Global Minimum Essential Requirements (GMER) is focused on training medical students to equip them with the scientific foundation of medicine, clinical techniques, a doctor’s professional ethos, social sciences, health economics, medical information management and communication skills, etc. Based on GMER and its evaluation and through the integration of GMER’s seven requirements into the objectives of the clinical-medicine major, Shanxi Medical University is reforming medical education to carry forward high quality education in a comprehensive way. These reforms include adjustments in the content, methods and means of the teaching in order to improve teaching conditions and optimize the curriculum structure, and to enhance the quality of education. At the same time the management system is being reformed and sustainability-featured mechanisms of management and operation are being created, to make simulated hospital a base wherein GMER is fully followed. Simulated hospital for clinical teaching is built to cultivate the students’ abilities in clinical thinking and clinical education. This takes into full consideration training in professional quality, the cultivation of students’ comprehensive ability and GMER’s aim of reaching the final objective, namely, the following four transformations of the students: from essential knowledge to clinical practice, from single technique to all-round ability, from patterning thought to integrated and innovative thought and from a student of clinical medicine to a professional doctor. The objective is to fulfill the task of teaching clinical medicine in a more favorable way, promoting the reform and development of China’s medical education and keeping pace with changes in medical education elsewhere in the world.
With the integration of new technologies such as molecular imaging, artificial intelligence, and big data with medical equipment, the role of clinical engineering talents with interdisciplinary knowledge and skills in the medical field is increasingly prominent. Since 2018, West China School of Medicine, Sichuan University has launched an introductory general education course on clinical engineering management for undergraduate students across the university. In response to the national education reform strategy, the course has shifted from a single theoretical teaching model to an “autonomy, cooperation, and inquiry” model, enriching the teaching staff and optimizing the teaching assessment. With 5 years of course practice, the number of course applicants has continued to grow, covering a wider range of subject areas, and students have given good evaluations of their teaching. The exploration and practice of this course provide new strategies for cultivating clinical engineering talents.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
Objective To explore the application and effects of Seminar case teaching method in teaching surgical nursing. Methods Nursing students of the Yiyang Junior Medical College were divided into two groups (140 students/group). Seminar case teaching was applied in the trial group, while traditional teaching method (classroom teaching or instruction) was applied in the control group. The two groups used the same materials, and were taught by the same teacher team during the same course. After the courses, surgical knowledge and skills were evaluated using theory exams and operation tests (tools included communication ability scale as well as the California Critical Thinking Dispositions Inventory Scale for students’ ability and quality levels, and an anonymous questionnaire for teaching satisfaction) were analyzed between the two groups. Results The scores of the trial group were higher than those of the control group in theory exams and operation tests, with a significant difference (Plt;0.01). The before-after score differences of communication skills and critical thinking ability of the trial group were also higher than those of the control group, with a significant difference (Plt;0.01). The result of the anonymous questionnaire showed that, the students in the trial group had better satisfaction about Seminar case teaching method. Conclusion Seminar case teaching method applied in surgical nursing teaching is feasible and effective, which is better than traditional teaching method in improving knowledge, ability, and quality of nursing students.
Objective To explore the impact of Diagnosis-Intervention Packet (DIP) reform on the operation of pilot county-level hospital, analyze the challenges that hospitals may face in DIP reform, and propose strategies to adapt to the reform. Methods The settlement list data of inpatients insured by medical insurance for 2022 from a county-level tertiary public hospital in Jiuquan City, Gansu Province were collected, where DIP was planned to operate. The DIP payment was simulated, and the operational status of the hospital and departments after implementing DIP reform was analyzed based on enrollment status, cost deviation, length of stay, hospitalization expenses, and DIP payment as relevant indicators. Results Under the implementation of DIP payment, the overall enrollment rate of the hospital was 98.1%, including 85.4% in the core group, 7.0% in the comprehensive group, and 7.6% in the grassroots group. Normal costs accounted for 88.9%, deviation costs accounted for 11.1%, with high magnification cases accounting for 1.9% and low magnification cases accounting for 9.2%. The payment standard for all cases included in the hospital according to DIP was 15.464 million yuan, the total amount paid by the pooling fund was 19.986 million yuan, and the difference between DIP payment and payment by project was –4.522 million yuan. Conclusion There is a significant difference in the medical insurance payments received by county-level hospitals after implementing DIP payment, and there is an urgent need to adapt to the DIP payment reform as soon as possible.
This article is based on the work practice of Medical-lnsurance-Medicine Linkage carried out by the Nanping First Hospital Affiliated to Fujian Medical University under the reform of payment based on diagnosis related group (DRG). It outlines the connotation and extension of Medical-lnsurance-Medicine Linkage in the hospital, including concept definition, organizational structure, the relationship between DRG payment and Medical-lnsurance-Medicine Linkage, and summarizes the specific measures and positive results of the Medical-lnsurance-Medicine Linkage work mechanism from four aspects: medical quality management, medical insurance management, medical drugs/consumables management, and performance evaluation. These experiences are of great significance for improving the quality and efficiency of medical care, actively responding to the reform of medical insurance payment methods, enhancing the level of medical services in public hospitals, and achieving a win situation among the medical insurance management departments, hospitals, and patients.
ObjectiveTo investigate the drug utilization in primary healthcare system of Xinjin county of Chengdu in 2010.
MethodsThe drug utilization information in regional health information platform of Xinjin county were collected. Microsoft Excel 2003 software was used to describe the types, forms and expenditure of medicines, particularly the use of antibiotics among outpatients and inpatients.
ResultsThe drug utilization of 17 hospitals in Xinjin county in 2010 was summarized below:a) there were 1 507, 1 356 and 695 kinds of drugs dispended for outpatients, and 1 271, 1 023 and 317 for inpatients in county-level hospitals (CLH), township hospitals (TH) and community healthcare centre (CHC), respectively. Among which, oral biomedicine and traditional Chinese medicine (TCM) accounted for about 45% of total types, and 46% to 73% of total drug expenditure among outpatients; while oral biomedicine and the injection accounted 37% to 61% of total types of medicines dispended to inpatients, particularly injection of biomedicine accounting for over 75% of total drug expenditure among inpatients. b) The expenditure of top 30 drugs in primary care hospitals accounted for 50% of total drug expenditure among outpatients and over 85% among inpatients. c) Among the top 20 drugs, there were 15 antibiotics, which accounted for 26.5% of total drug expenditure in Xinjin county. The top 10 antibiotics were mainly cephalosporin, accounting for 59.36% and 66.27% of total antibiotics expenditure among outpatients and inpatients respectively.
Conclusiona) The main forms of medicines dispended to outpatients are oral biomedicine and TCM, while oral agents and injection of biomedicine are the majority of medicines used for inpatients. b) The top 30 drugs should be monitored for rational use of drugs considering the huge expenditure. And c) the types, proportion of use and expenses of antimicrobial drugs ranked the first in CLH, CHC and TH, which may imply irrational use of antibiotics.
