ObjectiveTo explore a standardized model for cardiothoracic surgery resident training program based on a combined clinical and research oriented team approach.
Methods We conducted this study in a nationally ranked Class AAA hospital among the eleven residents who were accepted into the program. Throughout their training periods, clinical surgical skills were taught by one-on-one mentoring by individually assigned doctoral degree advisors, other attending surgeons and doctoral degree candidates in the program. To foster their scientific curiosity and research skills, regular didactic lectures in basic science and statistical skills by the doctoral thesis advisors, supplemented by monthly journal clubs during which trainees were required to present and discuss a previously assigned topics based on recent clinical cases within the department, thus combining acquisition of clinical skills and theory/research at the same setting.
ResultsEleven physicians were selected for this training path. With respect to clinical surgical skills, 4 residents were judged to be sufficient at the end of the first cycle. The other seven residents at the end of the second cycle. One trainee won the third prize in the Medical Skill Competition in the hospital. As for scientific research skills, the team produced 11 scientific articles, one of which was accepted by the annual national conference in cardiothoracic surgery and the first author was invited to present the article. The team submitted four research projects, one won funding at the provincial competition and three within the medical school.
ConclusionOur proposed standardized model of cardiothoracic surgery resident training based on a combined clinical and research oriented approach appears to be practical with moderate success. Adaptation of this model by other cardiothoracic surgery training programs in the nation will further attest to its value and functionality.
ObjectiveTo compare whether the training process of commissioned training residents from Tibet and non-commissioned training residents have achieved homogenized.MethodsThe training time and operation frequency data of 170 commissioned training residents from Tibet and 96 non-commissioned training residents of grade 2016 during the 19 months from September 2016 to April 2018 were collected. The 25 operational data of 11 departments that are representative and comparable are compared.ResultsThe two types of trainees completed the rotation of 47 different departments within 19 months, of which 45 departments were the departments where both types of students were rotated. Among these 11 departments, the average training time of trainees from Tibet in the Departments of Anesthesiology was lower than that of non-commissioned trainees (Z=–4.543, P<0.001). There were statistically significant differences in 7 of the 25 operating data (P<0.05). The operation number of arterial puncture and ventilator management (Intensive Care Unit); patient treatment (Department of Emergency); arterial puncture, ventilator management and intraoperative monitoring (Department of Anesthesiology) of trainees from Tibet were lower than those of non-commissioned trainees (P<0.05). The operation number of lung and mediastinal examinations (Department of Radiology) of trainees from Tibet was higher than that of non-commissioned trainees (P<0.05).ConclusionsDuring the training of the two types of trainees, the rotation schedule was basically the same, but there were differences in the clinical practice operations. Trainees from Tibet have higher requirements for radiology training. Trainees from Tibet will return to Tibet with independent practice needs, so their requirements of medical imaging skills operation would be higher. Due to language and training time, the critically ill, emergency first aid, and surgical skills of trainees from Tibet are not as good as those of non-commissioned trainees, and they need to gradually strengthen and improve these skills in subsequent trainings.
