The"4+4"Medical Doctor(MD)Pilot Program at PUMC:Implementation,Performance,and Prospects

Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective:The study aimed to assess medication management compliance and mental health in elderly patients with hypertension.Method:The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling.Data was collected using the Morisky Medication Compliance Questionnaire,Hospital Anxiety and Depression Scale,and a checklist.Ethical practices were strictly observed.Results:A study of 100 elderly hypertensive patients found poor drug management compliance,with female patients showing worse compliance.Female patients were more vulnerable to anxiety and depression.The study also found no significant association between gender,age,education level,marital status,living standards,and medication compliance.Barriers to medication management included food and daily necessities,lack of awareness about the importance of drug treatment,and basic family needs.The lowest-ranked barriers were lack of support from government health clinics,low income,and lack of family support.Conclusion:Based on the results,the study proposes an educational plan for elderly hypertensive patients and their families,to be evaluated and implemented by the hospital and township community service center.The plan aims to improve medication management and lifestyle modification compliance,encourage active participation,and provide access to medical and mental health clinics,support groups,and counseling services.

Evaluation of Length of Hospital Stay Joining Educational Programs for Type 2 Diabetes Mellitus Patients: Can We Control Medical Costs in Japan?

Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.

U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Effect of Medication Safety Education Program on Intensive Care Nurses’ Knowledge regarding Medication Errors

Background: Medication errors are the iceberg of patient safety in hospitals and leading cause of morbidity and mortality among patients. Objectives: The study aim was to evaluate the effect of an educational program of medication safety on the knowledge of critical care nurses regarding intravenous medication errors. Methods Design: There are one group pretest and posttest designs. Subject: A convenient sample of all registered nurses (52) works in Palestine Medical Complex. Data collection tools: A self-administered knowledge determination questionnaire consists of both qualitative and quantitative statements to measure level of knowledge, used as data collection tool in pre and post educational sessions, with educational booklet as intervention tool. Statistical analysis: Data were analyzed with Statistical Package for the Social Sciences Software Version 18. The results are presented as frequency & percentage as appropriate at alpha level of P < 0.05;inferential statistics were generated. Paired t-test was used to perform the comparisons. Results: There was statistically significant difference in the knowledge level for the intensive care unit’s nurses regarding the intravenous medication administration during pre and post education program. Statistical analysis showed that there was a statistically significant between age, educational degree, critical units/wards, years of nursing experience and previous medication administration education program of the nurses and their knowledge during different phases of program intervention. Conclusion: Educational program on medication safety improves the knowledge of critical care nurses regarding intravenous medication errors. This study recommends that medication errors should be periodically assessed by improving clinical guidelines of medication administration.

Practice and Exploration of Economic Benefit Evaluation of Medical Equipment in Our Hospital

Objective The evaluation index of medical equipment's economic benefit is based on the usage of medical equipment,the traditional data collection method is time-consuming,laborious and not entirely accurate.The usage of medical equipment is obtained by designing data query statements from the HIS system.Methods First the charging items are in correspondence with the device's name included,second fees and other relevant data are extracted from charging module in HIS.Through a rough estimate of the recovery period and an increase or decrease ratio,the economic benefit of the medical equipment can be analyzed.Results Through the method of the benefit analysis of the medical equipment,we can clearly find out the different economic benefit of the equipment,and finally analyze the reasons.Conclusion Practice has proved that,this methad,it can greatly reduce human,material resources required in data collection and improve the accuracy of the data.It can help hospital managers timely to grasp the operating costs of medical equipment and other information,and also provide scientific data for hospital managers when they purchase reasonable medical equipment.

Household Disposal and Recycling of Medication in Saudi Arabia: A Call for Introducing Drug Take-Back Programs

