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Objective:To explore the effect of comprehensive accusation intervention on the use of antibacterial drugs and the writing of medical records in elderly patients with closed fracture.Methods:A total of 120 elderly patients (aged ≥60 years) with fracture were enrolled from January 2017 to June 2019 in the department of orthopaedics and traumatology of the Second Hospital of Tangshan University and the Affiliated Hospital of North China University of Technology. According to random number table method, 120 patients were divided into intervention group (61 cases) and non intervention group (59 cases) by computer random number method. The patients in the intervention group received pharmaceutical care and quality control management intervention during the perioperative period; The patients in the non intervention group were routinely treated with antibiotics and wrote medical records. The use effect of antibiotics, the cost of antibiotics and the effect of standardized writing of medical documents were compared between the two groups. Independent sample t-test was used for comparison between measurement data groups with normal distribution, and χ 2 test was used for comparison between counting data groups. Results:Compared with the non-intervention group, the rate of perioperative use of antibiotics (49.2% (30/61)), the rate of drug use without indication (4.9% (3/61)), the rate of irrational drug selection (6.6% (4/61)), the rate of irrational drug use (6.6% (4/61)), and the proportion of irrational combined use of antibiotics (3.3% (2/61)) were significantly lower than that in the non-intervention group (81.4% (48/59), 16.9%(10/59), 22.0% (13/59), 20.3% (12/59), 18.6% (11/59)), the difference was statistically significant (χ 2 values were 13.65, 4.49, 5.91, 4.93 and 7.33, respectively; P values were <0.001, 0.034, 0.015, 0.026 and 0.007,respectively). The cost of antibiotics in the intervention group ((283.86±59.86) yuan) was lower than that in the non intervention group ((820.45±136.27) yuan), and the difference was statistically significant ( t=27.478, P<0.001). The eligible rate of the pre-operative informed consent document signing was 100% (61/61) in the intervention group, and the eligible rate of the operative record completion time was 100% (61/61) higher than that in the non-intervention group (84.7% (50/59), 79.7% (47/59)), the difference was statistically significant (χ 2 values were 7.98 and 13.79; P values were 0.005 and <0.001). The loss rate of preoperative alternative therapy (0) and postoperative communication (0) were significantly lower than those of non-intervention group (11.9% (7/59), 10.2% (6/59)) (χ 2 values were 5.68 and 4.56; P values were 0.017 and 0.033). Conclusion:The implementation of comprehensive quality control intervention mode reduced the application of unreasonable antibiotics and standardized the writing of inpatient medical records. It is of great significance for the rational use of antibiotics and the standardization of medical record writing in the elderly patients with closed fracture.
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Objective:To observe the value of tracer methodology combined case-based study (CBS) model in the standardized residency training of medical record writing.Methods:A total of 91 residents who were newly recruited from The Sixth Affiliated Hospital of Sun Yat-sen University in July 2019 were selected as the subjects and randomly divided into test group ( n=47) and control group ( n=44). The tracer methodology combined CBS model was used for test group while the traditional model was used for control group to compare the knowledge of medical record writing, performance of medical record writing and feedback to teaching in two groups. SPSS 21.0 was used for t test and chi-square test. Results:The correct response rate in knowledge of medical record writing, the normative scores and integrity scores after training were significantly higher than those before training ( P<0.05). The normative and integrity scores were significantly increased after training, and those in the test group were significantly higher than those in the control group [(90.3±3.5) and (91.3±3.2) vs. (88.6±3.5) and (89.8±3.0), P<0.05, respectively]. The test group was significantly superior to the control group in the autonomous learning ability [97.8% (44/45) vs. 82.9% (34/41)], communication ability [95.6% (43/45) vs. 78.0% (32/41)] and acceptance of teaching form [97.8% (44/45) vs. 82.9% (34/41)] ( P<0.05). Conclusion:The tracer methodology combined CBS model is a good way in the pre-job training of medical record writing for residents, which can mobilize the subjective initiative of the trainees and teachers, complete the teaching tasks and obtain better teaching value.
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Objective:To explore the application of micro-lecture system based on ASSURE model in clinical practice teaching of dermatology.Methods:Sixty clinical medicine undergraduate intern doctors in Batch 2014 of Anhui Medical University were randomized into 2 groups, with thirty interns in both experimental group and control group. Micro-lecture system based on ASSURE model teaching method was adopted in experimental group, while traditional teaching method was adopted in control group. At the end of practice, theory test scores and medical record writing was used to evaluate the clinical ability of interns in two groups, and questionnaire survey was conducted to evaluate the satisfaction of interns with the teaching method of micro-lecture system based on ASSURE model. SPSS 16.0 was used for t test. Results:①Theory test scores were higher in experimental group than in control group, with statistically significant differences between the two groups ( P<0.05); ②The scores of history of illness, physical examination, treatment plan and the medical record writing were higher in experimental group than in control group ( P<0.05); ③At the end of internship, the questionnaire showed that the interns in the experimental group were more recognized for this new way of teaching. Conclusion:Micro-lecture system based on ASSURE model teaching method has achieved better results in the teaching of dermatology, which is worthy of future research and promotion.
