《中华微生物学和免疫学杂志》2005-2016年发表的临床研究论文伦理问题的调查及分析

对《中华微生物学和免疫学杂志》2005-2016年刊出的457篇临床研究论文的伦理批准和知情同意情况进行统计分析.结果发现,获得伦理委员会批准的总的比例为17.3％,获得知情同意总的比例为26.0％,既获得伦理委员会批准又获得知情同意的论文比例为12.9％.提出加强医学研究的伦理审查、提高医学论文伦理水平的建议.     

手法复位加针灸理疗对运动中膝关节骨错缝23例疗效观察

观察手法复位加针灸理疗对运动中膝关节骨错缝的临床疗效。43例患者随机分为两组,治疗组(23例)采用手法复位加针灸理疗治疗;对照组(20例)采用中医常规疗法;4次为一疗程,疗程内治愈不重复治疗。得出结论,手法复位加针灸理疗对运动中膝关节骨错缝有显著性疗效,值得推广运用。     

Management as ideology: the case of ‘new managerialism’ in higher education

The paper explores ideological conceptions of management, especially ‘new managerialism’, with particular reference to their role in the reform of higher education. It is suggested that attempts to reform public services in general are political as well as technical, though there is no single unitary ideology of ‘new managerialism’. Whilst some argue that managers have become a class and have particular interests, this may not be so for all public services. The arguments presented are illustrated by data taken from a recent research project on the management of UK higher education. It is suggested that managers in public service organisations such as universities do not constitute a class. However, as in the case of manager‐academics, managing a contemporary public service such as higher education may involve taking on the ideologies and values of ‘new managerialism’, and for some, embracing these. So management ideologies do seem to serve the interests of manager‐academics and help cement relations of power and dominance, even in contexts like universities which were not traditionally associated with the dominance of management.     

Practicing What We Teach: Trauma-Informed Educational Practice

This article presents the starting case for applying the elements of trauma-informed care (TIC) to education and outlines the authors’ initial efforts to develop guidelines for what they call trauma-informed educational practice. To this end, the article starts with a literature review related to the potential for vicarious traumatization and retraumatization among students in clinical training, followed by a discussion of the TIC framework and past efforts to be trauma sensitive in social work education. The authors then describe what drew them to this perspective and inspired them to apply it to educational practice. They then present guidelines for implementing the trauma-informed principle of safety in the classroom in several domains.     

Mapping two new points on the tennis expertise continuum: Tactical skills of adult advanced beginners and entry-level professionals during competition

Abstract

Research examining problem representations of individuals during task performance is advancing our understanding of information processing and expertise in a variety of sports. However, few studies using similar methodology have been conducted on individuals of various competitive standards in one domain in similar contexts. This study examined problem representations of adult advanced beginners and entry-level professionals accessed during singles tennis competition (n = 12). These groups were selected to represent players with performance skills that were different from those studied previously (i.e. adult beginners and varsity players). Immediate recall and planning interviews were conducted between points during singles tennis competition. Players competed within their respective expertise groups. Verbal reports were transcribed verbatim and concepts were scored according to a model of protocol structure. Several multivariate analyses of variance were conducted on rank scores for measures of concept content and structure using the L-statistic. Entry-level professionals exhibited more advanced problem representations than advanced beginners regardless of interview type. These findings together with those of previous research suggest adaptations in long-term memory profiles with increases in performance skills. For example, beginners lacked action plan and current event profiles because they generated goals and reiterated game events during both interviews. Advanced beginners, who had better performance skills than beginners, exhibited rudimentary action plan profiles and deficient current event profiles because they generated and monitored several detailed actions related to the current context during recall interviews and generated only a few goals during planning interviews. In contrast, varsity players and professionals processed tactical information in the current context and beyond denoting the existence of both action plan and current event profiles. Varsity players, with inferior performance skills than professionals, exhibited fewer and less associated tactical concepts than professionals during both interviews.     

