Influencing Factors of Cross-cultural Communication between Medical Professionals and Patients and Ways to Improve Competence / 中国医学伦理学

In order to build a global community of health for all, it is necessary to deeply understand the influencing factors of cross-cultural communication between medical professionals and patients. Factors such as different health beliefs, cultural values and communication mediators influence cross-cultural communication between medical professionals and patients, and then affect the medical satisfaction and treatment compliance. Medical education should adopt the learning concept of constructivism, advocate maintaining a humble cultural attitude, incorporate more patient perspectives and adopt cross-cultural teaching mode to improve the cross-cultural communication competence of medical students and medical staff, so as to establish a relationship based on communication and understanding.

Application of self-directed learning theory combined with target teaching method in the teaching of new obstetric nurses / 中华医学教育探索杂志

Objective:To explore the role of self-directed learning theory combined with target teaching method in the teaching of new obstetric nurses.Methods:A total of 36 new nurses who were newly recruited in the Department of Obstetrics of Xuanwu Hospital, Capital Medical University from June 2018 to June 2019 were selected as the control group, and another 32 newly recruited nurses from July 2029 to July 2020 were selected as the observation group. The control group adopted the traditional teaching mode, while the observation group adopted self-directed learning theory combined with target teaching method. The scores of theoretical knowledge and practical skills, the scores of self-rating scale for self-directed learning (SRSSDL), the core competence of obstetric nurses before and after teaching and the satisfaction with the teaching mode were compared between the two groups. SPSS 20.0 was performed for t test, rank sum test and chi-square test. Results:After teaching, the scores of theoretical knowledge [(92.57±5.36) vs. (85.13±6.17)] and practical skills [(90.58±6.65) vs. (84.22±5.94)] in the observation group were both higher than those in the control group ( P<0.05). After teaching, the scores of all dimensions and total scores of SRSSDL scale and the scores of each item of core competence of obstetric nurses of the two groups were higher than those before teaching ( P<0.05), and the above scores in the observation group were higher than those in the control group ( P<0.05). The satisfaction of the observation group [93.75%(30/32)] with the teaching mode was higher than that of the control group [61.11%(22/36)] ( P<0.05). Conclusion:The combination of self-directed learning theory and target teaching method in the teaching of new obstetric nurses can consolidate theoretical knowledge, and improve the level of practical skills, self-directed learning ability and the core ability of obstetric nurses, with high satisfaction.

Application of wound dressing training based on Thorndike's learning theory in clinical nursing education / 中华医学教育探索杂志

Objective:To explore the effect of applying the wound dressing training based on Thorndike's learning theory (WCTT) in clinical nursing education.Methods:The study conducted controlled trial among nursing interns selected from Thyroid Surgery Department of West China Hospital of Sichuan University, and the nursing students were divided into the experimental group ( n=51) and the control group ( n=49). Nursing students in the experimental group were trained with WCTT, while the control group adopted the traditional teaching. Two groups were investigated by the ability of wound dressing questionnaire and were examined on the practical wound dressing operation to evaluate the teaching effect. SPSS 20.0 was used for statistical analysis. Results:Nursing students in the experimental group showed a higher self-evaluation on such aspects as understanding, interests, theoretical mastery, evaluation of wounds, practical skills, independence, fulfillment and model assessment. Meanwhile, the experimental group had a higher score of practical wound dressing operation than the control group [(93.25±2.11) points vs. (90.06±2.43) points] ( P<0.05). Conclusion:In clinical nursing teaching, WCTT could improve the wound dressing ability, independence and enthusiasm of nursing students, and this training mode had a positive effect on the clinical nursing teaching efficiency, which is worth further promotion.

Analysis and thinking of the integration of medical curriculum in China: from the perspective of learning theory / 中华医学教育探索杂志

This article starts with the definition of integrated curriculum, analyzes the modes of horizontal, vertical and spiral integration, and summarizes the implementation of integrated curriculum models in North America, Europe and Asian countries. At the same time, we present the implementation of the integrated curriculum teaching model in several domestic universities. Then, we analyze the problems of the domestic integrated curriculum from the aspects of mechanism structure, content connection, teaching ability and assessment and evaluation. Finally, we propose corresponding thoughts and suggestions for the problems from the learning theories view.

