目的 调查全科住院医师职业发展现况,完善全科住培体系.方法 通过问卷调查法,收集2008年7月—2020年7月上海市某三甲医院39名全科住培结业住院医师职业发展情况,调查项目包括基本情况、科研成果、工作满意度等,并使用SPSS 23.0统计学软件完成数据分析.结果 多数调查对象收入水平在10～15万元之间(79.5％).工作满意度显示:满意16名(41.0％),较满意15名(38.5％),一般8名(20.5％).结业住院医师年收入与工作满意度成正相关(r=0.332,P=0.039).不同性别、学历、毕业院校、工作年限的全科住培结业住院医师收入及发表中文核心期刊文章数量差异均无统计学意义(P>0.05).硕士学员毕业后参加科研工作的比例(50.0％)高于本科学员(5.7％),差异有统计学意义(P=0.045).不同学历、毕业院校、工作年限组的文章发表差异无统计学意义(P>0.05).结论 用人单位首先应考虑从收入出发,提升全科医师就业满意度.同时考虑优化分配机制,体现差异化,提高激励效果.就业后住院医师科研成果积累缓慢,存在一定科研懈怠,985/211院校全科医师并没有表现出较高科研水平.用人单位应重视全科住院医师科研发展,加强督促引导,搭建良好的科研平台.

目的 了解住院医师规范化培训(以下简称规培)临近结业学员的焦虑和抑郁情况及其影响因素,为规培临近结业学员的心理健康保健和规培教学管理体系的完善提供循证依据.方法 结合焦虑自评量表和抑郁自评量表制作调查问卷,对某军医大学2所附属医院2018年7月出站的252名规培学员进行调查并分析.结果 共发放问卷252份,回收有效问卷252份,有效回收率为100％.其中男123人(48.8％),女129人(51.2％);平均年龄为(28.3±2.1)岁;本科87人(34.5％),硕士138人(54.8％),博士27例(10.7％);规培1年者27人(10.7％),规培2年者96人(38.1％),规培3年者129人(51.2％);来自"985"院校或"211"院校者151人(59.9％),其他院校者101人(40.1％);军人20人(7.9％).94.4％(238/252)的规培临近结业学员表现为焦虑状态,60.3％(152/252)的规培临近结业学员表现为抑郁状态.经检验,规培临近结业学员焦虑的严重程度与培训年限有关(χ2=14.214,P=0.027),抑郁的发生与院校类别有关("985"或"211"院校vs其他院校:χ2=5.691,P=0.017;军队院校vs地方院校:χ2=5.069,P=0.024),该群体的焦虑状态和抑郁之间未见明显相关性(r=0.025,P=0.696).结论 规培临近结业学员同时面临医疗、就业、结业等多重压力,出现焦虑、抑郁状态比例远高于一般人群及医护人员.医院教学管理部门应予以足够重视,积极采取干预措施.

脊柱外科教学的特点是专业性强、涵盖面广、新理论、新技术发展更新较快,学生常因对所学内容感到繁多、难记、难掌握,从而产生畏惧心理,因此开展教学方法改革势在必行.本研究将"互联网+"的教学理念引入教学,评价利用其实现翻转课堂在八年制医学生脊柱外科教学中的效果.共66人参与本研究,翻转课堂组学生笔试、线上作业、总结汇报平均成绩高于传统教学组学生,同样的结果可以在学生主观评价问卷分数中观察到.利用"互联网+"实现的翻转课堂可以有效的提高医学生的学习兴趣,提高主观能动性,使教学的效果最大程度上得到优化.

As the university has been transferred to the Navy, we have been thoroughly implementing the idea of Chairman Xi by carrying out profound reflections and researches on building a powerful modern naval health care force. To improve the capability of military medical service of the existing Navy ships, we have designed a new teaching model in which hospitals and grass-roots vessels are intimately linked. Meanwhile, we have set up a "mobile classroom"circuit teaching project with four steps for its implementation. These measures are most popular among grass-roots officers and soldiers.