The anatomy competence score: a new marker for anatomical ability

The assessment of students' ability in gross anatomy is a complex process as it involves the measurement of multiple facets. In this work, the authors developed and introduced the Anatomy Competence Score (ACS), which incorporates the three domains of anatomy teaching and assessment namely: theoretical knowledge, practical 3D application of the knowledge, and clinical or bedside application of knowledge on patients. Equal contributions from these tripartite domains were used to synthesize the ACS. The theory knowledge was assessed using MCQs and short answer questions while the knowledge of practical 3D application was assessed using an Objective Structured Practical Examination (OSPE). The clinical or bedside application of anatomy knowledge was assessed by an Objective Structured Clinical Examination (OSCE). In this correlation study, the authors examined the interdomain correlations of the summative marks for the three contributing domains of the ACS, in order to examine the rationality of this new marker. Three cohorts of medical students (n = 538) at St. George's, University of London (SGUL) Medical School in the United Kingdom were included and analyzed. The results demonstrated that the correlations between the three domains were significantly low or moderate. The three domains probably represent unique knowledge and abilities. Therefore, it would appear that the average of the domains scores (the ACS) provide a comprehensive picture of a student's ability in anatomy.     

临床护理带教中存在的问题及对策探析

临床护理带教是帮助护生步入实践工作的重要手段,也是帮助护生实施角色转换的重要环节。文章详细分析了临床护理带教中教师、护生、带教管理等方面存在的问题,并提出了相应的对策。     

在院病例与病历资源相结合在神经外科见习中的应用

随着近十余年高等教育的改革发展．医学生培养规模逐渐增大,医学教育中存在临床病例资源相对不足．通过典型案例教学法,能部分弥补病例资源的不足。但在临床实习期间,住院患者中可能没有典型病例。我们在神经外科学见习教学中,采用出院病历资源中的典型病例与在院病例相结合的案例式教学模式,挖掘既往的临床病历资料．引导学生比较在院病例与典型病例的共同点和差异性．充分调动学生的学习积极性,培养学生正确的临床思维及解决问题的能力,使学生基本掌握神经外科常见病的共同性和特殊性。收到满意的教学效果。     

临床医学专业学位研究生培养模式的探索与实践

文章结合山东大学医学院临床医学专业学位研究生培养工作的实践经验,阐述了学院对临床医学专业学位研究生培养模式的探索与构建,从明确培养目标、健全培养体系、加强质量监控、完善管理体系等多方面着手,强化医学专业学位研究生临床能力培养力度,具有重要的现实意义。     

The most common nonconformities encountered during the assessments of medical laboratories in Hong Kong using ISO 15189 as accreditation criteria

Introduction:

ISO 15189 was a new standard published in 2003 for accrediting medical laboratories. We believe that some requirements of the ISO 15189 standard are especially difficult to meet for majority of laboratories. The aim of this article was to present the frequency of nonconformities to requirements of the ISO 15189 accreditation standard, encountered during the assessments of medical laboratories in Hong Kong, during 2004 to 2009.

Materials and methods:

Nonconformities reported in assessments based on ISO 15189 were analyzed in two periods – from 2004 to 2006 and in 2009. They are categorized according to the ISO 15189 clause numbers. The performance of 27 laboratories initially assessed between 2004 and 2006 was compared to their performance in the second reassessment in 2009.

Results:

For management requirements, nonconformities were most frequently reported against quality management system, quality and technical records and document control; whereas for technical requirements, they were reported against examination procedures, equipment, and assuring quality of examination procedures. There was no major difference in types of common nonconformities reported in the two study periods. The total number of nonconformities reported in the second reassessment of 27 laboratories in 2009 was almost halved compared to their initial assessments. The number of significant nonconformities per laboratory significantly decreased (P = 0.023).

Conclusion:

Similar nonconformities were reported in the two study periods though the frequency encountered decreased. The significant decrease in number of significant nonconformities encountered in the same group of laboratories in the two periods substantiated that ISO15189 contributed to quality improvement of accredited laboratories.