临床实习生常见问题以及应对措施

临床实习是临床专业医学生教学的重要环节,是培养学生充分掌握基本理论、基本知识、基本技能,是理论联系实践、积累临床经验的基础阶段,培养他们分析及解决问题的能力及临床操作技能的最佳途径之一,也是培养临床医学生向一名合格医生转变的重要教育过程。但随着人们法律意识的增强和思维方式的改变,医学生临床实习正面临着一些挑战和冲击,也是我们临床带教老师需要关注及期待解决的问题,如何保证和提高临床实习质量,已成为当前深化医学教学改革的重要研究课题之一。     

Critical assessment of intent-to-treat analyses

SUMMARY

Randomised clinical trial (RCT) is considered by many to be the gold standard in cost-effectiveness studies, as one is able to balance confounding factors by the procedure of randomisation. In many cases, intent-to-treat analysis (ITT) is preferred over other approaches in handling RCT data, for its extensive inclusion of all study subjects and complete collection of cost data. However, in situations where there are a large amount of drop-out subjects, it is necessary to consider other analytical methods together with ITT. Per-protocol analysis (PP) and as-treated analysis (AT) are two frequent options. PP only includes subjects with sufficient compliance to treatment, while AT categorises patients not only by treatment but also by compliance status. In real practice, scientists should balance the pros and cons of these methods and appropriately apply them to achieve maximum study validity.     

Community governance

American politics, especially at the national level, has become dysfunctional; citizens are deeply frustrated with their political leaders and feel that political institutions are unresponsive and corrupted by entrenched power and money. Government leaders must bear the brunt of this anger and distrust, and subsequently feel a sense of disconnection between themselves and those whom they serve. Ironically, at the same time as the ability of local government to solve problems is severely hindered due to this ‘disconnect,' devolution at the federal and state level is forcing local government to take more and more responsibility for resolving local challenges. This essay argues that the solution to this impasse lies in re-inventing the way communities operate—we need to make a shift from government to governance. The dominant model of local politics, which fit the political landscape of the 1940s–1970s, vested decision making authority solely with governmental leadership; citizens voted and governors governed. This essay describes a new mode of operation, one where non-governmental actors are ‘granted a seat at the table.' In this model the goal of political struggles is no longer to defeat your enemy, but to reach collaborative, consensus-based decisions; government, business, community groups and citizens work together; and leaders share power, working to enable others to decide issues.     

临床医学专业教学模式和课程设置问卷调查分析及改革建议

为客观评价黄石理工学院医学院临床医学专业教学改革的效果,对其所开设的28门课程和应用的教学模式在临床医学专业学生中进行问卷调查。要求不记名回答提问,收到有效反馈表47份,并进行了统计分析,获得了有意义的分析结果。根据这些结果,进行评价并提出改革建议,这对今后临床医学专业的教学改革有一定价值。     

高职临床医学专业学生就业情况调查与分析

通过对我院临床医学专业毕业班学生的调查,了解高职临床医学专业学生的就业愿景、就业现状,分析导致就业困难的各种因素,为临床医学专业课程改革提供线索。     

职业专业化与临床教师教育管理

适应教师职业专业化的发展趋势,本文以国际标准为导向,探索双师型临床师资队伍专业化建设,改变临床教学调查中反映出临床教师现代教育素养修炼不高及部分临床师资对师德规范和人文教育的认知缺失的现状。     

ICU临床带教心得

目的:探讨ICU护生带教方法与带教心得。方法:采用"总带教与带教老师相结合"的教学模式对护生进行带教。结果:通过教学满意度反馈表调查显示对ICU教学满意度达到95%以上。     

The Dynamics of Embedded Rules: How Do Rule Networks Affect Knowledge Uptake of Rules in Healthcare?

Rules – in organizations and elsewhere – often become connected to other rules pertinent to similar or related action, and often they form rule networks that structure entire organizations and jurisdictions. Although rule networks are a common phenomenon, their effects on rule change have found little attention so far. How do rules change when they become embedded in rule networks? We build on prior conceptions of performance programs, organizational learning, and organizational knowledge to explore how rule network characteristics affect different types of knowledge uptake revisions of rules. Our analysis is quantitative and longitudinal and draws on archival data of clinical practice guidelines in a Canadian regional healthcare organization. Our findings indicate that the inbound networks of guidelines significantly affect their revisions. Our study suggests that rule networks shape the speed and direction of knowledge uptake of rules. Rules are dynamic, and their elaboration is path dependent and network dependent.     

论非法学专业民商法课程教改——适应专业需要 还原法律本质

民商法课程在非法学专业学生的培养方案中承担着普法、专业和道德教育等特殊使命,应明确其性质和地位,科学安排开设时间和课时数量,改良演讲式、判例式等教学方法,辅以新颖生动的教学手段,转变僵硬的考核方法,内外结合的系统的教学改革可尽快提高民商法的教学质量和效果。