A Critique On Learning Theory

Learning in humans is an extremely complex process.Many theories have been espoused to explain the learning process. However, no single theory can fully explain how learning process occurs. There is no clear cut demarcation between the theories. Their boundaries seem to be overlapping with each other. Cognitive psychologists have explained how learning takes place from different perspectives. The major traditional schools of thought concerning learning include behaviourist, cognitivist, and constructivist schools. Socio-cultural, situated and activity theories of learning have emerged more recentlythroughunderstanding the ways in which students learn, teachers can help them learn by planning the most effective way to learn. The appropriateness of any learning theory depends on the context. A blend of learning theories is suitable most of the times.

A expansão do objeto da vigilância em acidente do trabalho: história e desafios de um centro de referência em busca da prevenção / Expansion of the object of surveillance for occupational accidents: history and challenges underwent by a reference center aiming at prevention

Resumo O Sistema de Vigilância de Acidentes de Trabalho (SIVAT), implantado pelo Centro de Referência em Saúde do Trabalhador de Piracicaba (CEREST-Piracicaba), em 2003, constitui-se em experiência consolidada de acordo com as diretrizes da Rede Nacional de Atenção Integral em Saúde do Trabalhador (RENAST). Este artigo visa analisar a história e o desenvolvimento do SIVAT, baseando-se na teoria da atividade histórico-cultural. Trata-se de pesquisa qualitativa, nas modalidades estudo de caso e pesquisa documental. Foram identificados dois ciclos de desenvolvimento e expansão do objeto 'vigilância': no primeiro, a ação do serviço visava adequar as empresas à legislação vigente; no segundo, objetivava a reorientação no que tange aos determinantes organizacionais, identificados pela equipe como associados à acidentalidade, mas não acatados pelas organizações. Para alcançar o objeto da prevenção, vislumbra-se uma nova modalidade de intervenção formativa - o Laboratório de Mudança (LM) - baseada na articulação entre a elaboração do diagnóstico, a remodelagem, a implantação de soluções e o desenvolvimento do protagonismo interno nas organizações.

Abstract The Surveillance System for Occupational Accidents (Sistema de Vigilância em Acidentes de Trabalho - SIVAT) established by Reference Center for Workers' Health (Centro de Referência em Saúde do Trabalhador - CEREST-Piracicaba) in 2003 represents an experience consolidated according to the guidelines formulated by the National Network for Integral Care of the Workers' Health (Rede Nacional de Atenção Integral à Saúde do Trabalhador - RENAST). The present article analyzes the history and development of SIVAT at CEREST - Piracicaba from the perspective of cultural-historical activity theory. The historical data comprise interviews, documents and observations performed by the researchers. Analysis showed that the studied activity underwent two cycles of expansion. During the first cycle, CEREST actions sought to adequate the targeted companies to the legislation in vigor. During the second cycle, actions aimed at introducing changes relative to organizational determinants in the targeted companies that CEREST staff identified as causes of accidents. A new modality of formative intervention, called Change Laboratory (CL), seems to be useful to attain the goal of prevention; it involves analysis of the causes of accidents, activity remodeling and implantation of solutions by developing agency in the targeted organizations.

Problem-based learning based on constructivism in medical education / 中华医学教育探索杂志

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.

