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1.
Article in Chinese | WPRIM | ID: wpr-911746

ABSTRACT

The Xidu Community Health Service Center has become the first general practice outskirt teaching site of Shanghai Zhongshan Hospital since May 2015; the Fudan University Shanghai Medical College Xidu General Practice Clinical Teaching and Training Base was formally established in May 2018. For last 6 years, with the cooperation with Zhongshan Hospital the Xidu Community Health Service Center has participated in teaching and training of general practice residents and general practitioners, which also greatly promoted the development of clinical service, disease prevention and scientific research of the center itself. This article introduces the "Fudan-Xidu" integrated model and its experiences in general practice teaching, focusing on the background, the organization, teaching implementation, achievements and future prospects, to provide a reference for talent training of general practice in grassroots institutions.

2.
Article in Chinese | WPRIM | ID: wpr-798588

ABSTRACT

In order to improve the quality of clinical teaching, Xidu Community Health Service Center of Shanghai Fengxian District established a teaching clinic for training of general practitioners in 2015. The clinic served as a suburban teaching station of Department of General Practice of Zhongshan Hospital, a tertiary university hospital. This article introduces the implementation methods, achievements, practical experiences and work prospects of the clinic. The issues of system evaluation and the generalization of this teaching model for training of general practitioners are also discussed in the article.

3.
Article in Chinese | WPRIM | ID: wpr-870740

ABSTRACT

Objective:To assess the concept and clinical practice of general practitioners in community health service centers (CHCs) on the use of antiplatelet drugs (APD) to prevent cardiovascular diseases(CVD).Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the situation of CVD patients, application of APD in primary/secondary prevention of CVD (schemes and regimes), the prescription concept of APD, and influencing factors.Results:Total 350 valid questionnaires were recovered. The survey showed that among all patients general practitioners routinely took care, 46% (30%, 60%) were hypertensive patients; 96.6% (338/350) of the general practitioners said that they had carried out primary prevention, mainly for patients with hypertension, diabetes, dyslipidemia or carotid artery plaque, and 34% (20%, 45%) of the patients had taken primary prevention drugs; the use of APD only accounted for 47% (35%, 60%) , among which 87% (80%, 95%) was aspirin. The main impediments were lack of awareness of disease from patients[ (8.0±1.4) points] and lack of awareness of primary prophylaxis from general practitioners[ (7.3±1.4) points]. The survey also showed that 28% (20%, 35%) and 17% (10%, 20%) patients were diagnosed as coronary heart disease and stroke, respectively; 83% (80%, 95%) of patients with coronary heart disease or stroke used APD for secondary prophylaxis; for coronary heart disease patients, 82% (70%, 95%) taking aspirin or clopidogrel, 18% (5%, 30%) taking aspirin and clopidogrel for 11 months; for stroke patients, 85% (80%, 95%) taking aspirin or clopidogrel, 15% (5%, 20%) taking aspirin and clopidogrel for 9 months. Compared with clopidogrel, aspirin had a relatively high score for clinical experience (8.3±1.1) and reasonable cost of treatment (8.3±1.3) .Most coronary heart disease patients (68%±15%) and stroke patients (70%±17%) took APD regularly. The lack of knowledge of disease [(8.4±1.1) points] and awareness of regular medication [(8.2±1.2) points] were the main factors affecting compliance of patients.Conclusion:The use of APD in primary prevention of CVD for general practitioners is insufficient, and there is still a big gap between the standardization and the practice in secondary prevention; in particular, the selection of APDs and treatment course should strictly follow the guidelines.

