临床医学硕士研究生的培养教育和发展设想

本文通过对临床医学硕士研究生培养教育的现状和存在问题进行阐述,提出在明确培养目标、改革课程教学内容和时间、调整学位类型设置比例及加强临床能力培训,建立临床能力考核体系等几方面的发展设想.     

Team-Based Ultrasound Objective Structured Practice Examination (OSPE) in the Anatomy Course

The clinical use of ultrasound has dramatically increased, necessitating early ultrasound education and the development of new tools in ultrasound training and assessment. The goal of this study was to devise a novel low-resource examination that tested the anatomical knowledge and technical skill of early undergraduate medical students in a gross anatomy course. The team-based ultrasound objective structured practice examination (OSPE) was created as a method for assessing practical ultrasound competencies, anatomical knowledge, and non-technical skills such as teamwork and professionalism. The examination utilized a rotation of students through four team roles as they scanned different areas of the body. This station-based examination required four models and four instructors, and tested ultrasound skills in the heart, abdominal vessels, abdominal organs, and neck regions. A Likert scale survey assessed student attitudes toward the examination. Survey data from participants (n = 46) were examined along with OSPE examination grades (n = 52). Mean and standard deviations were calculated for examination items and survey responses. Student grades were high in both technical (96.5%). and professional (96.5%) competencies with structure identification scoring the lowest (93.8%). There were no statistical differences between performances in each of the body regions being scanned. The survey showed that students deemed the examination to be fair and effective. In addition, students agreed that the examination motivated them to practice ultrasound. The team-based OSPE was found to be an efficient and student-favored method for evaluating integrated ultrasound competencies, anatomical knowledge, team-work, and professional attributes.     

如何做一名合格的基础医学学术型研究生导师

基础医学科学学位研究生培养对于提高我国医学科学的研究水平,培养创新型人才起到推动作用。文章就基础医学研究生导师应具备的素质以及在科研工作中培养研究生应尽的职责和研究生培养过程的管理等方面进行探讨。     

Fellows' Perceptions of a Mandatory Reflective Electronic Portfolio in a Geriatric Medicine Fellowship Program

Electronic portfolios (ePortfolios) can be useful for evaluating and documenting mastery of competencies. We investigated geriatric medicine fellows' perceptions of an ePortfolio. We conducted surveys and focus groups followed by quantitative and qualitative data analysis. Our study revealed that fellows considered the ePortfolio acceptable and accessible. Fellows reflected on aspects relevant to postgraduate training and future practice and documented adherence to competencies. However, fellows expressed resentment about the self-reflection component, which interfered with the overall acceptance of the ePortfolio. Although ePortfolios can be powerful and reflective tools for competency assessment, care must be taken in their implementation.     

临床模拟实训中心的建立与利用

临床实践教学与临床技能操作训练在医学教育中具有举足轻重的地位,但因多种因素使医学生临床技能操作训练受到限制。该文探讨了医学模拟教学在临床医学教学中的意义,介绍了临床模拟实训中心的建设和应用,以及临床实训主要内容,评价了应用医学模拟教学的效果。     

新时代临床医学教学新形式的探索

临床医学教育是培养医学人才的重要组成部分,关系医药卫生改革、国计民生等重要问题,也是人民美好生活的基本保障之一。对新时代临床医学教学的现状和存在的问题进行思考,提出临床医学职业素质与医患沟通能力培训,建立基于患者典型案例的临床教学资源库,完善系统的临床研究课程,充分激发医学生学习主观能动性等临床医学教学与实践的策略。     

Bases of competence: an instrument for self and institutional assessment

The Bases of Competence model provides a general framework for learner‐centred skill development and programme‐focused outcomes assessment. Based on previous research, the Bases of Competence model describes 17 skills and four base competencies important to graduates to achieve high performance in the workplace. Taking this work from research to relevant educational application as a tool for student self‐assessment and institutional outcomes assessment is the focus of this paper. Results from a multi‐year, multi‐course assessment initiative indicate that students rate themselves stronger in the foundation base competencies of Communicating and Managing Self, and weaker in more complex competencies of Managing People and Tasks and Mobilising Innovation and Change. Comparisons of skill confidence within each base competence as well as between year, student level, gender and beginning versus end of semester are presented as well. These results are discussed and suggestions made for programme design.     

