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Objective:To explore the application effect of case-based learning (CBL) based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine.Methods:A total of 80 trainees who had standardized training in Department of Respiratory Medicine of Daping Hospital from June 2019 to June 2020 were enrolled as the research objects. They were randomly divided into observation group ( n=42) and control group ( n=38). The control group was given traditional teaching mode, while observation group was given CBL based on UMU interactive mobile learning. The assessment results, control situations of core competence and teaching satisfaction after training were compared between the two groups. SPSS 20.0 was conducted for chi-square test and t test. Results:The scores of professional theoretical knowledge, case analysis ability and clinical operation skills in observation group were higher than those in control group ( P<0.05). The total control rate of core competence in observation group was significantly higher than that in control group (95.24% vs. 78.95%) ( P<0.05), and the teaching satisfaction rate of observation group was significantly higher than that of control group (100% vs. 84.21%) ( P<0.05). Conclusion:Application of CBL based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine is not only conducive to improving the teaching quality, but also conducive to cultivating core competence, clinical thinking ability and problem-solving ability of the training students, with higher teaching satisfaction.
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Objective:To explore the value of panoramic teaching in clinical practice teaching of department of respiratory medicine.Methods:A total of 35 clinical interns who had a 3-week rotation in the department of respiratory medicine from October 2019 to June 2020 were selected, and they were divided into a control group ( n=17) and a study group ( n=18) according to the order of admission. The control group used traditional teaching, and the research group used panoramic teaching. After the teaching, the teaching effect was evaluated through theoretical knowledge assessment, practical assessment and questionnaire survey. SPSS 19.0 was used for t test. Results:There was no statistically significant difference between the two groups of interns in theoretical assessment [(89.62±4.05) points vs. (90.84±4.12) points, t=-0.891, P=0.379]. The results of practice assessment (case analysis, physical examination of the department, medical history inquiry and skills manipulation) of the study group were significantly higher than those of the control group ( P<0.05). The interns in study group were better than those in control group in such aspects as learning interest, self-learning ability, self-study ability, doctor-patient communication language expression ability, literature review ability, clinical thinking ability, comprehensive analysis ability, knowledge development ability, system diagnosis ability, teamwork ability and teaching satisfaction ( P<0.05). Conclusion:Panoramic teaching can effectively improve the ability of interns to master the clinical diagnosis and treatment of respiratory medicine, improve the teaching effect, and improve the learning ability and clinical competence of interns in the future.
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Objective:To observe and compare the teaching effects of problem-based learning (PBL) and case-based learning (CBL) combined with problem-originated clinical medicine curriculum (PCMC) on standardized training of nurses in the department of respiratory medicine.Methods:Thirty-one standardized training nurses from the Department of Respiratory Medicine, Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital during April 2019 to March 2020 were taken as the control group, and CBL combined with PCMC was used for teaching. Another 31 nurses from April 2020 to March 2021 were taken as the observation group, using PBL combined with PCMC teaching. Both teaching period lasted for 3 months. The examination results, their work ability before and after training and their recognition of teaching methods were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:The scores of academic and practical evaluation were significantly higher in the observation group than the control group[(92.58±5.25) vs. (86.80±6.74); (90.05±6.27) vs. (85.64±7.23)]. After the training, the scores of leadership, clinical nursing, education and consultation, interpersonal relationship, legal and ethical practice, and professional development, critical thinking and scientific research and the total scores of working ability were significantly improved than before the training ( P<0.05), and the scores of the above dimensions of the observation group were significantly higher than those of the control group ( P<0.05). In addition, the observation group's recognition scores of teaching methods to clarify the learning focus, mobilize learning enthusiasm, broaden knowledge, enhance group collaboration, improve nurse-patient communication skills, cultivate critical thinking, and promote teacher-student communication were significantly higher than those of the control group ( P<0.05). Conclusion:The application of PCMC combined with PBL in the standardized training of nurses in the department of respiratory medicine not only helps to improve the assessment results, but also enhances their working ability and is recognized by them.
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ABSTRACT BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO platform: CRD42021229825.