4.
Article in Chinese | WPRIM | ID: wpr-870714

ABSTRACT

Objective:To survey the status of antihypertensive therapy knowledge and hypertension management among general practitioners in community health centers (CHCs) in China.Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the proportion of hypertensive patients in the consultation, treatment target rate, antihypertensive drugs and protocol, the medication compliance, follow-up, blood pressure self-measurement, and the impact of hierachical medical system on CHC.Results:Total 350 valid questionnaires were recovered. The survey showed that: (1) Among the patients treated by general practitioners, 46% (30%, 60%) were hypertensive patients including 41% (40%, 55%) with primary hypertension and 42% (40%, 50%) with secondary hypertension; 72% (60%, 80%) of the patients had comorbidities, including dyslipidemia, diabetes, and coronary heart disease. (2) Western medicine was the main antihypertensive treatment [90% (82%, 100%) ], calcium channel blockers were the most commonly used antihypertensive drug [46%(30%,60%)], the therapeutic protocol was mainly single agent [35% (25%, 50%) ]or free combination [50% (40%, 60%) ]; the stable(9.1±0.8), long-acting (9.0±0.9) and high standard reaching rate (8.1±1.1) antihypertensive drugs were first considered, and the standard reaching rate of hypertension treatment was 61% (50%, 75%) . (3) The regular follow-up rate, adherence to blood pressure self-test rate and long-term regular medication rate was 60%(50%,70%), 51%(40%,70%) and 65%(50%,70%), respectively. The factors affecting patients′ compliance were history of cardiovascular diseases (8.4±1.1)and patients′ cognition of disease(8.3±1.1). General practitioners believed that the positive effects of the hierarchical diagnosis and treatment system include helping to establish a closer relationship with patients [62.6% (219/350)] and improving patient compliance for community preferential reimbursement policies[58.6% (205/350) ]. The challenges faced by CHC included higher patient expectations [52.8% (185/350)] and increased outpatient visits [52.6% (184/350)]. Insufficient diagnostic equipment [68.3% (239/350)], inadequate dispensing [52.3% (183/350)] and other issues restricted the development of CHC, and the clinical competence of general practitioners [51.7% (181/350)] need to be improved.Conclusion:Patients with hypertension account for about half of the total number of visits in community health service centers, and most of them are comorbid with cardiovascular and cerebrovascular diseases or risk factors. The long-term treatment compliance and self-management of blood pressure need to be further improved.

5.
Article in Chinese | WPRIM | ID: wpr-870648

ABSTRACT

A pilot mixed assessment method was used to evaluate the clinical and teaching ability of general practitioners (GPs) in a suburban district of Shanghai. In December 2018, 29 GPs from 20 community health centers in a suburban district of Shanghai were assessed by a mixed method consisting of 3 domains and 8 stations for one day. The average age of GPs was (37.8±4.7) years and 22 were females (75.9%). In 3 domains, the average score (66.8±9.7) and qualified rate (75.9%) of clinical thinking abilities were the lowest. In 8 stations, the average score [(53.8+13.4) points] and qualified rate (34.5%) of adult SOAP medical record writing station were the lowest. The average score of pediatric outpatients consult station of GPs with<15 years of community work experience was higher than that of GPs with >15 years of work experience [(68.6+10.2) vs. (58.5+9.4), t=2.787, P<0.05]. There was no significant difference in the scores among GPs with different teaching years and titles. The average scores of clinical thinking ability domain ( t=2.115) and adult outpatient consult station ( t=3.410); in the clinical operation ability domain the ophthalmoscopy and readings ( t=3.816) and otoscopy and reporting station ( t=2.286); clinical teaching abilities ( t=2.618) and simulated educational situation station ( t=2.452) and mini lectures station ( t=2.802) of GPs in the community teaching base were higher than those in non-community teaching base (all P<0.05). Mixed assessment method can be used as one of the important means for GPs′ ability assessment. The community teaching bases have effectively improved the clinical and teaching abilities of GPs in suburban areas, however, the clinical thinking abilities of them are still weak.

6.
Article in Chinese | WPRIM | ID: wpr-870621

ABSTRACT

In order to improve the quality of clinical teaching, Xidu Community Health Service Center of Shanghai Fengxian District established a teaching clinic for training of general practitioners in 2015. The clinic served as a suburban teaching station of Department of General Practice of Zhongshan Hospital, a tertiary university hospital. This article introduces the implementation methods, achievements, practical experiences and work prospects of the clinic. The issues of system evaluation and the generalization of this teaching model for training of general practitioners are also discussed in the article.