摘要:目的: 了解綿竹市社區衛生服務系統震后現狀,同時分析社區醫療震后居民滿意度和社區衛生服務機構震后災害干預能力,以期為社區衛生服務體系地震應急恢復和重建提供參考意見。 方法 :采用隨機抽樣的方法,抽取綿竹市劍南社區衛生服務中心和天河社區衛生服務中心進行訪談,采取方便抽樣的方法,抽取24‰的綿竹城區居民采用面對面訪談的方式用自制問卷進行調查,并用Epidata30 進行數據錄入、SPSS130進行統計分析。 結果 :共發放問卷240份,收回有效問卷229份(有效回收率954%)。當地社區衛生服務系統在地震中受損嚴重。社區衛生服務系統災后工作居民滿意度為454%,社區衛生服務機構對居民進行抗災/防災知識教育的比例為336%,災后是否有持續而足夠的常見病藥品供應及是否有持續而足夠的慢性病藥品供應是影響當地居民對當地社區衛生服務體系災害應急工作的滿意度的影響因素(P 值分別是0033,0001)。 結論 :震后社區衛生服務居民滿意度較低,服務體系地震災害干預能力不足。居民在在災前接受抗災教育的比例較低,加強藥品儲備能提高社區衛生機構災害應急工作的效果。在社區衛生服務體系重建的過程中,應注重社區醫療基礎工作的恢復,基礎設施的重建和健全社區急救體系。Abstract: Objective: To investigate the reality of community health service system after earthquake in Mianzhu, the satisfaction of community residents to the community health service as well as the postdisaster emergency response capability of community hospital in order to provide decisionmaking suggestions on better reconstruction of community health service system. Methods : Jiannan and Tianhe community hospital were randomly selected for visiting and 24‰ of community residents in the city zone of Mianzhu were selected by convenience sampling for a facetoface interview using a questionnaire. Data entry and statistically analysis were completed by Epidata30 and SPSS130 respectively. Results :A total of 240 questionnaires were conducted to facetoface interviews, and 229 questionnaires were returned (response rate 954%).The community health service system was badly injured. Residents’ satisfactory degree of the community health service after earthquake was 454%. The proportions of disaster / disaster prevention education was 336%,medicine supply for familiar diseases and the chronic were the main factors which influenced judgements of residents to the emergency response capabilities of community hospitals(〖WTBX〗P =0033,P=0001,respectively). Conclusion :The community health services after earthquake had not been widely satisfied and the emergency response capability of community hospital was far from enough. The proportions of disaster / disaster prevention education were far from enough. The effectiveness of emergency response work of community hospitals can be enhanced by reinforcing medicine preparation.In the course of the reconstruction, community health service system should pay attention to the resumance of basic community health service,reconstruction of basic establishment and construction of firstaid system.
Objective To evaluate the quality of undergraduate medical education so as to provide useful and effective feedback information for medical schools and to extend GMER (Global Minimum Essential Requirements in Medical Education) standard. Methods Through questionnaires, 205 resident doctors self-evaluated their abilities or qualities based on GMER standard. The unconditioned logistic regression model was used for data analysis. Results Graduates from undergraduate medical programs mastered the abilities or qualities required in 4 GMER domains i.e. “professional values, attitudes, behaviors and ethics”, “clinical skills”, “communication skills”, and “scientific foundation of medicine”. But the abilities or qualities required in “information management”, “population health and health systems” as well as “critical thinking and research” domains have not been obtained. The main factors that affected the evaluation results were corresponding training to the essentials, learner’s attitude, teaching models and teaching hours. Conclusion Educational sectors should adjust curriculum design so as to help medical students master the abilities required in the 3 domains stated above. Medical schools should conduct some educational research to formulate the most beneficial teaching methods, and import advanced ones to raise the quality of medical education in China.
We summarize the primary structure, objective and achievements of the resident standard training program in West China Hospital of Sichuan University during the past decade. We also give some advices on how to develop and accomplish future goals of resident standard training.
ObjectiveTo evaluate the quality of life of residents in stricken area five years after Wenchuan earthquake, so as to explore the main influential factors such as gender, age, ethnic group, marriage status and the extent affected by the earthquake.
MethodsUsing WHOQOL-BREF, 500 residents from Hanyuan county in Sichuan province were assessed in order to analyze their life quality and related factors.
ResultsThe score on the overall WHOQOL-BREF and the level of each factor were significantly lower than the score on the normal people (P < 0.001). Male score in the factor of social relations significantly higher than female (t=3.963, P < 0.001). The overall score and the score of social factor were significantly lower in the minor than in the adults (t=-2.667, P < 0.01; t=-19.287, P < 0.001). And the quality score of social relationship was significantly lower in the single than in the married and cohabiting couples (P < 0.001; P < 0.01).
