基于模糊综合评判的带教质量评价方法。首先,进行一级评判,通过确定因素集、评价集,进行单因素评价,再确定各因素的权重,进行综合评价;其次,进行二级或多级综合评判,构建基于模糊综合评判的带教质量评价模型;最后,通过带教质量的模糊综合评价实例,对带教质量的评价方法进行研究。

5A教学模式在普通外科住院医师规范化培训中的应用

目的探讨5A教学模式在普通外科住院医师规范化培训中的应用效果。方法采用随机对照研究方法,以2020年1月至2022年12月在解放军总医院第一医学中心普通外科医学部接受住院医师规范化培训并进入本研究团队主诊组轮转学习的学员为研究对象,随机分为试验组和对照组。试验组20名,采用5A教学模式;对照组20名,采用传统教学模式。对2组学员进行理论考核、临床技能考核和综合能力考核,记录考核成绩,并比较2组的教学效果。结果相对于对照组,试验组学员在消毒铺巾、切开缝合和腔镜技能考核3个方面的成绩得到提高,差异有统计学意义(P<0.05);试验组学员在团队协作和科学研究2个方面的成绩高于对照组,差异有统计学意义(P<0.05);试验组学员带教满意度高于对照组,差异有统计学意义(P<0.05)。结论5A教学模式可以显著提高学员的临床实践操作、团队协作和科学研究能力,可作为普通外科住院医师规范化培训的有效教学方法。

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.

Application Research of Fragmented Case Teaching in Standardized Training of Residents in Anesthesiology Department

Objective:To explore the effect of fragmented case teaching in the standardized training of residents in anesthesiology department.Methods:80 doctors who participated in the standardized training of residents in anesthesiology department from January 2021 to January 2022 were selected as the research objects,and the 80 doctors were divided into experimental groups according to the clinical teaching mode(n=40,implemented case fragmented teaching method)and the control group(n=40,traditional teaching method).The training lasted for 2 months,and the medical history collection,medical record analysis,practical operation ability,theoretical assessment results,and the degree of satisfaction towards the training of the two groups of doctors were compared.Results:After 2 months of training,the theoretical knowledge and operational ability of the doctors in the two groups have improved to a certain extent,but the medical history collection,medical record analysis,practical operation ability,theoretical assessment results and satisfaction of the doctors in the experimental group were significantly better than those in the control group(P<0.05).Conclusion:The effect of the fragmented case teaching method in the standardized training of anesthesiology residents is significantly better than the traditional teaching mode.The abilities of doctors have significantly improved after the training.Hence,the fragmented case teaching method is worthy of promotion in clinical practice.

基于临床路径的多元混合教学法在内分泌住院医规范化培训中的探索

目的探讨基于临床路径(CP)的多元混合教学法在内分泌住院医规范化培训中的教学效果。方法对2020年1月-2020年12月内分泌科轮转的内科及全科住院医规范化培训97学员按照入科时间分为对照组(CPL+PBL+CBL)和观察组(CPL+PBL+改良CBL),通过教学效果、学员岗位胜任力、教学满意度三个维度进行定量研究。结果两组间出科考试理论成绩、教学满意度差异无显著性,P>0.05。观察组学员病例分析能力和岗位胜任力(CCMTV住培管理系统中360度评估)优于对照组,P<0.05。结论以CP教学法为基础,联合PBL、CBL教学法的多元混合教学模式适用于内分泌住院医规范化培训,在此基础上改良CBL教学法有利于学员临床思维和岗位胜任力的培养。基于临床路径的混合教学法在内分泌住院医规范化培训中具有良好的应用前景。

翻转课堂联合SimMan 模拟人在住院医师ACLS非技术能力培训中的应用

目的 本研究探讨翻转课堂教学法联合SimMan模拟人在住院医师高级心脏生命支持(advanced cardiac life support, ACLS)非技术能力培训中的应用效果。方法 选取西安交通大学第一附属医院80名三年级住院医师作为研究对象,将其随机分为翻转课堂组和传统课堂组,并应用SimMan模拟人进行ACLS的模拟培训。最后采用实践测试、非技术能力测试和问卷调查评估两种教学方法的培训效果。结果 翻转课堂组学员正确使用除颤仪得分、正确使用肾上腺素得分、团队合作得分及测试总得分高于传统课堂组学员,组间差异具有统计学意义(P<0.05)。较传统课堂组,翻转课堂组经过ACLS模拟培训后在情景意识、任务管理、团队合作及判断决策等非技术能力方面的合格率均明显升高(P<0.05)。问卷调查结果显示,翻转课堂组学员在良好的课堂互动、激发学习兴趣和积极性、加强团队合作和总体满意度方面优于传统课堂组,其差异均具有统计学意义(P<0.05)。结论 翻转课堂教学法联合SimMan模拟人可提高高年资住院医师的ACLS实践测试成绩和非技术能力,并增加学生满意度,在ACLS培训中具有重要的应用价值。