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Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.
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Objective To know the effects of electronic medical records(EMR) on the training quality of intern doctors' history-collecting and medical-records writing.Methods 195 students from Nantong University,Suzhou University and Xuzhou medical college were chosen as the subjects.For better effects,we divided the 195 students into two groups,81 students of Grade 2007 as the control group(hand-written medical record group) and 114 students of Grade 2008 as study group (electronic medical record group).The control group was arranged to complete EMR by transcribing the teacher's handwriting records into formal medical records after teachers' guidance and modification while the study group was arranged to write and directly modify the records on computer under the guidance of teachers and submit them for formal records.After the teaching,the medical record writing quality of two groups of interns was conducted centralized assessment to analyze the advantages and disadvantages of electronic medical records on the training of interns' collection and writing ability.SPSS 18.0 was used for statistical analysis,with count data using the number(percentage) and measurement data using mean +/-standard deviation.Measurement data of two groups of medical record writing scores were compared with t test,test level for α=0.05.Results The result of handwritten group was significantly better than EMR group(t=6.33,P＜0.001),which indicated training effectiveness of intern doctors' ability of writing medical record had digressive tendency on EMR group.Conclusion Negative effects of EMR are shown in intern doctors' history-collecting and medical-records writing.Cultivation quality of intern doctors' history-collecting and medical-records writing should be ensured by the combination of EMR and handwriting-medical training,the combination of daily inspection and key examination of medical record writing quality and establishment of feedback-rectification mechanism.
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Objective To discuss the effectiveness of tracer methodology in the training of intern medical record writing. Methods Fifty interns who received medical record writing training in July 2012 were set as control group and were trained by traditional methods. Meanwhile, 58 interns who received medical record writing training in July 2013 were set as investigation group and were trained by tracer methodology. Pre-training questionnaire survey was conducted for interns in investigation group and targeted training was provided. After the training, interns in two groups were surveyed by questionnaire of basic norms of medical record writing. Excel software was used to do data entry and SPSS 21.0 statistical software was used to statistical analysis. P<0.05 signifies statistical differences. Results Final record writing exam after the training demonstrated that there were significant differ-ences in basic requirement of record writing, basic principle of record writing, history taking, record time limit, contents of record writing and correct rate of patients' answer to the document between in-vestigation group and control group with statistical differences(P<0.05). Conclusion Tracer method-ology has obvious effects in intern medical record writing training and is worth popularization and ap-plication in clinical teaching.
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Objective To explore the application and effectiveness of simulated patient role play in the inquiry and the medical record writing teaching.Methods Carrying out the teaching model of simulated patient role play in the Second Clinical Medical College of Southern Medical University to the undergraduate students of grade 2009 snd 2010 in diagnose inquiry and medical record writing training class.A self-designed student questionnaire mainly about atmosphere of class,study enthusiasm,Self-evaluation of learning efficiency,the effect of the medical record writing in-class training and so on was used to do the survey.On the other hand,questionnaire for teachers included students' performance,students' writing ability,etc.100 students and 50 teachers were investigated with the survey.The percentage of the options of each question on the questionnaire was calculated in order to analyze the new teaching mode.Results The random questionnaire survey showed that 85％ (85/100) of the students believe that the new teaching mode can activate classroom atmosphere and improve learning motivation.About 62％(62/100) of the students said medical record writing errors can be obtained and corrected timely in-class training.Most students in grade 2009 have better capacity in medical record writing than those students who did not contact with new teaching mode.Conclusion The teaching model of simulated patient role play in the analogue inquiry and medical record writing is efficient and feasible in medical education,which can improve students' practical ability and is expected to be applied in undergraduate medical education.
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Objective To make the contrast analysis of concentrated training on clinical skill to college students before probation. Methods The students were devided into traning group (320pers) and contrast group (240pers), the training group undertook concentrated training on clinical skills before probation, while contrast group didn't. To make the contrast analyses on these two groups on medical record writing and to make questionnaire by those clinical teachers. Results The performance of traning group on medical record writing is higher than the contrast group (P<0.01) , and there also were significant difference in physical examination, medical record writing and comprehend capability. Conclusion The performance of clinical skills were elevated by concentrated training,and there were good teaching effects on the clinical teaching by the oncentrated clinical training.