Application research of Kolb experience learning theory in community nursing teaching / 中国实用护理杂志

Objective To investigate the application effect of Kolb experience learning theory in community nursing teaching Methods Convenient sampling method was used to extract the class of 2013 nursing students of 120 people. They were divided into 2 groups with 60 people each. Class one was as control group, and class two was as experimental group. The control group used the tradition teaching, while the experimental group used the teaching mode based on Kolb experience learning theory with specific experience, observation, reflection, active practice four phase of the cycle of learning teaching method. After the teaching the teaching effectiveness was evaluated by the method of theory test, the questionnaire survey. Results The theory exam results of class and the end of the end term were （42.75±2.21），（79.67±3.61）scores in experimental group. The theory exam results of class and the end of term werer（40.65±2.68）,（75.22±4.41）scores. There were significant differences, t=-4.68、-6.05，P＜0.05. The score of learning different dimensions (interest in learning, evaluation thinking ability, cooperation and communication ability, comprehensive analysis ability and problem solving skills) were（2.03±1.01）,（15.22±1.12）,（12.82±1.00）,（14.72±0.99）,（12.68±0.95） points in experimental group and （4.02±0.77），（13.93±1.02），（11.98±1.19），（13.18±0.95），（11.43±0.98）points in control group. There were significant differences，t=-6.21、-6.55、-4.16、-8.65、-7.10，P＜0.05. Conclusions The teaching mode based on Kolb experience learning theory in community nursing teaching can improve the students’ interest in learning and study effect, and push forward the reform of teaching the implementation of teaching reform.

Application of Kolb experience learning theory in Surgical Nursing teaching / 中国实用护理杂志

Objective To investigate the effect of the Kolb experience learning theory applied in Surgical Nursing teaching.Methods 120 students were selected randomly and were divided into 2 groups,the observation group operated the teaching mode based on the Kolb experience learning theory,the control group operated traditional teaching.After the experiment,using the theory test,the skill test,the questionnaire survey to evaluate the teaching effectiveness.Results The two groups showed statistical difference in theory exam results,learning effect of each dimension and evaluation of teaching effect.Conclusions The teaching mode based on the Kolb experience learning theory can improve the students' interest in learning and study effect,and push forward the reform of teaching implementatiou.

Ⅰ An overview of theories about interprofessional education and work / 医学教育

　The theoretical framework for interprofessional education is drawn from a number of academic disciplines. To put theory into practice, it is necessary to analyze major theories and use metacognitive frameworks focusing on the micro, meso, and macro levels.<br>　As major theories, social constructivism and social capital were introduced. Social constructivism emphasizes the necessity of interaction with the social environment and proposes that persons play a large role in cognitive development. In social capital, people tend to share a common idea as “the social network has value.”<br>　On the basis of social welfare theory, we have described several theories focusing on the micro, meso, and macro levels. In micro-level analysis, successful application of adult learning theory, or andragogy, is a key mechanism for well-received interprofessional education. In addition, contact theory provides appropriate ways to reduce prejudice between members of a group, and social identity theory provides a concept for explaining intergroup behavior. In meso-level analysis, team learning, the theory of cooperation, activity theory, and Tuckman’s team development model were introduced. In macro-level analysis, we explained that healthcare professionals are socialized in complex systems focusing on organizational learning or practice.<br>　Finally, the literature for interprofessional education focusing on a metacognitive framework was introduced. We expect that, through multifaceted reflection over time, a theoretical framework for multidisciplinary cooperation will be developed.

Cuando la contigüidad no es suficiente: bloqueo en relaciones de equivalencia / When Contiguity is not Enough: Blocking Equivalence Relations

El fenómeno de bloqueo describe una circunstancia en la cual se impide o se dificulta el la transferencia de funciones entre eventos que se han presentado en una relación de contigüidad espacio-temporal. Desde una perspectiva teórica y empírica, el efecto bloqueo no debería predecirse en la adquisición de clases de estímulos aun cuando algunos de los estímulos de la misma clase se presenten simultáneamente. El presente estudio examina si la historia adicional de entrenamiento A-EI bien sea previa o posterior al entrenamiento con un estímulo muestra compuesto AX, es la variable crítica en la presentación del efecto bloqueo. Los desempeños obtenidos en las pruebas de bloqueo por los participantes de un grupo expuesto al procedimiento de bloqueo, un grupo expuesto al procedimiento de bloqueo invertido, y un grupo control, sugieren que el entrenamiento adicional con un solo elemento del compuesto no impide la inclusión de todos los estímulos dentro de la clase. Los casos en los que se observó el efecto bloqueo se interpretan en términos de tipos de percepciones elementales y configurales.

