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Under the background of internationalization of medical education in China, the general medical education for foreign students started relatively late. At present, there are still some problems in it, such as imperfect curriculum system, lack of unified and standardized textbooks, inadequate language skills of community teachers, difficulties in carrying out practical courses, and cultural differences. Based on the current situation of general practice education for international students in China, this article proposes the following solutions: to insist on standardizing quality management and construct scientific training schemes; to understand the present situation of primary medical and health services in their country of origin, promote cultural integration, and actively explore the fit between training and demand; to write bilingual textbooks suitable for practical needs; to overcome language barriers and build a team of community teachers that speak English; to adopt flexible and diversified teaching modes and comprehensively improve the quality of general practice teaching for international students, so as to promote the communication and dissemination of basic medical and health concepts in China.
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Objective:To construct a scientific and systematic comprehensive evaluation index system for general practice teachers at grassroot practice bases, and to provide references for their selection, evaluation, and examination.Methods:On the basis of literature research, expert consultation, and group discussion, the original index system of general practice teachers at grassroot practice bases was preliminarily constructed. A total of 32 experts with intermediate or above professional titles and who had long been engaged in medical education management, general practice and teaching, and grassroot medical services and management were selected for two rounds of Delphi expert letter consultations. Through the statistical analysis of the consultation results, the comprehensive evaluation indicators of general practice teachers at grassroot practice bases were determined. Analytic hierarchy process was used to calculate the weight of each indicator and consistency test was performed. Data were imported and processed using the Yaahp software.Results:A comprehensive evaluation index system for general practice teachers at grassroot practice bases was constructed, including 3 first-level indicators, 12 second-level indicators, and 61 third-level indicators. The three first-class indicators were the criterion of teacher selection and inclusion, the criterion of teaching ability evaluation, and the criterion of teacher examination, with weights of 0.334, 0.525, and 0.142, respectively.Conclusion:The index system constructed in this study is scientific and systematic, which provides a theoretical basis for further strengthening the construction and management of the general practice teachers at grassroot practice bases and improving the quality of training resident general practitioners.
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The standardized patient (SP) has been widely used in medical education and clinical training. The teacher-standardized patient (TSP) is played by health providers or medical educators, taking roles as patient, evaluator and teaching guider. The consultation ability of general practitioners includes two aspects: the clinical competency and doctor-patient communication skill. This article reviews the application of TSP in evaluation of consultation ability of general practitioners, focusing on the recruit, training, assessment and application of teacher-standardized patients.
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Primary liver cancer is one of the common malignant tumors and its mortality ranks third in the world. Because there are no obvious symptoms in the early stage of liver cancer, most patients are diagnosed as advanced stage, without the opportunity of surgical resection. The authors report a case of hepatocellular carcinoma with portal vein tumor thrombus, which reduced significantly after hepatic artery infusion chemotherapy combined with bevacizumab and atezolizumab, showing the safety and efficacy.
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Objective:To construct a complete, effective, multi-dimensional index system that reflects the general faculty's ability level and post competency, so as to select and train excellent general medical faculty.Methods:The weight of each index was determine by analytic hierarchy process. Through consulting the relevant literature and discussing by the research group, the original index system of the comprehensive indexes of the general clinical teachers was designed. Consultation and investigation were made on 8 experts of the general teaching management experts from affiliated hospitals of higher medical colleges, and a comprehensive primary indicator system of general clinical teachers was constructed. Letter consultation was given to 26 general education experts, and a three-level framework for the comprehensive index system of general clinical teachers was formulated. Questionnaires were distributed to 65 general clinical teachers, and Yaahp statistical software was applied to calculate the weight values of each indicator and perform a consistency check.Results:A comprehensive index system of general medical clinical teachers including 3 first-level indicators, 15 second-level indicators and 49 third-level indicators was constructed, and the weight values of each indicator were calculated.Conclusion:The general medical clinical teacher qualification index system developed in this study has a high feasibility, which provides a theoretical basis for the construction of general medical clinical teacher team.
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A questionnaire survey on the perception of general practice and career intention was conducted among 365 undergraduates in Harbin Medical University in May 2018. Among all participants 71 (19.45%) had studied the course of Introduction to General Medicine, and 289 did not (79.18%). Twenty one students well knew general practice (5.78%), 189 knew (51.78%) and 155 students did not know (42.47%); 164 (44.93%) would pursue a master degree study in general practice after graduation, 216 people (59.18%) were willing to attend standardized residency training after graduation, and 147 (40.27%) choose to be a general practitioner after graduation. The proportion of students willing to pursue a master degree study in general medicine and to receive standardized resident training of general practice in students who had studied "Introduction to General/Family Medicine" was lower than that in hose did not studied (χ2=7.46, 7.14, both P<0.05). The top three reasons for becoming a general practitioner were more chance for career development (70.15%, 109/147), loving the subject (52.38%, 77/147), and difficulty to be employed for other specialties (27.21%, 40/147). The first three reasons for not being a general practitioner were less chance for career development (52.17%, 133/138), less interesting specialty (47.10%, 65/138), unfamiliar with grassroots work (39.86%, 55/138). The survey indicates that medical colleges should continue to strengthen the education of general practice, and constantly improve its curriculum system to attract more medical students to join the team of general practitioners after their graduation.
