前瞻性临床研究元数据语义结构体系的建构

在参考临床研究的相关数据标准和电子病历相关数据标准基础上,构建前瞻性临床研究元数据的宏观框架、中观类组和微观属性等三个层面的元数据语义架构体系(openPCR)。openPCR的宏观框架结构包括临床研究、公用元数据、内部元数据和研究数据集4个部分;中观类组结构是对公用元数据、内部元数据和研究数据集进一步细化后形成的结构;微观属性结构从标识类、定义类、管理类、关系类和表示类来详细描述各级元数据。openPCR成为建立前瞻性临床研究数据库的语义结构体系,为前瞻性临床研究的数据标准化、数据交换与共享以及与电子病历系统的兼容奠定基础。     

Impact and educational outcomes of a small group self‐directed teaching strategy in a clinical neuroscience curriculum

The complexity of the material being taught in clinical neuroscience within the medical school curriculum requires creative pedagogies to teach medical students effectively. Many clinical teaching strategies have been developed and are well described to address these challenges. However, only a few have been evaluated to determine their impact on the performance of students studying clinical neuroscience. Interactive, 2‐hour, self‐directed small‐group interactive clinical case‐based learning sessions were conducted weekly for 4 weeks to integrate concepts learned in the corresponding didactic lectures. Students in the small groups analyzed cases of patients suffering from neurological disease that were based on eight learning objectives that allowed them to evaluate neuroanatomical data and clinical findings before presenting their case analysis to the larger group. Students’ performances on the formative quizzes and summative tests were compared to those of first‐year medical students in the previous year for whom the self‐directed, small‐group interactive clinical sessions were not available. There was a significant improvement in the summative performance of first‐year medical students with self‐directed clinical case learning in the second year (Y2) of teaching clinical neuroscience (P < 0.05) when compared with first‐year students in the first year (Y1) for whom the self‐directed learning approach was not available. Student performance in the formative assessments between Y1 and Y2 was not significantly different (P = 0.803). A target of ≥70% student scoring above 80% in the final summative examination was met. The current study revealed evidence for the impact and educational outcomes of a self‐directed, clinical teaching strategy in a clinical neuroscience curriculum for first‐year medical students. Anat Sci Educ 11: 478–487. © 2017 American Association of Anatomists.     

Lower leg and foot contributions to turnout in female pre-professional dancers: A 3D kinematic analysis

Turnout is a central element of classical ballet which involves sustained external rotation of the lower limbs during dance movements. Lower leg and foot compensation mechanisms which are often used to increase turnout have been attributed to the high incidence of lower limb injury in dancers. Evaluation of dancers’ leg posture is needed to provide insight into the lower limb kinematic strategies used to achieve turnout. The primary purpose of this study was to use 3D kinematic analyses to determine the lower leg and foot compensations that are incorporated by female university dancers to accentuate their turnout. Active and passive external tibiofemoral rotation (TFR) was also measured. A moderate-strong negative relationship was observed between hip external rotation (HER) and foot abduction in the three first position conditions. A moderate negative relationship was found between passive TFR and foot abduction in all first position conditions. Our findings suggest dancers are more likely to pronate, than rotate the knee to compensate for limited HER. Dancers with a limited capacity to pronate may force additional rotation via the knee. Ongoing research would benefit from more in-depth analyses of the foot/ankle complex using a multi-segment foot model.     

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.     

护理临床教师职业素养对高护生的影响探析

临床教学质量的优劣直接关系到护理院校向社会输入合格护理人才的问题,而临床教学质量在一定程度上取决于临床教师质量。本文论述了护理临床教师职业素养要求,并针对现状提出了相关对策。     

Redefinition of gestational diabetes mellitus: implications for laboratory practice in Croatia

An increasing prevalence of gestational diabetes has become a very challenging task in prenatal care worldwide. International Association of Diabetes and Pregnancy Study Groups (IADPSG) has recently issued recommendations on the diagnosis and classification of hyperglycaemia in pregnancy. These recommendations, the first to provide harmonised, evidence-based criteria for the diagnosis and classification of diabetes in pregnancy, are currently being discussed and accepted worldwide by the relevant authorities. As the acceptance of the proposed criteria has major implications for both clinical and laboratory settings, a concerted action towards necessary changes in practice has to be carefully planned and adjusted to national health-care specificities.IADPSG criteria have been strongly advocated by the Croatian Perinatology Society, resulting in a new strategy for the detection and diagnosis of hyperglycaemic disorders in pregnancy.To address the respective laboratory requirements, in April 2012, the Croatian Chamber of Medical Biochemists appointed a Working Group to provide a standardised procedure for the diagnosis of gestational diabetes, applicable to all laboratories involved in prenatal care, in both primary and specialised health-care facilities.In this paper we discuss key laboratory-related issues regarding succesful implementation of the IADPSG criteria in Croatia.     

癫痫诊治临床教学模式转变思考

神经系统疾病复杂,诊治困难是很多轮转神经科医师的感受,尤其非神经科专业的医师缺乏神经系统症状学等疾病表现的理论基础,如何帮助他们尽快掌握神经科临床诊治思维,掌握神经系统常见病、多发病的临床表现,是很多神经科教员面临的教学任务。     

关于临床实习质量监控体系的研究

医学是救死扶伤挽救生命的一门重要的科学,其实践性很强。在医学教育全过程中的临床实习是实践过程中重要的组成部分,临床实习是学生将医学理论与技能相结合必经的过程,通过临床实践活动转化为独立处理病人和预防控制疾病能力的关键环节,其是考核医学教育质量的重要指标,是检测是否达到培养目标的重要方法。由于管理机制和学习环境等因素的不确定性、变动性,临床实习质量监控体系的完善一直成为医学教育中的一项重要课题。临床实习质量监控的意义,指为确保临床实习质量有所改善和提高而实施的临床带教的管理过程,其实质上是一个管理系统,因此就必须建立一个行之有效的临床实习质量监控评估体系。     

优化中西医临床医学专业医用化学课程教学的探讨

医用化学是中西医临床医学专业的一门重要的基础课,做好该门课的教学工作,应围绕人才培养目标,以实用为原则,突出医学特色,从教学内容、教学方法、实验教学、评价体系四个方面进行优化,为培养优秀中西医临床医学专业人才奠定坚实的基础。     

论床边教学对医学生临床思维的培养

临床思维贯穿于整个疾病的诊疗过程中,其意义重大。而床边教学作为医学教育的重要组成部分,其核心理念是让医学生尽早接触临床,以培养医学生的临床思维能力。现如今,床边教学模式尚不成熟,我们需要改革创新,从而使床边教学真正收到实效。