Medical violent events have become a focus of the current medical risk prevention.How to effectively prevent the occurrence of medical risks is a necessary skill for medical staff.Therefore, this paper analyzes the causes of medical disputes, so as to find out effective ways to prevent medical risks.In order to explore medical risk prevention, psychological counseling technique is introduced in this paper.

'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of "social beings", developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.

研究生教育须将业务学习与社会实践教育结合起来,调研发现,部分研究生存在交流能力差、医德医风欠优、社会活动能力低、就业能力不足等问题.鉴于此,我教学医院积极进行了教学的改革和探索.多年来组建了形式多样的“社会课堂”,如博士团下乡、义诊、定点服务、门诊讲堂等,提高了研究生医患交流能力、强化了爱患爱伤观念、增强了社会活动能力、提高了就业质量,获得了研究生和社会好评.

新军事变革背景下,后勤保障一体化对军队医学院校任职教育提出更高的要求,为了提高任职教育学员在基层医疗保障服务中发现问题、解决问题的能力,本校在战伤外科培训班中尝试开展课题导师制度,探索其作为理论授课和技能操作培训之外研究型学习模式的可行性,课题导师制度使教员能够更加深入的了解学员在实际工作中的需求和困惑,调动学员积极性和主动性,有助于军队医学院校任职教育分级培训体系的构建和完善,值得进一步探索和实践.

At present , the training objectives and methods of medical students are gradually changing in China.The three years residency standardized training reform model in Shanghai has been in nationwide promotion , which is gradually changing the concept of the traditional culture of medical students .The new “5 +3” training model will lead our medical education more focus on the training of medical students 'clinical practice and practical ability.In response to this positive and beneficial training mode reform and clinical hospital of the existing teaching conditions and characteristics , it has become an urgent problem to solve that how to better and more effectively im -prove the level of medical students'clinical practice .Aiming at this problem , the article put forward a number of new, more effective model of training and teaching methods based on a lot of positive and useful research teaching practice .

With the development of post education of military surgeon, traditional short training course based on theories teaching worked hard to adapt to the rapid development of medical post education.The stiff teach-ing mode can't meet the demands of improving capabilities of military surgeon.The author proposed some sugges-tions that the clinical tutorial should be introduced into the teaching training on the basis of the traditional medical training course.The reform of the new teaching mode of closing to the clinical practice outside of classroom could improve the effect of teaching and achieve the target of improving the doctors'ability of clinical treatment.

医学院校的毕业生往往存在理论知识丰富而临床能力偏低的问题。眼科学的研究对象是眼球及其附属器官，其特有的检查和诊疗方法与其它的学科十分不同，专业性很强，临床操作动作要求轻细，学习和掌握起来较为困难。本文就带教眼科临床见习的一些方法如小组学习，互学互练；检查室内，病史采集；循序渐进，动手动脑；学科交叉，提高兴趣；多点教学，增广视角等进行了总结，在一定程度上提高了眼科带教见习的学习效率，加强了教学效果，完善了教学设计。使医学生能更好地掌握课本知识并将其转变为独立正确地处理病人的能力，更快地成长为一名合格的医师。

介绍采用计算机多媒体技术制作脊柱畸形三维矫正术网络教学课件,应用文本、图形、图片、动画、视频以及音频等手段,加大教学信息量,提高教学效果及学习效率.

从医学人才整体素质的培养过程看,医学人才的培养与理工科人才培养不尽相同,是一个基础理论知识与临床技能相辅相成、紧密结合的过程,讨论式教学查房作为一种教学方式富有民主色彩、参与性强,能成功地使学生积极投入到教育过程中去,因此被广泛地应用于临床教学.但是由于教学查房的成员是由具有不同讲话方式、不同思维方式的学生组成.对同样的问题持有不同的看法或表达各自见解时所用的术语不一致,很多时候由讨论发展到争论而出现不和谐的现象,极大地降低了教学质量.