7.
Article in Chinese | WPRIM | ID: wpr-745894

ABSTRACT

Objective To apply objective structured teaching evaluation (OSTE) in teaching competence assessment for general practice preceptors in community training bases.Methods The teaching competency was assessed with OSTE for 28 general practice preceptors in Fengxian District of Shanghai in December 2017.The application of OSTE was evaluated with questionnaire among preceptors,examiners and standardized students(SS).Results Among 28 preceptors there were 23 females (82.1%),with an average age of (37.3±4.2) years.The average teaching duration was (2.8±2.1) years.In the five OSTE station,the highest total score was (88.1 ±2.7) points in the first station self-presentation,while the lowest was (70.8± 14.5) points of the second part physical examination feedback of the third station ambulatory care teaching.The total score in the fifth station (doctor-patient communication teaching) of participants with< 15 years of community practice was higher than those ≥15 years of community practice [(80.1±8.5) vs.(71.6± 7.1),t=2.092,P=0.007].Except"being able to adapt to this form of evaluation",the proportions of choosing "very good"were all more than 50% in other 4 aspects.The overall willingness of "recommending OSTE as the main method to evaluate the teaching competence of GP trainers" was higher in examiners and SS than that inpreceptors (Z=2.836,P=0.005).Conclusion The innovative approach of OSTE has been widely recognized,but the professional capability,the cognition of general practice,the teaching competence and the willingness to use OSTE need to be strengthened for general practice receptors in community bases.

8.
Article in Chinese | WPRIM | ID: wpr-745879

ABSTRACT

One hundred and fifty diabetic patients,who received management by community family doctors and hospital consortium (1+1+1) team for at least 1 year,were enrolled from January 2017 to May 2017.After that they continued to receive the management for 1 more year by the team which were trained with TeamSTEPPS (team strategies and tools to enhance performance and patient safety).The management effect before and after TeamSTEPPS training was compared.After the TeamSTEPPS training,the team management ability was improved,so that the compliance of diabetic patients with medical advice,regular examination of blood glucose,regular follow-up assessment,health education,regular exercise and diet control were all better than before,and the differences were statistically significant (all P<0.01).Fasting blood glucose,postprandial 2 h-blood glucose,glycosylated hemoglobin and LDL-C levels were all lower than before,and the achieved rate of the above indicators were also increased (P<0.05).It is suggested that application of TeamSTEPPS in team training can effectively enhance the management ability for chronic disease of family doctors and improve compliance and clinical indicators of patients with diabetes under management.

9.
Article in Chinese | WPRIM | ID: wpr-734837

ABSTRACT

Objective To survey the requirement of objective structured teaching evaluation (OSTE) use for general practice (GP) trainers and the station design.Methods A questionnaire survey on the requirement of OSTE use was conducted among 161 hospital trainers and 110 community trainers from a national key GP trainers training workship in April 2016.The survey included basic information,OSTE use requirements,frequency of clinical teaching scenarios,and frequency of teaching methods.Results The survey showed that 86.3%(234/271) of trainers were willing to use OSTE for assessing teaching competence and 92.3% (250/271) for training teaching competence.The proportion of “having been observed and being given feedback from superior trainers for teaching process” was higher in hospital trainers than that in community trainers [68.3%(110/161)vs.40.9%(45/110),x2=20.060,P<0.001].In the part of frequency of teaching scenarios,the proportion of “often” plus “always” was higher in “instructing students to write the medical records” [64.6%(175/271)],“teaching doctor-patient communication skills” [60.9%(165/271)] and “observing students' consultation and giving feedback” [57.9%(157/271)];there were no significant differences in above questions between the two types of trainers (all P>0.01).In the part of frequency of teaching methodS,the proportion of “often”plus “always”was higher in “clinical supervisor's report” [60.9% (165/271)],“applied knowledge test” [52.4%(142/271)] and “problem-based learning” [38.0%(103/271)];there were no significant differences in above questions between the two types of trainers (all P>0.01).Conclusion The requirements of assessment and training by using OSTE are strong in GP trainers.The OSTE stations should be designed based on the routine teaching scenarios and methods for both hospital trainers and community trainers without discriminations.