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Humans , SARS-CoV-2 , COVID-19/drug therapy , Dexamethasone/therapeutic use , Communicable Disease ControlABSTRACT
Objective:To explore the role of clinical pathway teaching in the practice teaching of respiratory medicine.Methods:A total of 51 intern students in the Department of Respiratory Medicine from January 2019 to June 2020 were selected as the research objects, and they were divided into a control group (25 cases) and a study group (26 cases). The control group adopted traditional clinical teaching, and the research group adopted clinical path teaching; the two groups' assessment results, comprehensive quality scores and satisfaction evaluations were compared respectively. SPSS 22.0 was used for t test and chi-square test. Results:In terms of evaluation results: including theoretical knowledge, case analysis, practical ability, and coping ability, the study group was higher than the control group, with significant differences ( P<0.05); in comprehensive quality: including the improvement of learning interest, the scores in 6 aspects, including expanded knowledge, professional diagnosis and treatment level, self-study ability, clinical thinking ability, teamwork ability, etc., were higher in the study group than in the control group, and the difference was statistically significant ( P<0.05); the number of people satisfied with the teaching in the study group was more than the control group. Conclusion:The role of clinical pathway teaching in the practice teaching of respiratory medicine is better than that of traditional teaching. By clarifying the teaching objectives and standardizing the teaching process, it can effectively improve students' assessment scores, overall quality and teaching satisfaction, which is worthy of further promotion.
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There are many types of respiratory diseases, affecting a large population, and their incidence, prevalence, disability rate and mortality are high as well, posing severe harms to the health of the Chinese people. The PEST analysis as used in the study, explored the present status and difficulties of respiratory medicine in terms of the political, economic, social and technological dimensions, and put forward strategies, and theoretical references as well.
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Standardized training of resident doctors is the golden stage for clinicians to establish good clinical thinking. Although respiratory disease is common, there are serious and critical diseases, which need to develop clinical thinking and improve the analytical ability. The resident physicians' instructor should help residents to establish the correct diagnostic thinking through the following means: clinical demonstration teaching show, guidance of reading the relevant literature and books, strengthening the basic skills of collecting patients' history and physical examination, and guidance of appropriate use of auxiliary examination and analysis of the results. For the treatment thinking, solid theoretical knowledge and life-long learning ideas and habits can improve the successful rate of initial treatment. Furthermore, being familiar with the efficacy evaluation system and analyzing the reasons for the success and failure of the treatment will help the residents to develop a good therapeutic thinking. The good clinical thinking established by the residents in the department of respiration will be conducive to their own follow-up specialist training and career development.
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It is an important teaching task how to make respiratory disease specialists to accept the standardization training of pulmonary function. However, the theory of pulmonary function is comparatively abstract and the training time is short, but the task is heavy. In order to explore a set of feasible training mode, the pulmonary function laboratory of Zhongshan Hospital affiliated to Fudan University carries out various forms of training, such as compiling textbooks, establishing case database, using multimedia teach-ing, arranging one-to-one guided teaching, and training the ability of doctor-patient communication.
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@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to evaluate efficacy of tiotropium as add-on therapy on top of standard regimens for uncontrolled asthma, specifically in terms of FEV1, morning and evening PEF, reduction in exacerbations, rescue medication use, and quality of life improvement.<br /><strong>METHODS:</strong> A search was done for eligible trials after which validity screen and data extraction was performed. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically as forest plots. Estimates were pooled using the random effects model with I2 and Chi2 tests used to assess heterogeneity. Adverse events were reported as dichotomous variables.<br /><strong>RESULTS:</strong> Four studies were included totaling 1617 participants. The tiotropium group had statistically significant improvement in FEV1 (95% Cl, 0.14 [0.09, 0.19], p<0.00001), morning (95% Cl, 20.03 [11.71, 28.35], p<0.00001) with trend towards benefit in reduction of rescue medications (95% Cl, 0.12 [-0.17,0.4],p=0.42) and quality of life improvements (95% Cl, 0.1 [-0.05,0.25], p=0.20). Homogeneity (I2= 0%, Chi2= 0.47-3.22) was found across studies.<br /><strong>CONCLUSION:</strong> Tiotropium is associated with significant improvement in pulmonary function among patients with uncontrolled asthma, with possible benefit in reduction of rescue medications and quality of life improvement.</p>
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Humans , Male , Female , Adult , Asthma , Bronchodilator Agents , Confidence Intervals , Quality of Life , Respiratory Physiological Phenomena , Scopolamine Derivatives , Tiotropium Bromide , Meta-AnalysisABSTRACT
Objective To understand the needs and suggestions of respiratory medicine specialist nurses training, in order to provide some basis for the establishment of training mode of respiratory medicine specialist nurses. Method Using objective sampling method, we interviewed 12 students of different seni-ority , qualifications , title in the first session of training of nurse specialist in department of respiratory medicine of Chongqing, using qualitative research methods to analyze the data of the interview. Result Respondents had unified opinion on the curriculum setting, conditions of the training base, the requirements of core competence of junior nurses in department of respiration, but there existed differences about the length of service of the students . And the length of service of the teachers needed further discussion . Conclusion The opinions of the respondents collected provide reference for the establishment of training mode of nurse specialist in department of respiratory medicine. However, the students' opinions on the estab-lishment of the training standards are not uniform, which is worth further discussion.