目的建立以岗位需求为导向,以能力培养为目的的护理人员培训模式,全面提高护理人员综合素质。方法采取大样本调查了解护理人员培训需求,制定各级护理人员分层次培训方案.实施能级护士的分层次管理,对培训效果及时进行阶段性的总结性评价。结果各级护理人员的核心能力得到提高,护理质量、护理安全、各项服务指标创优,创新思维在护理管理、科研、教学等方面得到充分体现。结论建立以岗位需求为导向的护理人员培训模式是时代发展的需求,是体现综合竞争力的有效手段,在现有护理人力资源紧张的情况下,可以达到充分挖掘护理队伍潜力,提高护理服务内涵的目的。

鼻饲法就是将胃管经一侧鼻腔插入胃内,从管内灌注流汁食物,水和药物的方法,对于不能经口进食者,可通过鼻饲胃管供给营养丰富的食物、水以及患者疾病治疗,患者胃管的固定及护理对于鼻饲胃管的患者是极其重要的.临床上大多选用胶布固定,随着固定的时间延长,胶布黏度逐渐减轻容易脱落,鼻翼两侧及面颊部的胶布痕迹又很难去除,常常给患者造成诸多不适.为此我科试用其它方法来固定鼻饲胃管,现将其制作方法及研究结果报道如下.

当前医疗市场竞争日趋激烈,医院要想永立潮头,不仅要着眼于加强硬件建设,更需要优化就医流程的软环境.而病人在就医过程中,能否感到安全、便利、舒适,则有赖于医院能否提供一套全方位的规范化标识系统.因此,医院标志应用规范与否也是衡量病人对就医环境满意度的决定因素之一,应引起医院管理者的高度重视.

目的了解社区居民对脑卒中认知状况,以便有针对性地进行脑卒中防病知识的普及工作.方法采用自行设计的问卷对100例社区居民进行调查.结果调查对象对脑卒中基础知识和急救护理知识认知状况均较差,普遍缺乏脑卒中防病知识.结论帮助社区居民认识预防脑卒中的重要性,采取多种形式普及脑卒中基础知识,指导社区居民掌握脑卒中急救护理手段将是今后社区健康教育的重点工作.

根据法律规定,护生只有在职业护士的严密监督和指导下,严格按照操作规程才能从事临床护理工作,否则其行为将被认为是侵犯行为[1].然而,在分析临床近年来发生的非正常护理情况时,我们发现由实习护生导致的差错占护理差错的比例较高,且多发生在护生超越老师指导单独进行治疗性操作时.在深入探讨差错发生的原因后,我们认识到,缺乏法律意识和知识是引起护生实习差错事故的重要原因,并指出只有加强法律法规教育,才能从根本上帮助护生明确自己的合法身份,防范差错,保证临床教学质量.

Objective: Know the current situation of knowledge of rescuing wounded by nursing staff in military hospital, discuss the necessity and method of training in military hospital. Methods: Investigate 222 military nurses in four military hospitals by questionnaires. Results: There is no significance in 222 military nurses, though their level of study and professional title are different. The level is low and the average record is below 5. Conclusions: Enforce mental education, sense of war preparedness, basic knowledge of first aid, improve new knowledge and technology, develop training mode integrated peacetime and wartime to raise comprehensive quality of nursing staff in military hospital for war.

采用问卷调查法对96户社区居民进行健康教育需求调查.结果100%的被调查者认为学习保健及疾病护理知识对自己及家人很有必要,需求频次较高的前3项依次为应用药物注意事项(85.0%)、饮食护理方法(82.0%)及学习相关保健知识(80.0%).最受欢迎的健康知识获得方式是医务人员讲课(69.8%)、健康宣教手册(52.1%).提出开展社区健康教育应因人因病施教、形式多样化,且需全社会的参与和支持.