ConclusionThe quality of life of residents in stricken area five years after Wenchuan earthquake was significantly lower than the national norm. There are significant differences in terms of gender, age, marriage status and earthquake damage on social relations. Steady intimate relationships with others help improve the quality of life of residents in stricken area. Besides, compared those with average damage or no damage, the residents with serious damage are relatively worse in the overall quality of life as well as environmental conditions.
Objective To investigate the construction and services of the community health service system in Shifang, as well as the satisfaction of community residents with the community health services and the post-disaster emergency response capability of the community hospital, so as to provide decision-making suggestions on better reconstruction of the community health service system and improvement of its post-disaster emergency response capability. Methods There were 4‰ of community residents in Fangting town were selected by convenience sampling for a face-to-face interview using a questionnaire. Logistic regression was used to identify the influencing factors of residents’ satisfaction with community health services. Results A total of 250 questionnaires were conducted for face-to-face interviews, and 246 ones were retrieved (response rate 98.4%). Residents’ understanding and satisfactory degree of the community health service were 41.1% and 36.6%, respectively. Health education, medical expenses and medical insurance were the main factors influencing the residents’ satisfactory degree of community health services (P=0.050, 0.001, and 0.001). The proportions of disaster / disaster prevention education, exercises of post-disaster contingency plans, and psychological intervention as well as rehabilitation for residents were 37.4%, 10.6%, and 12.6%, respectively. Conclusion Community health services have not been widely accepted by community residents, and the satisfactory degree is low. The residents’ understanding and adaptation can be improved by strengthening the community health service propaganda. Strengthening health education, improving the quality of services, controlling costs, and introducing medical insurance reimbursement mechanism can increase the residents’ satisfactory degree. Including disaster emergencies into basic tasks can strengthen the emergency response capability and then provide guarantee for the residents’ health.
Objective To survey the current status of residents’ health examination in township medical units in Shuangliu county, so as to provide references for exploring the residents’ health examination mode suitable for the well-off rural hospitals, and for improving the effects of physical examination. Methods The self-designed questionnaires were made to survey the current situation of health examination for the residents in 24 township medical units in Shuangliu County, including 3 central township hospitals, 3 community health centers and 18 general township hospitals; and the outline was designed to interview the people responsible for managing and implementing the resident’s examination work. The Epidate 3.1 was used for data input, the SPSS 17.0 was used for descriptive statistics and stratified analysis, and the classification method was adopted for qualitative research of personal interview data. Results The number of primary health care units for carrying out residents’ health examination got gradually increased year by year from 2008 to 2010; and all 24 township-level medical units had already carried out that examination by 2010. But some issues still existed such as lower participation rate and ineffective utilization of the archives. Conclusion a) It is necessary to prepare well, enhance organizing, expand publicity, and increase participation rate when primary health care units carry out the health examination for residents; b) It is necessary requires to fasten the informatization construction of health archives, and to quicken the process and analysis of examination information; and c) It is advisable to constantly optimize the examination items according to exam information, to improve the qualification of medical staffs, and to fasten the construction of exam team.
Objective To learn about the evaluation of the practical value of resident doctors towards the Global Minimum Essential Requirements in Medical Education (GMER), so as to provide effective information for the usage of GMER in China. Methods Two hundred and five resident doctors of West China Hospital of Sichuan University were investigated by the use of questionnaires. Results The evaluation of the practical value towards the 7 domains of GMER was high, but the “population health and health systems” domain gains the lowest scores. Conclusion The society might ask doctors to use the abilities required by GMER, especially the requirements in the "population health and health systems" domain. It is suggested that the doctors’ performance evaluation system be adjusted by adding the weight to the lower score domains, and the medical students be trained to be equipped with both macro and micro thinking abilities in medical school, so as to cultivate doctors with the "core competence" of GMER.
Standardized resident training is one of the important contents of reform of the medical and health system. Meanwhile, it is the key part of education for medical graduates, and serves as a bridge for the cultivation of high-level medical talents. This article analyzes the necessity of standardized resident training, current situation and the difficulties faced, puts forward feasible suggestions based on previous practices, and envisions the future of training work.
