拉丁美洲医学教育的变化、趋势与挑战

泛美医学院校协会(PAFAMS)董事PA Pulido等人撰文[Medical Teacher,2006,28(1):24-29]分析了拉丁美洲医学教育的多种影响因素,认为该地区的医学院校无计划地高速增长,质量得不到有效保障,卫生人力分布不合理.他们认为开展医学院校认证是解决上述问题的一条途径,并介绍了该地区医学院校认证的进展情况和趋势.     

现代医学生科研素质和实践能力培养的探索与实践

复旦大学上海医学院经过多年不断改革与探索,建立了一套行之有效的科研素质及临床实践能力培养机制,主要体现在全程导师制的实施、课程体系的优化及教学方法的改进、床旁教学的实施、课外科技活动的开展等诸方面.通过鼓励本科生早期接触科研实践、早期接触临床病人,培养学生严谨的科学态度、创新意识和团队合作精神,显著提高了医学生的研究创新能力和临床实践能力.     

卫生健康系统业务档案管理服务职能透析

本文为实现充分发挥卫生健康系统业务档案管理服务职能这一目标,针对卫生健康系统业务档案管理工作中存在的思想不重视、制度不完善、缺少专业人才等问题进行研究,采用文献分析法等研究手段,从完善制度、提升思想、人才培养和方法创新四个角度提升卫生健康系统业务档案管理服务能力.     

Dissecting through Barriers: A Follow-up Study on the Long-Term Effects of Interprofessional Education in a Dissection Course with Healthcare Professional Students

Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.     

Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study

Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear’s highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope- and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2–4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes.     

How Haptics and Drawing Enhance the Learning of Anatomy

Students’ engagement with two-dimensional (2D) representations as opposed to three-dimensional (3D) representations of anatomy such as in dissection, is significant in terms of the depth of their comprehension. This qualitative study aimed to understand how students learned anatomy using observational and drawing activities that included touch, called haptics. Five volunteer second year medical students at the University of Cape Town participated in a six-day educational intervention in which a novel “haptico-visual observation and drawing” (HVOD) method was employed. Data were collected through individual interviews as well as a focus group discussion. The HVOD method was successfully applied by all the participants, who reported an improvement of their cognitive understanding and memorization of the 3D form of the anatomical part. All the five participants described the development of a “mental picture” of the object as being central to “deep learning.” The use of the haptic senses coupled with the simultaneous act of drawing enrolled sources of information that were reported by the participants to have enabled better memorization. We postulate that the more sources of information about an object, the greater degree of complexity could be appreciated, and therefore the more clearly it could be captured and memorized. The inclusion of haptics has implications for cadaveric dissection versus non-cadaveric forms of learning. This study was limited by its sample size as well as the bias and position of the researchers, but the sample of five produced a sufficient amount of data to generate a conceptual model and hypothesis.     

Neuroanatomy Learning: Augmented Reality vs. Cross-Sections

Neuroanatomy education is a challenging field which could benefit from modern innovations, such as augmented reality (AR) applications. This study investigates the differences on test scores, cognitive load, and motivation after neuroanatomy learning using AR applications or using cross-sections of the brain. Prior to two practical assignments, a pretest (extended matching questions, double-choice questions and a test on cross-sectional anatomy) and a mental rotation test (MRT) were completed. Sex and MRT scores were used to stratify students over the two groups. The two practical assignments were designed to study (1) general brain anatomy and (2) subcortical structures. Subsequently, participants completed a posttest similar to the pretest and a motivational questionnaire. Finally, a focus group interview was conducted to appraise participants’ perceptions. Medical and biomedical students (n = 31); 19 males (61.3%) and 12 females (38.7%), mean age 19.2 ± 1.7 years participated in this experiment. Students who worked with cross-sections (n = 16) showed significantly more improvement on test scores than students who worked with GreyMapp-AR (P = 0.035) (n = 15). Further analysis showed that this difference was primarily caused by significant improvement on the cross-sectional questions. Students in the cross-section group, moreover, experienced a significantly higher germane (P = 0.009) and extraneous cognitive load (P = 0.016) than students in the GreyMapp-AR group. No significant differences were found in motivational scores. To conclude, this study suggests that AR applications can play a role in future anatomy education as an add-on educational tool, especially in learning three-dimensional relations of anatomical structures.     

冰雪运动员伤残与医疗保险研究

运用保险学、管理学等基本理论,采用理论分析和调研等方法,借鉴发达国家体育保险的经验,分析了我国体育保险现状,认为冰雪运动员伤残、医疗保险存在缺乏应有的保险理念,缺乏法律、制度、机制上的有力支持,缺乏筹资渠道和专门人才,缺乏市场培育等主要问题;提出了树立尽快建立与完善冰雪运动员伤残、医疗保险体系的保障理念,建立健全相关的政策法规体系,积极培育保险市场、转变体育保险运作模式,积极培养专门的冰雪运动保险人才等对策,为健全我国冰雪运动的伤残、医疗保险体系提供理论参考。     

日语计算机与网络词汇使用状况初探--基于网页与操作系统的实证研究

计算机、互联网技术的不断发展与普及,为语言在网络虚拟空间的拓展提供了可能。日语也不例外,计算机技术领域、网络世界中各种新词层出不穷,构成了现代日语中最为活跃的风景之一。本文以日本网页和日文操作系统作为分析文本,对日语计算机与网络词汇的使用状况展开实证研究,力求对其有一个较为全面、切实的认识。     

中国传统“动形养生”文化源流

早在上古时代,我国"动形养生"的思想已萌芽,但"动以养形"的理论始于《吕氏春秋》所记载:"流水不腐,户枢不蠹"。并在养生学长期的发展过程中,逐渐走向成熟,其内涵为:动静结合,形神共养。本文对我国传统动形养生思想的理论源流进行了梳理,尤其对《黄帝内经》之"形神兼养"这一养生观进行了详尽论述。旨在追溯我国传统动形养生文化之源流。