The blocking effect describes a circumstance which impedes function transfer among events that are part of a relation of spatiotemporal contiguity. However, theoretical and empirical evidence in stimulus class acquisition predicts that the blocking effect should not be observed even if some of the stimul11n the class are presented simultaneously as compound stimuli. The present study examines if additional A-EI training, whether prior or following training with a compound sample AX, constitutes a critical variable in the occurrence of the blocking effect. Performances in blocking tests by a group exposed to the blocking procedure, a group exposed to the backward blocking procedure and a control group were compared. Findings suggest that additional training with one member of the compound does not impede responding to all stimuli as members of the class. Instances where the blocking effect was observed are interpreted in terms of configural and elemental types of responding.

Do medical lecturers need to be specially trained in teaching?

Over the years, the emphasis on research practices in healthcare has received more recognition than the emphasis on teaching practices. Also, in contrast to the strong focus on aligning care-giving practices with evidence of effectiveness; aligning educational practices with evidences of effectiveness has continued to be neglected. This creates a chasm that hinders the delivery of effective health practices. Many challenges in the current healthcare delivery system warrant a call for a revamp of health professionals’ education, and for a greater focus in effective teaching, assessment and supervision. This paper highlights the current challenges in health professional education (as revealed by the Institute of Medicine, IOM, 2003). It focusses on fi ve key issues for promoting teaching excellence, and supports the move for new lecturers to be educationally trained so that ‘teaching for learning’ becomes current, effective and enjoyable. More importantly, the vision for health professional education that “all health professionals are educated to deliver patient-centred-care as members of an interdisciplinary team, emphasising evidence-based practice, quality improvement approaches, and informatics” can be attained. This vision has important implication for medical lecturers as it means they have to be better educated to teach in order to be prepared to meet the demands of a reformed healthcare system.

Curriculum of Medical Schools in North America Offering Various Education Programs: A Report of the Inspection Tour Organized by Dr. Hinohara in July, 2005 / 医学教育

1) The study tour was organized by Dr. Hinohara to learn about the medical education in North America and its philosophy to support the method.<BR>2) The McMaster University, which started PBL curriculum in 1969, began COMPASS curriculum which focuses on conceptual thinking and e-learning in which tutorial groups still remain as the key to the learning process.<BR>3) The Duke University, which values the researcher promotion, began a new curriculum including at further integration of basic and clinical medicine and structural clinical training (Intersession).<BR>4) The Washington University, which constructed WWAMI Program that cooperated with the medical institutions in four states surrounding Washington, started College System to support the students and to strengthen their clinical competencies.<BR>5) Common aspects of the innovation of medical education in North America are (1) further integration of the basic and clinical medicine, (2) early exposure to the principle of clinical medicine and (3) promotion of professionalism by Clinical Preceptorship.

Educational Evaluation of Problem-solving Skills by Means of Concept Mapping / 医学教育

Tools to assess problem-solving skills are limited, and comprehensive evaluation is difficult. Concept mapping might be used to evaluate learners' organization of knowledge at various points during training. We used concept mapping to evaluate postgraduate training at the Department of Education Training Technology and Development, National Institute of Public Health. Thirty-five healthcare workers, including physicians, and public health nurses, underwent concept mapping training, drew preinstruction concept maps about public health or community organization, completed an educational course, and then drew postinstruction concept maps. Maps were assessed independently through qualitative comparison of concepts, conceptual links, hierarchy, knowledge domains, cross-links, and examples of preinstruction and postinstitution maps. This study provides preliminary evidence that concept mapping reflects changes and differences in the conceptual framework of individuals and of members of different healthcare specialties. Concept mapping can be used to clarify conceptual frameworks and to develop problem-solving skills. Moreover, concept mapping might be used to evaluate problem-solving skills.