Background: Inappropriate disposal practices of medicinal products by households can harm nature. Alternatively, passing unused medications to friends and family members can have undesirable consequences as the quality of the product is in question. Objective: To investigate the disposal and recycling practices of medicinal products by households in Saudi Arabia. Methods: A cross-sectional questionnaire designed to investigate disposal and recycling practices aimed at households in Saudi Arabia. Phone interviews were conducted with healthcare providers from hospitals and community pharmacies as well as medical charity representatives. A thorough search (Jun-September 2020) for disposal and recycling policies was performed on the Saudi Food and Drug Authority (SFDA) and the Ministry of Health websites. Results: More than 900 participants were included in this study. Approximately 40% of respondents claimed to follow the SFDA recommendations for the disposal of unwanted medications in the wastebasket, whilst ≥6% preferred disposal via the toilet. On the other hand, 10% and 5% of households donated their unwanted over-the-counter and prescription-only medication products, respectively, to a person in need, without referring to healthcare professionals. Interviews with healthcare providers and medical charities revealed no drug take-back programs were currently available for households. The SFDA website provides a brief guide on the disposal of unwanted or expired medication. Conclusions: The absence of a clear drug disposal policy for households has created a gap allowing incorrect disposal practices that may lead to harming patients and/or the environment. The launching of drug take-back programs may lead to the provision of a clear consensus of governing bodies and healthcare providers on patient guidance for a safe drug disposal policy.

he Design and Implementation of Medical Image Processing System based on DICOM Format

In order to fast transmission and processing of medical images and do not need to install client and plug-ins, the paper designed a kind of medical image reading system based on BS structure. This system improved the existing IWEB in the framework of PACS client image processing, medical image based on the service WEB completion port model. To realize the fast loading images with high concurrency, compared with the traditional WEB PACS, this system has the advantages of no client without plug-in installation, at the same time in the transmission and processing performance image has been greatly improved.

CBL联合PBL在神经外科住院医师规范化培训教学中的应用研究

目的:在神经外科住院医师规范化培训中按照规范化培训的大纲要求,引入特定情景的临床案例,并结合问题引导式的教学方法,探讨这一教学模式在临床规培生教学中的效果。方法:纳入某院神经外科规范化培训并自愿报名的40名学员,随机分成两组,对照组采用传统的教学方法授课,观察组采用案例分析(CBL)结合问题导向(PBL)联合教学,比较两种方法的教学效果。结果:观察组学员在出科考核多项环节中(自主学习能力,问题解决能力,团队合作能力以及综合考核)成绩明显优于对照组(P<0.05),同时观察组学员对教学模式评分也高于对照组(P<0.05)。结论:CBL联合PBL在神经外科规范化培训中能更好地提高学员对理论知识的理解和掌握,获得了广大学员的欢迎。

关于医学专业“大创计划”参与度调查及近6年“大创项目”分析

目的:为提高医学类大学生创新创业型人才的建设质量,以“大创计划”为出发点,从大学生参与情况及近年来获奖项目详情2个角度进行深入分析,为创新创业型人才的培养提供可靠的数据支持。方法:结合文献及学生访谈对问卷进行设计,采用问卷星进行线上匿名问卷调查大学生“大创计划”的参与情况并对2015年至2020年我校国家级和省级“大创项目”的项目学院、项目类型、项目类别、项目级别进行统计描述,卡方检验进行不同专业组间的比较,SPSSAU.(Version 20.0)对数据进行统计分析及可视化。结果:医学类大学生参与度明显高于非医学类大学生,“大创计划”中兴趣度最高的项目类型是“创新训练类项目”,未参与“大创计划”的主要原因是“不知道参加途径”。2015年至2020年我校6个医学类学院申请的国家级和省级“大创项目”占比最高的项目类型是“创新项目类”,项目类别占比最高的是“科学探索类”。结论:目前我校医学类大学生“大创计划”参与度尚可,对于未参与“大创计划”的大学生需要提供更多的参与机会和多样化结题标准;医学类大学生对创业型项目的兴趣度有待提高,项目类别上“科学探索类”热度最高。

浙江大学医学生创新性实验项目的调查分析

大学生创新创业训练计划是高校教育教学改革的重要环节,也是高校深度融入国家创新体系的重要举措。文章就浙江大学医学部2020-2023级医学类专业本科教育阶段学生63人参与大学生创新创业训练计划项目(简称大创项目)的情况进行了问卷调查。结果表明,该项目有助于提升医学学生的综合能力,包括发现问题与解决问题的能力(73.77%)、文献检索能力(80.33%)、实验操作能力(73.77%)、数据整理与分析能力(81.97%)、学术论文构思与写作能力(62.30%)和团队协作能力(75.41%)。大创项目的训练不仅有益于提高医学生的主动学习能力和热情,而且有利于提高医学生的科研创新能力和医学生的综合能力,同时获得学术产出。