住院医师规范化培训师资队伍能力提升路径探讨

住院医师规范化培训(简称“住培”)指导医师的综合能力和素质是培养优秀住院医师的重要保障,也是影响住培质量的关键要素。随着我国住培管理制度的不断完善,住培师资队伍能力提升最主要的途径已不仅限于师资培训,骨干师资培育计划也逐渐成为高效提升住培师资能力的创新途径。骨干师资培育计划将住培师资培养目标进行了更加细致的划分,指导医师以自身教学业绩及教学能力水平等为基础,通过开展一系列的教学活动逐步提高综合教学能力。教学管理部门组织专家通过遴选体系、培训体系、考核体系对骨干师资培育对象进行严格的三级培育体系管理,严把入口、过程、出口三个关键环节,强调过程管理和目标考核,并引入住培督导反馈机制,同时配套资助及激励政策。骨干师资培育计划的开展探索了住培师资队伍建设的新途径,对逐步分层次提升住培师资能力提供新的思路。

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。

“双导师制”管理在麻醉专业学位研究生与住培并轨教育中的应用

目的:在麻醉学专业学位研究生与住培并轨教育中引入“双导师制”协同管理模式,探究该模式在提升教育质量与学生职业能力方面的有效性。方法:本研究选取中国医科大学附属盛京医院麻醉专业的60名硕士研究生为对象,通过随机数字表法分为对照组(n=30)与试验组(n=30)。对照组采用传统单导师教学模式,而试验组则实施创新的“双导师制”模式。试验组研究生除了接受学位导师的科研指导外,还配备经验丰富的住培导师,专注于临床实践能力的培养。本研究通过研究生自评问卷与专业考核成绩对教育效果进行评估。结果:相较于对照组,试验组在自评问卷和专业考核成绩上表现更佳(P<0.05)。结论:“双导师制”管理模式的引入显著提高了麻醉专业学位研究生的教育质量,有效增强了学生的专业能力和实践技能。

以培养自主学习能力为导向的中医康复科线上线下混合住培模式构建

以培养自主学习能力理念为导向,构建中医康复科的线上线下相结合的住院医师规范化培训新模式,更新并完善教学设计,充实教学内容。利用教学短视频等信息化教学资料传播方式,使线上和线下教学内容形成互补,并紧密结合。尤其是在疫情期间,充分的线上教学资料保障了教学工作的稳定开展,现代化和信息化的教学方式受到学生认可与喜爱,提高了学生自主学习的积极性。但教学实践活动的开展效果要有相应的考核方法,基于上述新模式,还应建立过程性评价与终结性评价相结合的康复科考核办法,以提高学生的自主学习能力与临床综合实践能力。

慕课在普通外科住院医师规范化培训中的应用效果

目的分析慕课在普通外科住院医师规范化培训中的应用效果。方法选择2021年1月—2022年1月在佳木斯大学院临床医学院轮转的100名普通外科住培医师为研究对象,采用随机数字表法分为对照组(传统临床教学模式)和观察组(慕课结合传统临床教学模式),每组50名。比较2组的评判性思维、理论考核、操作技能、手术技巧、医患沟通能力评分及满意度。结果开课前,2组住培医师的评判性思维评分比较,差异无统计学意义(P>0.05);开课后,观察组住培医师的评判性思维评分高于对照组,差异有统计学意义(P<0.05)。观察组住培医师的理论考核、操作技能、手术技巧、医患沟通能力评分[(91.32±5.23)分、(94.66±3.54)分、(8.96±1.15)分、(9.32±0.23)分]高于对照组[(86.69±4.56)分、(88.67±5.64)分、(7.01±1.12)分、(7.69±1.56)分],差异均有统计学意义(P<0.05)。观察组住培医师的满意度高于对照组,差异有统计学意义(P<0.05)。结论慕课对普通外科住院医师规范化培训的综合应用价值更高,在对住培医师的临床教学中,采用慕课的教学模式能进一步提升外科住院医师的批判性思维、理论知识以及实践技能,同时外科住院医师对培训结果的满意度更高,该临床教学模式的综合价值较高。

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。

情景模拟结合CBL对提升产科住院医师医患沟通能力的效果分析

目的探讨在产科住院医师规范化培训(简称住培)中进行情景模拟结合以案例为基础的教学对医患沟通技能培训的效果。方法选取50名在产科规范化培训的住院医师为研究对象。培训前进行学员调查和医患沟通能力SEGUE测评。基于产科住培大纲选择5个典型病例情景,由教师录制5个典型病例病情医患沟通的示范视频,并梳理相关背景知识,在产科住院医师中依次开展培训课程,即视频示范、小组讨论、病例背景知识梳理讲解、分角色演练、演练后反馈和评价以及临床实践。培训后再次进行学员调查和医患沟通能力SEGUE测评。使用配对样本的非参数检验方法评价培训效果。结果情景模拟结合以案例为基础的教学的医患沟通技能培训后,学员医患沟通能力SEGUE测评总分提高[13.00(11.00~16.00)vs.22.00(20.00~24.00)],差异具有统计学意义(Z=-6.159,P<0.001);医患沟通能力SEGUE测评总体合格率提高[36.0%(18/50)vs.98.0%(49/50)],差异具有统计学意义(χ^(2)=43.464,P<0.001)。结论情景模拟结合以案例为基础的教学的医患沟通技能培训可有效提高学员医患沟通能力,调动学员的学习主动性,激发学员内在学习动力,建议在产科住培中纳入此类课程。

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。