Lumbar puncture for children is a difficult technique and is an important aspect of clinical teaching for residents and interns in the neurological department of pediatrics. In this article, we summarized techniques and experiences of clinical teaching in pediatric lumbar puncture, and discussed difficulty, variability and remedial strategy for lumbar puncture in children. Narrow intervertebral space, poor compliance and resistance of children are the main difficulty for pediatric lumbar puncture. The causes of failure for medical students include different sensations of breakthrough when using different needles, choice of un-preferable intervertebral space, excessive vertical angle for needling performance, deviation from the longitudinal midline of the body, incorrect anesthesia, and exceeding resistance of children patients. Corresponding remedial strategy for failure of puncture includes informing students of the technique and variability of puncture, training experienced staff for second- and third-line substitutes, and reinforcing nursing after surgery. This summary of techniques for pediatric lumbar puncture and experiences of clinical teaching will benefit pediatricians and their clinical training.
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.
Prosthetics and orthotics is an applied discipline which require students to have a good ability of clinical application. However, the present doctor-patient tension poses great difficulties in students’ clinical practice and study, and thus proposes higher requirements in the talent cultivation. Standardized patients (SP), as a newly established teaching mode, has been applied well in such areas as internal medicine, diagnostics and clinical care for about 20 years in this country. However, in prosthetics and orthotics, we hardly have any SP teaching experience in China. According to the experience of using SP in clinical medicine, this article discusses the necessity of SP in the teaching of prosthetics and orthotics, explains the advantages and disadvantages of SP teaching, and analyzes the feasibility of SP application in the teaching of prosthetics and orthotics under the present situation. Finally, this article concludes that using SP can improve students’ motivation, interest in learning and communication skills with patients. Therefore, it will become a research direction and development trend of prosthetics and orthotics.
Evidencebased medicine (EBM) is different fromtraditional medicine in that the practice of EBM comes from evidence and experience of the doctors. The objective evidence plays a key role in clinical practice. During the clinical teaching process, the following steps should be taken: firstly, the students should find a problem in their clinical practice; then, theyshould search for the evidence with the help of their teachers, evaluate the evidence, apply the evidence to the clinical practice, and solve the problem; finally, they should evaluate the effectiveness. An introduction of the principles and methods of EBM to the clinical practice can greatly improve the students’ ability to analyze and solve a clinical problem.
Objective To evaluate the feasibility and significance of problem-based learning (PBL) in orthopedic internship. Methods A total of 315 students in grade 2002 were involved in PBL during their internship in the Department of Orthopedics at the First Affiliated Hospital of China Medical University, Shenyang, China. Teaching effectiveness was evaluated with a questionnaire and an ability examination. The results of PBL teaching during different semesters were compared, and the feasibil ity and significance of PBL were analyzed. Results Students who participated in PBL were in a dominant position and were more active in the learning process. The PBL pattern could improve students’ ability to identify, analyze and solve problems, and also contribute to fostering and enhancing their clinical thinking. This could help them solve the problems that emerged from the theory curriculum.Conclusions The PBL pattern used in the orthopedics internship has advantages and practical significance, which are applicable in modern medical teaching practice.
ObjectiveTo improve the quality of clinical teaching by restructuring the clinical teaching process with Six Sigma management theory. MethodsBased on the Six Sigma management theory, this paper explored the key causes of the quality of clinical teaching in the respiratory department by using scientific tools including Brainstorming, Fishbone Diagram and Pareto Principle. The problem of teaching of professional clinical skills was the key factor that affected the quality of department's clinical teaching. This paper improved the quality of clinical teaching by restructuring the clinical teaching process including drawing up and carrying out The Manual of Clinical Skills Teaching in respiratory department and introducing the scientific teaching method. ResultsAbout the survey on the satisfaction of clinical teaching process, the score of the control group was much higher than that of the experimental group (P < 0.05). And the score of the skill test of the control group was much higher than that of the experimental group (P < 0.05). ConclusionThe application of Six Sigma management and process restructuration to improve the clinical teaching is significantly effective.
摘要:目的:探讨临床教学的全程制度化管理及其效果。方法:通过健全组织,完善制度,加强教学、临床及实习生管理、建立激励机制等措施,进行全程制度化的规范管理。结果:教学质量显著提高,不良事件鲜见,无恶性事件发生。近来医院已有6篇教学论文公开发表,4个先进集体和8名先进个人受到医院表彰,5名优秀带教教师和8名实习生受到各学院奖励。结论:临床教学全程制度化管理是提高教学质量的切实有效途径。Abstract: Objective: To investigate system management during the entire clinical teaching process and its effect. Methods: To robust organization, perfect rules, strengthen management of clinical teaching and intern student, and establish encouragement mechanism,and other measures, so as to conduct standard system management during the entire process. Results: Quality of teaching improved notably, bad event was scarce, no malignant event occurred. There were six teaching articles issued publicly, four advanced collectives and eight advanced individuals had been praised by hospital, and five excellent teachers,eight intern students had been rewarded by each college. Conclusion: System management during the entire clinical teaching process is an effective way to improve teaching quality.
ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.