某市预防接种人员对非免疫规划疫苗推荐意愿及影响因素分析

目的探讨某市预防接种医务人员对非免疫规划(expanded program on immunization,EPI)疫苗推荐意愿及影响因素。方法选取2021年8月—2022年12月聊城市疾病预防控制中心免疫规划管理所500名预防接种医务人员为研究对象。调查医务人员非EPI疫苗推荐意愿,并采用多因素logistic回归分析影响医务人员非EPI疫苗推荐意愿的危险因素。结果纳入的500名调查对象中,非EPI疫苗的推荐意愿率为65.20%(326/500),其中流感疫苗(flu vaccine,FLU)、水痘减毒活疫苗(live attenuated varicella vaccine,VarV)、b型流感嗜血杆菌疫苗(Haemophilusinfluenzae type b vaccine,Hib)、乙型肝炎疫苗(hepatitis B vaccine,HepB)的推荐意愿率分别为88.60%(443/500)、84.00%(420/500)、79.00%(395/500)和77.20%(386/500),其他5种非EPI疫苗的推荐意愿率为36.60%~58.00%。单因素分析显示,工作年限、收入是否与非EPI疫苗接种量有关、是否经历疫苗负性事件、是否认为预防接种工作有风险、疫苗接种流程、接种工作量及被推荐者态度不同者非EPI疫苗推荐意愿率比较差异有统计学意义(P<0.05);不同性别、年龄、文化程度、职称、工作岗位、非EPI疫苗知识是否知晓者非EPI疫苗推荐意愿率比较差异无统计学意义(P>0.05)。多因素logistic回归分析显示,工作年限(OR=4.008,95%CI1.528~10.934)、经历疫苗负性事件(OR=4.870,95%CI 1.328~17.859)、疫苗接种流程(OR=5.275,95%CI1.541~18.063)、接种工作量(OR=4.773,95%CI1.413~16.122)及被推荐者态度(OR=5.778,95%CI1.772~18.838)是预防接种医务人员非EPI疫苗推荐意愿的影响因素(P<0.05)。结论某市预防接种医务人员非EPI疫苗推荐意愿总体处于较低水平,且工作年限、经历疫苗负性事件、疫苗接种流程、接种工作量及被推荐者态度均是其主要影响因素,建议完善非EPI疫苗预防接种保障措施,以提高预防接种医务人员非EPI疫苗推荐意愿。

基于RE-AIM和柯氏模型的反思实践培训方案在本科医学带教中的应用

目的观察基于可及性、有效性、采用率、实施性与持续性(reach,effectiveness,adoption,implementation,maintenance,RE-AIM)和柯氏模型的反思实践培训方案在本科医学带教中的应用效果。方法选取2022年3月-2023年6月重庆医科大学附属第一医医学临床医学专业学生124名,使用随机数字表法将其分为对照组(n=61)及研究组(n=63)。对照组采用传统教学方案,研究组使用基于RE-AIM和柯氏模型的反思实践培训方案进行教学。观察2组学生的教学效果、考核成绩、自我效能、批判思维评分及学生满意度。结果研究组临床思维能力、医学人文精神、公共卫生服务、社区情怀评分均高于对照组;研究组实践成绩、理论成绩、总分高于对照组;研究组工作职责评分、教育要求评分高于对照组;研究组寻找真相、自信心、求知欲、分析能力、开放思维、认知成熟度、系统化能力7个维度均高于对照组;研究组学习兴趣激发、思维能力提高、自学能力培养、理论知识掌握、语言和表达能力提高5个维度满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论基于RE-AIM和柯氏模型的反思实践培训方案有助于提高本科医学生的教学效果,提高教理论及实践成绩,培养实习生批判思维并提高其对带教工作的满意。