10.
Article in Chinese | WPRIM | ID: wpr-807017

ABSTRACT

Objective@#To examine the prevalence of depression and anxiety symptoms, and the related factors in family members of schizophrenic patients in a Shanghai community.@*Methods@#From March to May 2017, the family members of 206 schizophrenic patients registered in Xuhui district Kangjian community of Shanghai were enrolled in this cross-sectional survey. The participants were evaluated with Patient Health Questionnaire Self-rating Depression Scale (PHQ-9) and the Anxiety Screening Scale (GAD-7). The factors related to depression and anxiety symptoms were analyzed.@*Results@#The detection rates of depressive symptoms and anxiety symptoms in the family members of schizophrenia patients were 40.3%(83/206) and 37.9%(78/206), respectively.Univariate analysis showed that the relationship with the patient, education levels were the influencing factors of depressive symptoms (χ2=17.045, 9.702; P<0.01); while age, relationship with the patient, education levels were factors related to the occurence of anxiety symptoms (χ2=11.862, 22.042, 15.060; P<0.01). Multivariate regression analysis showed that the parents of patient was more prone to depressive symptoms than spouses (OR=2.861, P<0.01); higher education was more prone to be depressive than primary education (OR=10.071, P<0.01). Age group 18-40 years were more prone to anxiety than the age group ≥66 years (OR=0.060, P<0.05); sibling relationship is more prone to anxiety than spouse relationship (OR=10.018, P<0.01), followed by parental relationship (OR=7.467, P<0.01); higher education was more prone to anxiety than primary education (OR=5.119, P<0.05).@*Conclusions@#There is high prevalence of depression and anxiety symptoms in family members of schizophrenic patients, which is related to the relationship with the patient, the education level of family members and other factors.

11.
Article in Chinese | WPRIM | ID: wpr-666138

ABSTRACT

Objective To assess the needs and demand of continuing medical education(CME)for general practitioners(GPs)after completion of residency training.Methods A series of surveys were carried out from July 2015 to December 2015 using a questionnaire on needs and demands of CME among 152 GPs, who completed residency training in Zhongshan Hospital from September 2000 to July 2013. Results One hundred and fifty two valid questionnaires were received with a retrieval rate of 100%.Among 512 participants,53(34.9%)regarded CME as necessary,129(84.9%)were willing or very willing to receive CME,87(68.9%)stated that they were willing to receive CME even without credits,120 of them (78.9%)stated that the primary purpose of receiving CME was to update professional knowledge;87(57.2%)stated lack of certain knowledge and 52(34.2%)stated lack of certain skills to some extent;8(5.3%)thought that the previous CME they received did not completely meet their needs,105(69.1%) thought that it partially met their needs;136(89.5%)thought that only high level experts were suitable for CME teaching;the teaching methods they preferred were problem-based learning(PBL), followed by case study,clinical demonstration and instruction,and systematic lectures focused on common clinical problems;88(57.9%)preferred short term training with an average length of 5.01 days(91.4%,139/152);111 (75.0%)preferred CME course to be offered on both workdays and off hours.The factors influencing willingness to attend CME included length of time(87.5%,133/152),lack of suitable program(64.5%, 98/152),monotonous way of training, impractical training contents and its inconsistency with actual need (60.3%, 91/52).Conclusion The needs and demands of continuing medical education for GPs completing residency training are high.The results of this study would provide useful information for effective implementation of continuing medical education for GPs.