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Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.
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The Chilean Society of Respiratory Diseases was founded in 1930. It was initially named as "Society of Tisiology" since tuberculosis was a major health problem at that time. From then on, its development has mirrored the changes that Chilean society and medical sciences have undergone during XX and XXI centuries. Nowadays, the Chilean Society of Respiratory Diseases embraces distinct disciplines and types of health professionals, maintaining its involvement in clinical and public health issues. This review mentions the pioneers of Respiratory Medicine in Chile, as well as some of the most relevant actors, institutions and activities that have been developed by our society during its 85 years of existence.
La Sociedad Chilena de Enfermedades Respiratorias fue fundada en 1930. Inicialmente fue denominada "Sociedad Chilena de Fisiología" ya que en esa época la Tuberculosis era un problema crucial de salud. Desde entonces el desarrollo de la Sociedad ha reflejado los cambios que han experimentado la sociedad chilena y las ciencias médicas en el siglo XX y en los inicios del siglo XXI. Actualmente la Sociedad Chilena de Enfermedades Respiratorias abarca diversas disciplinas y profesionales de la salud, manteniendo su compromiso con temas clínicos y de salud pública. Este artículo menciona a los fundadores de la Medicina Respiratoria en Chile, como también a los actores, instituciones y actividades más relevantes que se han desarrollado en nuestra Sociedad durante sus 85 años de existencia.
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History, 20th Century , History, 21st Century , Respiratory Tract Diseases , Pulmonary Medicine/history , History of Medicine , ChileABSTRACT
Objective To evaluate the effect of modern comprehensive three-dimensional teaching method in clinical practice of respiratory medicine. Method The problem based teaching method PBL (problem-based learning), the standardized patient-based practice SPE/Xs (standardized patient experiences/exam) and Mini clinical examination practice Mini-CEX (Mini clinical examination exercise) method and other methods were organically combined and used in respiratory medicine clini-cal practice, and it was named“modern comprehensive three-dimensional teaching mode”. 60 students were randomly divided into the modern comprehensive three-dimensional teaching method group (30 students) and the traditional teaching method (SBL) (30 students), using the modern com-prehensive three-dimensional teaching method and the SBL breathing internal medicine practice teaching respec-tively. After the teaching, the methods of performance testing and questionnalre survey were used to evaluate the teaching effect of two groups of students. SPSS software was used to compare t test. Results The test results of modern three-dimensional integrated teaching method group was (86.91±4.77), higher than that of the control group (79.00±7.51) points (t=12.4, P=0.026 0). In the subjective questions (such as discourse analysis problem and case), modern three-dimensional integrated teaching group (47.63± 2.14) points is obvi-ously superior to the traditional group (36.00±6.71) points (t=21.6, P=0.001 9). According to the results of the survey, the modern comprehensive teaching method can improve students' subjective initiative and enthusiasm for learning, improve students' ability of comprehensive analysis, promote the formation of clinical thinking, and help students master the basic knowledge and basic skills of respiratory diseases. Conclusions In the respiratory medicine teaching, implementation of modern comprehensive three-dimensional teaching method is helpful to improving the teaching effect.
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Through discussing the connotation of medical humanities spirit and the current situation of medical humanities education in our country, the authors put forward that in clinical practice, respiratory medicine interns medical ways for the cultivation of the humanistic spirit, which include: guide the trainee doctors in treating pa-tients alike, on the basis of understanding and respect for life and death;to cultivate the ability of effective commu-nication between patient and physician internship; interns cultivated the spirit of collaboration and leadership skills;the in-depth, on the basis of clinical practice, in practice the doctor to write a detailed records;construc-tion of a high level of teacher love team, set an example for the students.
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Objective Through discussing application of case analysis to improve the comprehensive quality of nursing staff,and promote their implementation of high quality nursing care for the patients.Methods all 61 nurses in general wards were trained by daily half-hour case analysis method.After the training,questionnaire was given to investigate the nursing staff's evaluation on case analysis training,and at the same time compared before and after the training,the patients' satisfaction survey result,the monthly examination result of the nursing department,nursing paper quality and the number of nursing adverse events.The relevant data was done by t test orx2 test.Results After the implementation for half an hour case analysis training,most nurses think their own various ability was improved.After the training,the patient satisfaction was (t=-0.391),the monthly assessment score of the nursing department(t=3.823),the quality of care increased(x2=5.495),while the nursing adverse events reduced(x2=6.441),and the difference was statistically significant compared with before the training(P＜0.05).Conclusion Daily half-hour case study method can improve the nursing staff comprehensive quality and scientific research ability,the patients' satisfaction,and reduce the nursing adverse events,which is helpful to clinical practice.