EVALUATION OF A GERIATRICS ROTATION FOR POSTGRADUATE RESIDENTS IN LEBANON

As we enter the 21st century, increasing numbers of older adults will reside, either temporarily or permanently, in nursing homes. Training in nursing home care must become an integral part of the curriculum for internal and family medicine residency programs. The changing demographics of the Lebanese population have created an imperative for medical schools to increase their emphasis on the education and training of residents in the care of the elderly. A four-week block rotation was started for residents in the family medicine department in Hotel Dieu (The French Medical School). The rotation is taking place at the comprehensive Geriatric Program at Ain Wazein Community Hospital. The goal of the rotation is to provide formal training in nursing home care to family practice residents as a component of the geriatrics curriculum. The organization and the curriculum content of the rotation are presented. The initial evaluation of the rotation by the residents showed that the residents became more comfortable with elderly issues by the end of the rotation. Residents responded on a scale of one to six regarding four constructs. The rotation was positively evaluated by residents and staff. Consequently, the rotation has been incorporated into the curriculum of family medicine residents in Hotel Dieu.     

Empirical and clinical methods in the assessment of personality and psychopathology: An integrative approach for training

School psychologists have a critical role in identifying social‐emotional problems and psychopathology in youth based on a set of personality‐assessment competencies. The development of competencies in assessing personality and psychopathology is complex, requiring a variety of integrated methods and approaches. Given the limited extent and scope of formal preparation in personality assessment in school psychology training programs, it is important to develop models using multiple methods of assessment. It is proposed that an integrated paradigm associated with a combination of empirical and clinical methods serve as a framework for the development of school psychology practice competencies in personality assessment. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 513–526, 2006.     

Promoting assessment efficacy through an integrated system for online clinical assessment of practical skills

This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of practical skills assessment in knee joint examinations for a pre-clinical cohort of second year medical students. eCAPS involves a progressive organisation of online video experiences and task expectations for formative and summative assessments of selected competencies. Data are presented from semi-structured interviews with the medical students (N?=?40). eCAPS successfully supported students’ skill development in knee joint examinations on fellow students and allowed remote assessment of candidates’ performances by clinicians experienced in musculoskeletal examinations. An ‘indicative standard’ paradigm, involving formative assessment of one randomly selected performance from the submission of all students’ responses within a small group, offered an efficient and efficacious avenue for providing consolidated feedback to students and promoted desirable learning behaviours. Overall, there was evidence of reciprocal learning benefits to the ‘blending’ of an online learning and assessment approach with an existing face-to-face environment. The medical students were able to successfully engage online with high quality and consistent practical skill-based materials in a flexible, independent and individual manner.     

CURRICULAR STRATEGIES FOR GERIATRICS EDUCATION IN A MEDICAL SCHOOL

Geriatrics education at the University of Valle Medical School uses many teaching strategies in undergraduate and postgraduate programs. These include improving communication with older patients, accepting one's own aging, teaching human values, providing experiences with well elderly, and participating in an interdisciplinary team. There are common curricular areas in geriatrics for health care disciplines which include medicine, dentistry, nursing, speech therapy, physiotherapy, and occupational therapy. However, each discipline also has specific curricular components. There is a curricular program for family medicine and internal medicine residents. A curriculum design was approved for a new geriatrics fellowship program which is in development. Finally, the progression of the curriculum is according to the learning needs of each level of education among medical students, residents and fellows.     

医学院临床技能教学的困境与对策

为了提高和培养医学生临床动手能力和临床综合诊断治疗等技能，广州医学院引进模拟病人应用到临床医学专业学生的临床技能教学中。模拟病人真实地模拟各种病理生理改变等临床各种症状体征，为在新形势下培养医学生临床动手能力和临床综合诊断治疗等技能提供了良好的对策。     

七年制医学生放疗科临床实习带教体会

临床实习是医学专业学生培养体系中最重要的环节之一,是培养学生将理论知识运用于临床实践,提高其临床实践能力、临床思维能力和医患沟通能力的重要阶段。七年制临床医学专业研究生是一个特殊的群体,其培养模式不同于五年本科加三年研究生(5+3)的临床医学专业学位培养模式。本文对七年制医学生放疗科临床实习的带教体会进行了总结,并结合七年制医学生的特点,探讨提高放疗科临床实习教学质量的方法,为临床医学生的实习培养提供参考。     

The National Training Reform and the Preparation of Teachers: new approaches

The series of Australian Government policy initiatives somewhat misleadingly known as the national‐training‐reform agenda (FitzGerald, 1994) represent a new reference point for faculties of education engaged in the preparation of teachers. The ideas first floated in Australia Reconstructed (ACTU, 1987)—the creation of a high‐wage, high‐skill economy based on a national system of skills formation and skills enhancement—reflected three underpinning principles on which government, unions and employers were united. These principles—a move away from time served and towards competencies achieved, a system of nationally recognised qualifications and a central role for industry in the specification of standards—continue to enjoy such tripartite support and are central to the implementation of training reform. Lundberg (1994) identified five main themes of the training‐reform agenda, namely, nationally consistent competency‐based training, national recognition of competencies however attained, an open training market, fair participation in vocational education and training, and an integrated entry‐level training system. The effect that the implementation of reforms to the training system is having on the work of those teaching in schools is only now becoming apparent (Schools Council, 1994a). This paper describes the approaches used by the Faculty of Education and Training at the Royal Melbourne Institute of Technology (RMIT) and considers the impact that the changed training system might also have on the work of teacher educators in higher education in Australia.     

