A prospective,randomized crossover study comparing direct inspection by light microscopy versus projected images for teaching of hematopathology to medical students

Instruction in hematopathology at Mayo Medical School has evolved from instructor‐guided direct inspection under the light microscope (laboratory method), to photomicrographs of glass slides with classroom projection (projection method). These methods have not been compared directly to date. Forty‐one second‐year medical students participated in this pilot study, a prospective, randomized, crossover study measuring educational performance during a hematology pathophysiology course. The students were randomized to one of two groups. All students received the same didactic lectures in the classroom and subsequent case‐based review of peripheral blood smears using either laboratory or projection methods, on day one with a crossover to the other method on day two. Pre‐ and post‐test examinations centered on morphology recognition measured educational performance on each day, followed by a questionnaire identifying the student's favored method. There was no significant difference in the pre‐test and post‐test scores between the two teaching methods (rank‐sum P = 0.43). Students overwhelmingly preferred the projection method and perceived it as superior (76%), although post‐test scores were not significantly different. Student's recommended method was split with 50% favoring the projection method, 43% favoring a combined approach, and 23% noting logistical challenges to the laboratory. In this study, the laboratory and projection method were equivalent in terms of educational performance for hematopathology among medicals students. A classroom‐based approach such as the projection method is favored, given the large class sizes in undergraduate medical education, as well as the ergonomic challenges and additional resources required for large group instruction in a laboratory setting. Anat Sci Educ 7: 130–134. © 2013 American Association of Anatomists.     

A retrospective look at replacing face‐to‐face embryology instruction with online lectures in a human anatomy course

Embryology is integrated into the Clinically Oriented Anatomy course at the Texas Tech University Health Sciences Center School of Medicine. Before 2008, the same instructor presented embryology in 13 face‐to‐face lectures distributed by organ systems throughout the course. For the 2008 and 2009 offerings of the course, a hybrid embryology instruction model with four face‐to‐face classes that supplemented online recorded lectures was used. One instructor delivered the lectures face‐to‐face in 2007 and by online videos in 2008–2009, while a second instructor provided the supplemental face‐to‐face classes in 2008–2009. The same embryology learning objectives and selected examination questions were used for each of the three years. This allowed direct comparison of learning outcomes, as measured by examination performance, for students receiving only face‐to‐face embryology instruction versus the hybrid approach. Comparison of the face‐to‐face lectures to the hybrid approach showed no difference in overall class performance on embryology questions that were used all three years. Moreover, there was no differential effect of the delivery method on the examination scores for bottom quartile students. Students completed an end‐of‐course survey to assess their opinions. They rated the two forms of delivery similarly on a six‐point Likert scale and reported that face‐to‐face lectures have the advantage of allowing them to interact with the instructor, whereas online lectures could be paused, replayed, and viewed at any time. These experiences suggest the need for well‐designed prospective studies to determine whether online lectures can be used to enhance the efficacy of embryology instruction. Anat Sci Educ 7: 234–241. © 2013 American Association of Anatomists.     

城镇职工医疗保险统筹住院次均费用增长分析和对策

次均费用反映了当今社会普遍关注的看病贵难题,体现医疗保险制度效率。次均费用受多种因素影响,经济、人口结构和质量、医药卫生体制和新诊疗技术的使用是主要影响因素。增加过度治疗的机会成本,当边际成本超过边际收益时定点机构才会加强自律,规范治疗。引导就医流向可以降低来自参保人行为导致的费用增长。医保管理者在控制次均费用增长问题上责任重大,并大有作为。实行按病种支付、对三级医院重点检查、增加平均住院日指标、规定大型设备阳性检查率、充分利用信息平台加强管理等有利于控制次均费用不合理增长。     

医学院校信息工作面临的挑战与对策

分析了医学院校信息工作的特点及面临的挑战,并提出了应对措施。     

国内医学文献检索网络课程开发的现状及建议

通过调研概述目前国内医学文献检索课网络课程的现状,指出存在问题,并结合开发、制作网络课程的实践提出建设医学文献检索课网络课程的建议。     

The Role of Anatomy Computer-Assisted Learning on Spatial Abilities of Medical Students

Currently, medical education context poses different challenges to anatomy, contributing to the introduction of new pedagogical approaches, such as computer-assisted learning (CAL). This approach provides insight into students' learning profiles and skills that enhance anatomy knowledge acquisition. To understand the influence of anatomy CAL on spatial abilities, a study was conducted. A total of 671 medical students attending Musculoskeletal (MA) and Cardiovascular Anatomy (CA) courses, were allocated to one of three groups (MA Group, CA Group, MA + CA Group). Students' pre-training and post-training spatial abilities were assessed through Mental Rotations Test (MRT), with scores ranging between 0-24. After CAL training sessions, students' spatial abilities performance improved (9.72 ± 4.79 vs. 17.05 ± 4.57, P < 0.001). Although male students in both MA Group and CA Group show better baseline spatial abilities, no sex differences were found after CAL training. The improvement in spatial abilities score between sessions (Delta MRT) was correlated with Musculoskeletal Anatomy training sessions in MA Group (r = 0.333, P < 0.001) and MA + CA Group (r = 0.342, P < 0.001), and with Cardiovascular Anatomy training sessions in CA Group (r = 0.461, P = 0.001) and MA + CA Group (r = 0.324, P = 0.001). Multiple linear regression models were used, considering the Delta MRT as dependent variable. An association of Delta MRT to the amount of CAL training and the baseline spatial abilities was observed. The results suggest that CAL training in anatomy has positive dose-dependent effect on spatial abilities.     

医学期刊论文中表注的不规范表达及其修改

分析医学期刊论文表注表达不规范和不合逻辑的几种情况,提出修改意见,并予以实例说明.     

医药卫生期刊的质量评价

医药卫生期刊质量评价,一是可以促进提高期刊质量,二是可以促进提高编辑人员的业务素质并发现编辑人才,三是可以了解医药卫生期刊的现状并总结其办刊经验予以推广;但由于种种原因,目前医药卫生期刊评价工作中尚存在如下一些问题.     

刍议医药院校图书馆建设药品样本展览库的意义

样本库是信息源中重要组成部分,文章探讨在网络环境下,医药院校图书馆建设特色样本库建设的新思路———药品样本展览库及其意义。     

中美医学图书馆比较研究

通过对比研究中国、美国医学图书馆及图书馆员的基本情况、需求及服务等,指出我国医学图书馆、图书馆建筑、图书馆协会及图书馆馆员存在的优势及不足,强调我国医学图书馆的管理应更科学化,信息服务工作应更主动、深入,医学图书馆协会应搞得更活,井注意引导我国医学图书馆的工作与国际接轨。