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Electromyography and neurophysiological examination are not only a clinical examination technique, but also play a more and more important role in the interpretation and solution of clinical problems of neuromuscular diseases by emphasizing the correlation between clinical and neurophysiology. In order to accurately locate the lesion site, further provide pathophysiological information, and assess the severity and course of the disease, it is necessary to develop a personalized examination program according to the symptoms and signs of patients, and it is also necessary to conduct systematic standardized training for clinicians and electrophysiological practitioners.
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The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.
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Objective:To analyze the results of self-assessment on the position competency of residents in a certain hospital, and to provide reference for improving the quality of training.Methods:From June 2021 to October 2021, a whole-group questionnaire survey was conducted among 224 residents who participated in the standardized training in Beijing Friendship Hospital, Capital Medical University. The questionnaire consists of general information questionnaire, position competency questionnaire. The position competency questionnaire contains eight dimensions. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:The position competency score of residents was (3.94±1.07) points, among which the scores of interpersonal communication ability was the highest (4.42±0.68) points. The scores of scientific research ability [(3.26±1.30) points] was the lowest among the eight dimensions. There were statistically significant differences among residents of different genders in post competency, disease prevention and health promotion and interpersonal communication ability ( P<0.05). There were statistically significant differences in the scores of medical knowledge and lifelong learning ability and scientific research ability among residents with different identity ( P<0.05). There was statistical significance in the score of scientific research ability among residents with different educational backgrounds ( P<0.05). There were statistically significant differences in the scores of position competency, disease prevention and health promotion, interpersonal communication ability, medical knowledge and lifelong learning ability among residents of different majors ( P<0.05). Conclusions:The position competency of residents should be further improved. To guarantee the quality of training, it was suggested to establish a competence-oriented training mechanism, strengthen the construction of teachers′ training teams, enrich and innovate training contents and methods.
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Oral and maxillofacial radiology (OMR) in the United States is one of the nine dental specialties recognized by the American Dental Association (ADA). It has a nearly 100-year history of development and has also established a complete set of specialist training system. Staffing, base facilities, financial status, timing of training courses, contents, plans, and goals to be achieved are all clearly defined. All training centers need to undergo regular assessments every seven years with the ADA's Commission on Dental Accreditation (CODA). After graduation, the specialist graduates can be engaged in the clinical teaching and scientific research of radiological diagnosis in universities or general hospitals. They also have the option to open their own business by setting up imaging diagnostic centers or being specialized in tele-radiology to provide imaging diagnosis or consultation report to clinicians in other disciplines, or even assisting in the development of treatment planning for dental implants and orthodontic procedures. Of course, stomatology and OMR education systems are different in China and the United States due to different national conditions. Although the experience in the United States cannot be completely copied, many concepts, standards and goals of OMR specialty training there have been practiced and improved for a long period of time and are worth learning by the Chinese OMR counterparts or relevant agencies.
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[Abstract ] Objective To investigate the present situation and demand of nurses training in the different level hospitals of a suburb,so as to provide reference to the building of nursing team.Methods Stratified random sampling was taken in 764 nurses in 20 different level hospitals of a suburb of Beijing.Results In recent 3 years, 31.9% of nurses went out to short -term training and 15.58% of nurses went out to further study for a longer time. The continuous education scores came mainly from own hospital(88.22%),suburb training center(77.75%)and networks(42.54%).About training needs,over half of nurses chose training inside themselves areas,58.38% of nurses chose special short duration training,53.66% of nurses chose further study,48.04% of nurses chose WeChat network platform.About the training content,the first need of training for nursing administrators was nursing safety management (4.65 ±0.54)points,the first need of training for clinical nurses was emergency techniques training (4.41 ±0.69)points.89.14% of nurses would like to have two -way feedback.Conclusion The present situation of nurses training should be improved.Integrating resources and flexible and multiple training methods should be adopted to satisfy nurses training demand.
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The neonatal resuscitation program consisted of three stages:pilot promotion, provinces promotion and grass-roots promotion in China. Neonatal resuscitation was easy to learn, training forms were various, the duration was different. There were regional differences in the pass rate of examination and standard recovery rate. The neonatal resuscitation training rate, the system execution rate and the equipment rate in primary hospitals was lower than secondary hospitals and tertiary hospitals. The primary hospitals would be the key link of the neonatal resuscitation program. We suggested to build neonatal resuscitation training and treatment system.
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ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.