12.
Article in Chinese | WPRIM | ID: wpr-666050

ABSTRACT

Objective To survey the attitude to sexually transmitted disease(STD)testing among physicians in community health service centers(CHC)of 20 cities in China.Methods A cross-sectional survey using stratified random sample was conducted in September to December 2015, among 1 734 physicians from 158 CHCs in 20 cities of 6 provinces and 2 municipalities.Results The average age of participants was(39.7 ±10.6)years, the time for present position was(15.8 ±11.5)years, and 47.0%(799/1 700)were general practitioners(GPs).The survey showed that in the last month,8.1%(138/1 699)of the physicians contacted with the specific population of STD(sex worker,MSM,drug user, etc), and 18.3%(313/1 706)of them managed STD patients or provided services to suspected STD patients;62.0%(1 048/1 689)of them received the STD-related training previously;46.5%(784/1 686) thought the lack of training in STD testing as the biggest barrier for carrying out STD testing in CHC.As for the specific populations, 73.4%(1 241/1 692)of physicians thought that it was meaningful, 62.0%(1 043/1 683)of them worried about"have difficulty to deal with their STD clinically", and only 5.8%(97/1 683)of them expressed their"dislike of specific population".Conclusions Most physicians in CHCs believe that STD testing should be included in the routine tests, and it is feasible to carry out STD testing in CHCs.Lack of training is the main barrier for STD testing, so it is necessary to conduct STD testing related trainings in CHCs.

13.
Article in Chinese | WPRIM | ID: wpr-710911

ABSTRACT

Objective To compare the awareness, training and assessment of teaching competence between hospital and community general practice (GP) trainers. Methods A questionnaire survey on teaching competence was conducted among 161 hospital GP trainers and 110 community GP trainers in 2016 April. Results There were 96 male and 175 female participants with an average age of (30.4 ± 8.0) years. On the the awareness of teaching competence,the propotion of"very important"of"creating a quality teaching environment for students","knowing how to teach students","ability to teach students medical knowledge and skills", " feedback ability ", "showing the virtue of being a teacher" in hospital and community trainers were 47.8%(77/161) and 40.0%(44/110), 66.5%(107/161) and 59.1%(65/110), 71.5%(115/161) and 62.8%(69/110), 54.7%(88/161) and 52.7%(58/110), 65.2%(105/161) and 60.9 (67/110), respectively;there were no significant differences of all importance ratings between the two groups (all P>0.05). Hospital trainers had higher proportions of "having received teaching method training" [70.2%(113/161)vs. 50.0%(55/110),χ2=11.302,P=0.001] and"having received teaching training before practice teaching for the first time" [(45.3%(73/161)vs. 21.8%(24/110),χ2=15.735,P<0.001] than those of community trainers. The proportion of "having received teaching comptence evaluation" was higher in hospital trainers than that in community trainers [(60.9%(98/161)vs. 43.6%(48/110),χ2=7.810,P=0.004], but there were no significant difference in teaching comptence evaluation methods between two types of trainers (P>0.01). Conclusion The awareness of teaching competence is similar between hospital and community GP trainers, but the community trainers are lack of teaching competence training, and their teaching competence evaluation methods need to be improved.

14.
Article in Chinese | WPRIM | ID: wpr-710892

ABSTRACT

Objective To survey Introduction to General Practice course taking and knowledge of general practice among medical students in Fudan University.Methods A survey with self-designed questionnaire was conducted in June 2017 among medical students of 5 year program in Fudan University who had taken the course of Introduction to General Practice.Results One hundred and ninety seven questionnaires were distributed and 186 valid ones returned with a recovery rate of 94.42%.The survey showed that 95.16% of participants (177/186)gained knowledge about the post of general practitioners (GPs) through community practice;97.31% (181 / 186) thought community practice as necessary;92.47% (172/186) were very satisfied or fairly satisfied with the community practice course;94.09% (175/186)gained clear understanding of the duty of GPs through the course study;87.63% (163/186)completely understood the required capabilities of a GP;74.19% (138/186)said that the course had opened their mind;64.52% (120/ 186) said that they had changed their views about general practice;63.44% (118/186) said that they had acquired new knowledge.The participants also gave some suggestions regarding the content of community practice.Although 96.24% of the students (179/186)thought that general practitioner had a bright career prospect,only 7 of them (3.76%)were willing to be GPs after graduation;meanwhile 161 of them (86.56%) were willing to be specialists.The main reasons of not willing to be a GP were "wish to be a specialists (82.61%,133/186)","the job was not challenging or difficult for career development (45.34%,73/186)" and "not paid well for GPs (45.34%,73/186)".Conclusion Although many students thought GP would have good career prospect,only few of them are willing to be a GP.How to attract more medical students to chose GP as their career should be paid high attention by education and health authorities.