多元视角探索下订单定向医学生满意度调查

[目的]从在岗订单定向医学生、履约单位及当地卫生健康管理部门等多元视角深入探究订单定向医学生的工作满意度与履约单位、卫生健康管理部门之间的相互满意度及影响因素,为提升基层全科医生的培养、使用及管理提供参考。[方法]采取整群抽样方法,对山西省683名在岗履约订单定向医学生、162家履约单位及45家卫生健康管理部门进行线上问卷调查,采用统计描述、秩和检验、多重响应分析和非条件Logistic回归进行数据分析。[结果]70.4%的在岗订单定向医学生对目前工作现状满意,85.1%的履约单位对订单定向医学生表示满意,98%的卫生健康管理部门对订单定向医学生表示满意。薪资、工作环境、医疗设备状况是影响订单定向医学生满意度的主要因素,专业知识能力、临床操作能力、团队协作能力是影响履约单位对医学生满意度的主要因素。[结论]卫生健康管理部门对订单定向培养政策比较满意,而订单定向医学生与履约单位相互满意度有待提高,需提高薪酬水平,注重全科特色岗位胜任力培养。

中医药院校医工融合类专业实践项目管理平台的开发与实现

文章结合中医药院校医工融合类专业的特色,建立以多学科专业学生为主体,教师为引导,过程管理为重点,学生评价和项目评估为手段的一体化管理流程,旨在加强中医药院校多学科师生团队的专业思想交流,提升实践和创新能力,发掘更多优质的科创项目,推动成果转化落地,促进中医药创新发展。

八年制临床医学教育质量的学生评价与分析

基于全国11所八年制临床医学教育培养单位的毕业生调查数据,从培养入口、培养过程和培养出口三个层面对我国八年制临床医学生的培养状况、就读体验和职业发展进行实证分析。结果表明,我国八年制临床医学教育存在培养目标定位不够明确、教学方法较为单一、部分课程质量不高、毕业生科研能力发展欠佳、工作负担较重、职业满意度不高等挑战。为了提高八年制临床医学教育培养质量,要进一步从强化学生学习动机、丰富教育教学方法、重视学生科研能力培养、提高课程质量、明确培养目标、做好学生职业生涯规划等方面不断加以完善和改进。

职教本科试点背景下思政课教师适应性提升策略研究——以四川省医药卫生类专业为例

本科层次职业教育(以下简称职教本科)试点是职业教育改革发展的新事物,对职业教育思想政治理论课(以下简称思政课)提出了新要求。文章以医药卫生类专业开展职教本科试点为例,探寻职教本科试点思政课产生的变化,通过研究发现职教本科试点思政教师存在课程开发、科学研究、指导帮助、信息化应用等能力不足的问题,进而提出思政教师要做学生终身学习的示范者、做课程开发的推动者、做教法变革的践行者、做数字化改造的建设者、做课程思政的指导者等对策,以提高他们对职教本科试点的适应性。

罕见病医学科临床医学博士后教学模式探索

临床医学博士后培养项目是中国探索新时代医学精英教育的崭新形式。北京协和医院罕见病医学科是2023年成立的国内首个开展罕见病诊疗的临床科室,基于《中国住院医师培训精英教学医院联盟住院医师核心胜任力框架共识》,罕见病医学科探索了独特的临床博士后教学模式。该模式强调在三基三严的基础上全面提升学员核心胜任力,优化教学评价和反馈体系,有望成为中国复合型罕见病医学精英人才的教育样板,为我国罕见病领域培养具备优秀临床思维和综合能力的复合型人才奠定基础。

美国公共医保仿制药替代制度评价研究——基于Medicaid计划的实证分析

本文以Medicaid计划为研究对象,分析美国公共医疗保险仿制药替代体系运行机制,定量评估其在节省医保费用和促进仿制药产业发展方面的作用,为我国医疗保险制度改革提供借鉴。

基于微信小程序的疼痛药物剂量设置工具研发与应用

目的研发关于疼痛药物剂量设置微信小程序,并测试其可用性。目的2020年1-2月,根据临床需求组建团队研发。3-4月,采用方便抽样法行预实验,选取某三甲医院的医生和护士各20名,分别使用该小程序和传统计算器进行不同阿片类药物的剂量转换(医生)及患者自控镇痛泵的药物参数设置(护士)各400次,比较所需时间及正确性,并采用易用性量表(USE)评价小程序。目的医生、护士运用小程序计算的准确率为100%,均高于传统方法(p<0.01);计算所需时间均快于传统方法(p<0.01);医生和护士USE量表的平均得分分别为6.56±0.20分、6.60±0.19分。目的研发的小程序为医生转换疼痛药物剂量提供参考,满足护士对镇痛泵参数的准确计算和设置的需求,医护人员的接受度较高,可用性好。