美国研究生STEM教育最新核心能力——政策脉络、标准框架及培养路径

美国研究生STEM教育核心能力框架为其高科技人才培养提供了理论基础。基于对《21世纪研究生STEM教育》报告中美国硕士与博士研究生STEM教育的最新核心能力分析,形成2项一级指标、4项二级指标和26项三级指标的最新核心能力标准框架。跨学科多元教育要素整合的内生路径和多元利益主体协作的外促路径,构成了美国研究生STEM教育核心能力培养路径。我国研究生教育亟需构建基于类型和专业的研究生核心能力框架;强化学科能力各要素的关系研究,完善专业能力的内容与考核机制;明确可转移能力的具体内容,制定多元的培养路径;立足协同多元利益主体,建立研究生核心能力联动培养机制。     

Cognitive Tools in a Clinical Encounter in Medicine: Supporting Empathy and Expertise in Distributed Systems

This paper examines how, in use, culturally-provided tools can be said to embody knowledge and distribute thinking. It focuses on the routine procedures used by medical professionals to investigate patient complaints and examines explicit and implicit contributions of these conventional procedures to distributed thinking in clinical encounters in medicine. After characterizing these tools, examples of how the tools guide and constrain medical problem solving are provided. The tools support the development and exercise of the routines characteristic of medical expertise, while at the same time preserving the nonroutine, controlled deliberation necessary for sound and ethical medical care. The paper concludes with ways in which the tools' role in thinking can be promoted through medical education, particularly during students' early clinical exposure: (a) Organizing learning experiences that expose the tools' meanings; (b) exploiting the benefits of small group work to promote collaborative and individual competencies in distributed systems; and (c) explicitly utilizing the products of thinking with these tools to further the goals shared by participants in clinical encounters.     

Complementary assessment in teacher and school leadership training: Necessity,conceptualization and validation

Contemporary education requires teachers and school leaders who have well developed basic skills and competencies such as interpersonal communication, teamwork and leadership, in order for them to lead their students toward successful integration into society. These skills and competencies are crucial for proper functioning in modern society. Existing training programs for teachers and school leadership roles, however, have little if any dedicated guidance for developing these skills and competencies. Inclusion of basic skill development in training programs necessitates a new model that focuses on their assessment. As a first step toward the development of such a model, this study, carried out using the Delphi method, offers definition and validation of a new concept called “complementary assessment”.     

Use of the Collaborative Drawing Technique in School Counseling Practicum: An Illustration of Family Systems

According to the extant school consultation literature, counselors can effectively use brief family interventions and family assessment procedures in schools as part of a collaborative consultation approach. School counselors, however, often lack training in family systems theory, because counselor training programs tend to use individual counseling models. When used in a school counselor practicum course, the Collaborative Drawing Technique (CDT; G. M. Smith, 1985) introduces counselors‐in‐training to family systems concepts and lays the foundation for postgraduate training in family systems. The authors use a case illustration to explore paradigmatic shifts in trainees' case conceptualizations as a function of their use of the CDT with a family.     

浅析临床医学生从理论到实践中角色转换与对策

临床医学是一门理论与实践紧密结合的学科,临床医学生从“象牙塔”步入医院的“大熔炉”过程中将面临从外到内各个方面的转变与适应。文章结合我国医学教学改革背景,厘清学生从理论知识走向临床实践中所面临的角色转换,进而更好地帮助学生将理论知识转化为临床实践,练就临床医生理应具备的多方面素质,为最终培养成为我国卓越的医疗人才打下坚实基础。     

临床医学研究生的科研训练

科研能力是研究生的一项最重要的素质.加强临床医学研究生的科研训练,有利于提高研究生的科研能力,为国家和社会培养优秀的医疗和科技人才,促进实验室和学科的发展.实践表明:制定和严格执行切实可行的科研训练计划,能减轻临床研究生的学习负担,提高工作和学习效率,达到既定的教学目标.