15.
Article in Chinese | WPRIM | ID: wpr-710826

ABSTRACT

Objective To evaluate the application of TeamSTEPPS in training of community osteoporosis management team .Methods The TeamSTEPPS was applied for training of osteoporosis management team, and 1 513 residents aged ≥45 year were screened for osteoporosis in Kangjian community from January 2014 to March 2017.The identified patients with osteopenia and osteoporosis were intervened for one year.Cognitive level of the risk factors and symptoms associated with osteoporosis were assessed by questionnaires before and after the intervention .The bone density was examined at baseline and 6 months, 12 months after intervention.The effect of intervention was evaluated .Results A total of 467 patients (30.87%) with osteopenia and 476 patients (31.46%) with osteoporosis were detected .The cognitive levels of osteoporosis risk factors , including low calcium, vitamin D deficiency, lack of exercise, low weight, women menopause, matrilineal family history, smoking, excessive alcohol drinking and coffee drinking, were higher than those before intervention ( χ2=62.909,78.742,59.974,50.478,29.512, 34.699,6.500,15.779,6.089,all P<0.05).The awareness rates of symptoms , including lower back pain or body bone pain, shorter height and hunchback , low energy or nonviolent fracture , were also increased (χ2=59.942,76.220,16.856,all P<0.01).After intervention, the bone mineral density levels were increased compared to those before intervention (F=530.28, P<0.01 for osteopenia group; F=339.51, P<0.01 for osteoporosis group ); meanwhile, the differences were also significant between 6 months, 12 months after intervention and before intervention , between 12 months and 6 months after intervention (t=-0.452,-0.968,-0.516,all P<0.01 for osteopenia group; t=-0.530,-1.045,-0.518, all P<0.01 for osteoporosis group ).Conclusion The community osteoporosis management team trained by TeamSTEPPS can effectively improve the management levels of osteoporosis among residents in the community.

16.
Article in Chinese | WPRIM | ID: wpr-710737

ABSTRACT

Objective To survey the prevalence of stress urinary incontinence(SUI)and related knowledge among postpartum women in Shanghai Melong district.Methods A questionnaire survey on the knowledge of stress urinary incontinence was conducted among 317 postpartum women who were home visited by Meilong Community Health Service Center between March 2017 and June 2017.The self-designed questionnaire included the general situation(age, height, weight, occupation, menstrual history), pregnancy and childbirth, and knowledge of SUI; the International Consultation on Incontinence Questionnaire Short form(ICIQ-SF)was also used.Total 317 questionnaires were distributed and 313 valid ones were retrieved(98.73%).Results The prevalence of SUI in the participants was 26.84%(84/313).Multivariate logistic regression showed that BMI≥24 kg/m2(OR=6.24, 95% CI: 3.41 -11.41), complicated metabolic syndrome(OR=9.84, 95% CI: 2.77 -34.96)and birth weight of previous child ≥4 kg(OR=0.09,95%CI:0.04-0.19)is independent risk factors for the development of SUI.The average SUI knowledge score was(10.39 +8.65)points, only 26.20%(82/313)of the participants knew Kegel training(score 5.99 ±1.60).The SUI knowledge level of postpartum women was associated with educational level(F=12.41),occupation(F=9.06), income(F=4.05), reproductive history(F=10.98)and presence of urinary incontinence symptom(F=22.31)(all P<0.05). Conclusion The knowledge level of maternal stress urinary incontinence in Meilong district is relatively low,and the publicity of SUI and pelvic floor rehabilitation knowledge should be enhanced for the pregnant women.

