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Objective:To explore the application effect of laparoscopic surgery skills training course in the standardized residency training of surgery.Methods:A total of 40 standardized trainees of surgical residents rotating in general surgery were selected as the research objects, and randomly divided into the experimental group and the control group. The experimental group was offered laparoscopic surgery skills training course. The course content includes theoretical teaching module, simulated teaching module, virtual teaching module and clinical surgery practice teaching module. The control group was taught by traditional theory teaching and clinical surgery practice teaching. At the end of the courses, the two groups of students were assessed for their skills in laparoscopic grasping and pass, suture and knotting. At the same time, a questionnaire survey was conducted among the students and teachers. The t-test was performed using SPSS 22.0 statistical software. Results:The theoretical scores of the experimental and control groups were (67.90±13.24) and (69.70±13.46), respectively, with no statistically significant difference ( P > 0.05). After the courses, the performance of grasping and pass, suture and knotting of the experimental group (15.25±3.24 and 5.45±2.14) was higher than that of the control group (11.25±2.12 and 2.75±1.16), and the difference was statistically significant ( P < 0.01).The questionnaire survey showed that the proportion of "better" feedback from students and teachers on laparoscopic skills training courses was significantly higher than that of "general" and "poor". Conclusion:The laparoscopic surgery skills training course can improve the laparoscopic surgery skills of the trainees in the standardized residency training of surgery, shorten the learning curve, and make the training standardized and homogeneous. It is worthy of wide promotion and application in the standardized training base.
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Objective:To explore the application effect of modified direct observation of procedural skills (DOPS) as a formative assessment tool in clinical skills training of professional graduate students.Methods:A total of 130 professional graduate students of Batch 2019 were selected as the experimental group, and 127 graduate students of Batch 2018 were selected as the control group. Two groups of students received clinical general skills training after enrollment, the control group adopted the traditional skills teaching method, and the experimental group added DOPS as formative assessment on the basis of traditional teaching. The teaching effect of DOPS was evaluated by means of scores analysis and student self-assessment. SPSS 23.0 was used for t-test. Results:The score of the experimental group (84.35±3.41) was higher than that of the control group (77.58±2.68), which showed a statistically significant difference ( t=2.63, P<0.05). The scores of "skill operation ability" and "communication ability" were the lowest single indexes in the assessment of DOPS. The results of self-assessment showed that the scores of autonomous learning ability, clinical thinking ability, clinical practice ability and professional accomplishment of students in the experimental group were all higher than those in the control group ( P<0.05). Conclusion:Modified DOPS is helpful to improve clinical core ability, which is worth promoting for application.
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Objective:To explore the application effect of situational case-based learning (CBL) teaching method in the surgical animal experiment course.Methods:The five-year clinical medicine students of the Batch 2016 teaching reform classes in Inner Mongolia Medical University were selected as the research objects. The teaching reform Class 1 was the control group, and the teaching reform Class 2 was the experimental group, with 36 students in each group. The control group adopted traditional teaching, while the experimental group introduced situational CBL teaching. The mid-term assessment of the course was carried out, using a multi-station examination including theory and skill operation. At the same time, a questionnaire survey of course satisfaction was carried out among the two groups of students. SPSS 22.0 was used for t-test and Chi-square test. Results:The theoretical performance of the experimental group (72.44 ±7.91) was significantly higher than that of the control group (60.49±8.23), and the performance of skill operation (77.69±7.13) was significantly higher than that of the control group (60.58±8.91). The course satisfaction of the experimental group was significantly higher than that of the control group.Conclusion:The introduction of situational CBL teaching could significantly improve the classroom teaching effect of surgical animal experiments, and be beneficial for medical students to master the basic skills of surgery and the related general theory knowledge of clinical medicine.
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Onodera prognostic nutrition index (OPNI) is a simple and effective parameter. It is calculated by serum albumin level and peripheral blood lymphocyte count. Initially, OPNI is used to assess preoperative nutritional status and surgical risk. In recent years, researchers have found that OPNI is related to the prognosis of many tumors. Simple and accurate prognosis evaluation can help to select treatment methods for digestive system malignant tumors, determine the best pre-operative treatment time and operation time, and improve the survival rate of patients with diges-tive system malignant tumors. The authors review the related literatures at home and abroad, and summarize the research advances in the prognostic value of OPNI for malignant tumors of digestive systems.