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In order to follow the policy of medical system reform,promote the supply capabilities of primary health services and realize the connection between general and special medical practice,the researcher put forward the concept of General Practitioner Specialization (GPS),which represented "focusing on the basics of general practice,the cultivation of specialty and the division of labor",analyzed the background and its connotation,explored the training mode of GPS based on "human life cycle and organ system",and demonstrated the prospects and problems for the specialization of general practitioner,thereby providing reference for continuing medical education for general practitioners and enhancing service efficiency in China.
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Vertigo is one of the most common symptoms in general practice. During the standardized training in theory and practice of vertigo diagnosis and treatment, researchers from group of vertigo subspe-cialty of department of neurology analyzed the epidemiological characteristics of vertigo disease and the present teaching situation of theory and practice teaching. They put forward and adopted the "Three Steps"(laying firm foundation, consolidating and strengthening, and improving skills) which is based on multidis-cipline and conforming to trainees' understanding of the disease. It helped general practitioners tofamiliarize themselves with the etiology, diagnosis, and treatment of vertigo, to perfect their multidisciplinary knowl-edge structure, to establish scientific clinical thinking, and to improve their levels of the diagnosis and treatment of diseases relating to vertigo, which has produced good effects and has been playing an important role in improving the prognosis for vertigo patients.
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The purpose is to establish an emergency medical system that covers a certain region, responds quickly, operates efficiently, functions perfectly and develops sustainably. Such a system leverages the potential social functions of research disciplines, and is guided by the concept of " expanding the emergency system of comprehensive emergency medicine". The authors identified the problems and shortcomings of the existing system and proposed to build a regional emergency medical system led by research disciplines. The path, system layout and functions are stated explicitly, while the system construction strategy is proposed by taking emergency treatment of myocardial infarction patients as an example. The system will be the pivotal support for integrating effectively regional emergency medical resources, improving the ability and level of emergency and first aid in medical institutions at various levels and of different types, promoting the formation of a new pattern of regional emergency medical service and achieving homogenized emergency medical services that everyone enjoy.
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The standardized patient or simulate patient (SP) plays treble roles in the clinical teach-ing and training:the role of a patient, the role of a teacher and the role of an evaluator. The SP has been wide-ly used in clinical skill teaching and assessment in medical colleges and universities at home and abroad. This article reviews the progress of SP in general practice education and training, to provide the knowledge base for promoting its wide application in field of general practice.
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Under the situation of national demand for cardiopulmonary resuscitation (CPR) skills, it is very important to develop a scientific and feasible education and training program to popularize CPR skills, and improve first-aid ability. This study illustrated the significance and feasibility of setting up car-diopulmonary resuscitation courses in colleges and universities. On this basis, specific suggestions and countermeasures were put forward to improve teaching organization and leadership, teaching material de-velopment, curriculum design, teaching faculty development, teacher training and laboratory construction. This study proposed to strengthen the legislation, and the implementation of first-aid qualification examina-tion in colleges and universities, making the students become the preferred educational group of CPR skills, which is of great significance to improve public popularity rate of CPR.
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An in-depth analysis of the problems found in the hierarchical medical system,found that the research hospitals should focus on the conceptions of Big Times and Big Health,initiative the task to undertake Strong grass-roots,and actively build leading model of hierarchical medical system based on the PDCA cycle.At the same time,taking the practice of the 2nd Affiliated Hospital of Harbin Medical University as an example,we propose the research hospitals should strengthen service capabilities in primary health care institutions from talent,technology,management and other aspects, so as to enhance the patient's willingness to visit the grassroots,and to promote the further deepening of our medical reformation.
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may sever as an indicator for the progression of malignant melanoma.
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Objective To study the impact of hepatitis B virus (HBV) infection on the activity of cord hematopoietic stem cells. Methods CD34+ cells were isolated from healthy human cord blood by miniMACS. Cells were cultured in IMDM complete culture medium containing stem cell factor (SCF),fms-like tyrosine kinase 3 ligand (FL), thrombopoietin (TPO), interleukin-3 (IL-3) and 10% fetal bovine serum. High copies HBV were added to the culture system. The proliferation of stem ceils and virus replication were observed. Following the proliferation, dendritic cells (DCs) were induced by adding granulocyte-macrophage colony-stimulating factor and IL-4. Morphous of stem cells and DCs were observed by microscope and the cell surface molecules were detected. Results The proliferation of stem cells infected with HBV was significantly lower than that of healthy stem cells (P＜0.01),and enhanced after adding cytokines (P＜0.01). At the same time, HBV replication was increased after adding cytokines in the culture system (P＜0.01), but the proliferation was still lower than that of healthy stem cells with cytokines in the culture medium (P＜0.05). Dane particles were found in the cytoplasma of stem cells infected with HBV by electron microscope. The expression of CD80,CD86 ,CD1a and HLA-DR on DCs derived from HBV infected stem cells were all lower than those on DCs from non-infected stem cells (P＜0.01). Conclusions HBV could infect CD34+ stem cell and the proliferation of the stem cell could enhance the virus replication. HBV could not only inhibit the proliferation of stem cells,but also down-regulate the immuno-phenotype expression of DCs derived from CD34+stem cells.