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Objective To explore the value of computer-animal-clinic sequential training model in colonoscopy training.Methods Sixty-five gastroenterologists without any experience in colonoscopy were randomly assigned to 2 groups to accept a two-week′endoscopy training with computer simulator or with com-puter-animal-clinic sequential training.Both groups underwent at least 10 hours of training with a computer-based simulator,and sequential training group also underwent animal simulator training for 2 days in first week,then both groups underwent clinical endoscopy training in the second week.Performance parameters including cecal intubation,procedure duration and degree of comfort were evaluated.Results The training group had higher cecal intubation rate (46.28% VS 35.79%;P <0.01 )and shorter procedure duration (9.05 ±2.12 min VS 11.15 ±3.12 min;P <0.05)and less degree of comfort (5.18 ±1.41 VS 6.78 ± 2.15;P <0.05).The sequential training group was much better in performance than the other group in colonoscopy training.Conclusion Computer-animal-clinic sequential training model is effective in providing trainees with colonoscopy skills in improving the success rate,shortening the teaching times and lessening the uncomfortable of patients.
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Objective To investigate the influence of PBL combined with CBS education on reporting cognition and reporting intention of adverse events.Methods Using convenience sampling method,66 registered nurses working for over 6 months were extracted as the study object.The training group was set up and the training files were established,PBL combined with CBS mode were implemented for 6 months from March to August 2013,once a month,2 hours per time.Training cases were designed and written,teaching staff was organized to carry out the training,problems were raised in class and discussed on site.Training staff looked up relevant data,collected information,organized another focused discussion and summarized the results.The Adverse Event Reporting Cognitive Questionnaire and Adverse Nursing Event Reporting Intention Questionnaire were adopted to evaluate reporting cognition and reporting intention before and after the training.Results After the implementation of PBL combined with CBS education,cognition of nurses for adverse events scored (7.23±1.20),higher than that before the intervention,(6.48±1.49),t=3.17,P ＜ 0.01.The numbers of nurses to report adverse events such as potential vulnerabilities and not doing any harm were 42 and 45 before the intervention,while 53 and 56 after the intervention.Conclusions Using PBL combined with CBS model to implement educational interventions can improve reporting cognition and report intention on nursing adverse events of nurses.
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A total of 180 community medical staff in Jiangning District of Nanjing received continuous education in practical emergency medicine through theory teaching,practice and scene simulation once a year from 2011 to 2013.And the training outcomes were evaluated before and after training and the feedbacks of community medical staff collected each time.The assessment results of theory and practical skills after training in 2013 were better than before training in 2011 [theory:(61.72 ± 5.03) vs.(92.11 ± 5.56) points ; operation skills (55.28 ± 6.18) vs.(93.33 ± 3.45) points] (P ＜ 0.05).And the total satisfaction rate was 98.0％.
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Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.
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Objective To investigate awareness of definition, diagnostic criteria, severity classification and standard diagnosis and treatment for chronic obstructive pulmonary disease (COPD) among primary-care physicians at the grassroots in urban and suburban Shanghai.Methods In total, 298 physicians were surveyed by unified questionnaire for COPD-related knowledge in two secondary-care general hospitals (one in urban and suburban areas each ) and 12 community primary-care centers (four in urban and eight in suburban areas) in Shanghai.One hundred and fifteen physicians in two urban hospitals and one suburban hospital were trained professionally and then evaluated for its effectiveness.Results Awareness of diagnostic criteria of COPD was only 22.4% (35/156), 25.6% ( 10/39), 4.3 % (3/69)and 26.5% (9/34) among physicians in urban primary-care hospitals, urban secondary-care hospitals,suburban primary-care hospitals and suburban secondary-care hospitals, respectively.Their awareness of knowledge about use of anti-cholinergic agents was 13.5 % (21/156), 35.9 % ( 14/39), naught (0/69),and 14.7 % ( 5/34 ), respectively.Only 0.67 % of them ( 2/298 ) knew about severity classification of COPD.Awareness of definition and diagnostic criteria for COPD in the physicians increased to 72.2 % ( 83/115) after training from 18.2% (21/115) before it, and their awareness of severity classification for COPD increased to 45.2% (52/115) after training from 0.8 % (1/115) before it.Conclusions Awareness of COPD-related knowledge, especially of standard diagnosis and treatment for COPD, was poor in primary-care physicians at the grassroots in Shanghai, so it is necessary to strengthen training for them in COPD-related knowledge, including pulmonary function tests.