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Objective:To explore the application of formative assessment in clinical skills simulated training course.Method:s The clinical skills simulated training course for excellent doctors in our school was selected as the research focus, students of Grade 2014 adopted traditional summative evaluation (control group), and the multi-station examination was used as evaluation method. Students of Grade 2015 adopted the formative evaluation on the basis of summative evaluation (experimental group), a diversified evaluation system was established, including inter-group evaluation by students, random evaluation by teachers, feedback of operation videos of different stages and real-time feedback of students' opinions after class. Questionnaires were conducted among students and teachers at the end of the course.Result:s The scores of the experimental group were higher than those of the control group, with differences being statistically significant ( P<0.05). Questionnaires showed that the proportion of "good" selected by teachers and students in the feedback of formative assessment was markedly higher than that of "just so-so" and "bad", indicating that formative assessment is conducive to increasing students' initiative for self-studying, improving students' learning effect, comprehensively and accurately evaluating students' clinical operational skills, as well as improving the teaching level of clinical practice skills. Conclusion:The diversified evaluation system, which combines formative evaluation with summative evaluation, has achieved good teaching results in clinical skills simulated training course and it is worth to be widely applied.
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Objective To investigate the teaching effect of standardized patient teaching model in the practice teaching of emergency medicine. Methods A total of 50 standardized training residents were randomly divided into experimental group and control group during the process of medical history collection and special physical examination. The residents in the experimental group were taught with the standardized patient teaching model, and those in the control group were taught with the model of traditional theory teaching followed by clinical practice. Assessment was performed after the course was completed. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection and physical examination (P<0.05). The experimental group also had significantly higher scores of communication and humanistic concern than the control group (P<0.05). The questionnaire survey showed that the medical students preferred the standardized patient teaching model, and they thought such model could improve doctor-patient communication ability and clinical practice ( P<0 . 05 ) . Conclusion The standardized patient teaching model can significantly improve the effect of practice teaching of emergency medicine and plays an important role in improving the clinical skills of medical students in emergency.
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By formulating the standard operating procedures for clinical skills, and standardizing the operation steps, the Affiliated Hospital of Inner Mongolia Medical University further refines and quantifies the scoring criteria, and this is also applied in the teaching practice of medical students' clinical skills. The two operations of clean wound dressing and diagnostic peritoneal puncture are taken as an example for description. The assessment results shows that the level of medical students' clinical skills has improved significantly. Questionnaire survey also shows that teachers' training efficiency and students' learning effi-ciency have been improved , indicating that clinical skills standard operation procedures have achieved good teaching results in clinical skills teaching practice.
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In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.
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Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.
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Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P ＞ 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3％ and 11％,respectively,three years mortality was 14％ and 24％,respectively (x2 =0.61、1.22,all P ＞0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P ＜ 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P ＜ 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding.
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Objective To discuss the diagnostic value of peritoneal effusion detection by emergency-ultrasound in patients with closed abdominal injury. Method From August 2006 to June 2009,212 patients with closed abdominal injury were studied to evaluate peritoneal effusion detection by emergency ultrasound. Results of 212 patients,peritoneal effusion frequency rate was 78.8%( 167/212), meanwhile,abdominal paracentesis confirmation ratio was only 46.2%(98/212). In the follow-up, 13 patients with injuried hollow viscera and 1 patient with rupture of kidney showed peritoneal effusion. The volume of abdominal fluid was increasing in 17 patients,which needed to be managed by surgery. The accuracy rates were respectively 78.3%( 112/143) and 36.1%(13/36) in the solid organs and the hollow organs. Conclusion During the course of diagnosis and treatment in closed abdominal injury,peritoneal effusion monitoring by ultrasound should be used routinely, which can help to decrease the rate of misdiagnosis and avoid delayed treatment.
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Radiological evaluation is a key step for donor's preoperative evaluation in living donor liver transplantation(LDLT).There are many powerful functions in multi-slice computed tomography (MSCT)which can suit all-in-one radiological evaluation before donor's operation.By referring to the articles from home and abroad in recent years,from viewpoint of surgeon,this artical reviews the application status of multi-slice CT for preoperative assessment in LDLT,which can help to provide theory support for choice of radiological examination in LDLT donor.