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After years of respiratory medicine clinical practice teaching , we have discovered that there exist some problems such as teachers' job burnout, teachers' lowprofessional knowledge level of clinical teaching and lack of teaching ability, medical students' fear, low self-esteem, psycho-logi-cal fear and emotional weariness breeding as well as the patients and their family members ' refusal of practice because of their worrying about being a test and so on. To solve these problems , we have put forward some proposals such as recognizing and rewarding teachers to affirm their teaching levels , organizing teachers to participate in academic conferences, seminars, etc. to expand their professional knowledge in order to improve their overall quality. And at the same time, we have adopted PBL teaching method, applied multimedia technology and network platforms, put emphasis on basic skills training, the improvementof departmental rotation assessment, the establishment of teaching files and doctor-patient communication and other ways to improve clinical teaching quality and develop interns' clinical thinking ability to help them transitto clinicians.
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Objective: To explore how to set up the service management center of ventilators depending on department of respiratory medicine , how to perfect daily management of ventilators, how to rationally and timely allocate ventilators ,how to reduce the fault of ventilators and ensure the safe use of ventilators, and how to cost savings of purchasing ventilators. Methods: To figure out and compare data of before and after the establishment of the service management center of ventilators in 2010 and in 2012. Results: Non machine failure rate was 42.86% in 2012 and 69.35% in 2010, had remarkably decreased. At the same time, the total failures have decreased significantly. Conclusion: Setting up the service management center of ventilators depending on department of respiratory medicine have achieved timely allocation ventilators, have improved the level of medical personnel of using ventilators, have ensured the safe use of ventilators, have cost savings of purchase ventilators, have reduced the fault of ventilators.
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Objective To study the application effect of clinical pathway teaching in respiratory medicine. Methods Seventy clinical medical students of our department during 2007 to 2009 were randomly divided into two groups. The control group (35 students) was treated by traditional teaching ways, while the experimental group(35 students) was treated by clinical pathway teaching ways, with 5 to 6 students forming a small group. Teachers provided one copy of the CP version to each person in advance. Then progressive questions and discussions were conducted according to the diagnosis, dif-ferential diagnosis and treatment of CP. After its implementation for a certain time, students were co-mprehensively assessed by the practice examination and questionnaire and the statistical analysis was performed by using SPSS 17.0 version statistics software. Results The experimental group's total aver-age score was (90.00±4.00) points, while the control group's total average score was (76.00±7.20) points. There was significant difference between the two groups(P=0.001). The effect of these two kinds of teaching was evaluated and compared in stimulating interest in learning (P=0.002), improving the analytical ability(P=0.004),improving self-study ability(P=0.001), deepening the under-standing of the basic concepts(P=0.112), improving the innovation ability (P=0.005), improving the efficiency of learning(P=0.034), improving clinical comprehensive ability(P=0.016), and improving the ability of language expression(P=0.000), showing that teaching method of clinical pathway could significantly improve clinical teaching effect, and there was statistically significant difference between them. Conclusion Clinical pathway teaching has obvious advantages in cultivating students' diagnostic thinking and clin-ical ability to solve practical problems, and therefore it has better clinical teaching effect than the tra-ditional teaching method.
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Objective To evaluate the application efficacy of responsibility system for holistic nursing system in high-quality nursing service in the department of respiratory medicine.Methods Department of respiratory medicine unit which was the quality nursing service demonstrated unit in our hospital was selected.The nursing responsibility-bound grouping system was first performed and the nurse-incharge would provide the patients with whole and continuous nursing service.Before and 6 months after the application,the nursing job satisfaction was conducted and the nursing grouping system satisfaction was also evaluated among nurses and doctors.Results Six months after the application of nursing responsibility-bound grouping system,the patient satisfaction with nursing job was raised obviously in the unit.Conclusions The application of responsibility-bound grouping system can not only promote the activity but also mobilize the enthusiasm of nurses,and then high-quality nursing service was resulted.So the service system was worthy of clinical application.
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With the advantages of displaying visceral organs intuitively,showing the operative procedure vividly,making and spreading videos conveniently in clinical teaching,electrobronchoscopy image system was adopted in clinical teaching of respiratory medicine to assist the traditional teaching method,to make up for the deficiencies of tradition method and to improve the learning effectiveness of respiratory medicine for medical students at internship.