17.
Article in Chinese | WPRIM | ID: wpr-611063

ABSTRACT

TeamSTEPPS(Team Strategies & Tools to Enhance Performance & Patient Safety)is an evidence-based set of teamwork tools,aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.It integrates teamwork skills with clinical practice to improve team performance in healthcare services and improve the quality of care effectively.The article introduces the TeamSTEPPS course and its clinical application.

18.
Article in Chinese | WPRIM | ID: wpr-670439

ABSTRACT

Objective To evaluate the reliability and validity of the Chinese version of the Diabetes,Hypertension and Hyperlipidemia(DHL) Knowledge Instrument in community diabetic patients.Methods A face-to-face interview was conducted among 513 patients with diabetes in the community from January to March 2016 by using the Chinese version of DHL Knowledge Instrument.Forty of them were randomly sampled and reinvestigated 4 weeks later.The analyses on Cronbach's α coefficient,test-retest reliability,content validity,discriminant validity and construct validity were performed to evaluate reliability and validity of the DHL Knowledge Instrument.Results The qualified questionnaires were collected from 488 participants,including 232 males and 256 females with a mean age of (66 ± 6)years.The overall scores of the Chinese version of DHL Knowledge Instrument was 67.7 ± 18.0 and the scores of diabetes,hypertension,hyperlipidemia,medications and general issues sub-scales were 82.0 ± 22.5,65.9 ± 25.2,38.2 ± 34.3,75.5 ± 20.8 and 72.1 ± 22.9,respectively.The standardized Cronbach's α coefficient of the total scale was 0.849 and the test-retest reliability of the total scale was 0.706 (P < 0.01).In term of content validity,the correlation coefficient was from 0.580 to 0.827 among total scale and sub-scales (P < 0.01).In term of discriminant validity,the difference between the high and the low score group on total scale and sub-scales were significant (t value =-13.486 to-35.528,all P < 0.01).In term of construct validity,based on exploratory factor analysis,the scale was revised.According to confirmatory factor analysis of revised scale,four factor model containing 20 items was well fitted (X2 =159.689,df =134,P =0.064);the GFI (goodness of fit index) =0.966,AGFI (adjusted goodness of fit index) =0.952,RMSEA (root mean square error of approximation) =0.020.Conclusion The Chinese version of DHL Knowledge Instrument possesses good reliability and validity and is suitable to evaluate the knowledge of community diabetic patients,and the modified version may work better than the original one.

19.
Article in Chinese | WPRIM | ID: wpr-670429

ABSTRACT

Department of General Medicine in Zhongshan Hospital,Fudan University was founded in 1994,which was the only unit established in a tertiary hospital in the country at that time,engaged in clinical practice,teaching and research of general practice.Zhongshan Hospital won the second prize of National Teaching Achievement in 2014 forExploration and innovation of training system of general practitioners in China,which contributed to development of standardized training system of general practitioners suitable to China's national conditions.This article summarizes the experience in training general physician,development of disciplines and enhancing influence of Zhongshan Hospital over years,hopefully it will be of reference value for medical educators.

20.
Article in Chinese | WPRIM | ID: wpr-670362

ABSTRACT

The objective structured teaching evaluation (OSTE) is a new method for training and objective assessment of the teaching ability of clinical faculty by using standardized students and teaching scenario.It is mainly used to evaluate training programs,train teaching skills and assess teaching ability of clinical faculty.The differences and association between teaching ability,teaching skills and teaching scenario should be clarified before designing OSTE.Although there are some differences in various studies,OSTE can be summarized into two aspects:teaching administration knowledge and special teaching skills.Given the great potential of OSTE in training and assessing faculty,medical educators in general should actively explore its concept and application.

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