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Objective:To explore the competency for the assistant general practitioners in China to provide theoretical support for the construction of the post competence model of assistant general practitioners and training and evaluation of assistant general practitioners.Methods:During January 22 to June 18, 2019, Using snowball sampling method and behavioral event interviews, 23 general practitioners and assistant general practitioners were interviewed in China, including 14 general practitioners in the superior performance group and 9 assistant general practitioners in the average performance group. The interview contents were coded and analyzed, and the statistical methods of t test and rank sum test of two independent samples were used to screen competency characteristics and construct the competence model of assistant general practitioners.Results:The total classification consistency and the total coding reliability coefficient was respectively 0.79, 0.87. 59 competency characteristics of assistant general practitioners were obtained including 3 differentiated competency characteristics "Understanding the medical and health system and related policies", "Critical thinking skills" and "General practitioner clinical thinking" and 10 baseline competency characteristics. There was no statistically significant difference between the average performance group and the superior performance group in the total frequency of competency [(29.4±12.7) times to (23.4±7.0) times, t=1.27, P=0.22]. Conclusion:The preliminary competency characteristics of assistant general practitioners have good reliability and can provide references for further exploration of the competency model.
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Objective:To evaluate the effect of general practice service based on network platform in health management of patients with multiple chronic conditions (MCC).Methods:Based on network platform, the general practitioners provided health management service for 626 MCC patients in a petrochemical company in Panjin city of Liaoning province from June 2015 to June 2016. The individualized health management plan included health counseling, diet and exercise guidance, health information delivery, health file establishment, and rational medication guidance. After intervention the patient activeness, quality of life, clinical variables were evaluated.Results:Ninety participants dropped out of study (14.38%, 90/626), the questionnaire survey was conducted in rest 536 participants. After 1-year intervention, the scores of physical functioning, role-physical, general health, vitality, social functioning, role-emotional, mental health, and total scores in SF-36 were significantly increased ( F=12.350, 13.215, 10.515, 29.114, 42.972, 10.951, 89.783 and 33.311, respectively, all P<0.05); the values of BMI, waist, systolic and diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol, fasting blood glucose were significantly decreased( F= 30.039, 33.849, 7.152, 27.453, 59.938, 214.270, 73.488 and 62.014, respectively, all P<0.05); the values of high density lipoprotein cholesterol were markedly increased ( F=16.491, P<0.01); the overall scores of activation were increased ( F=9.471, P<0.01), the level of activation was changed (χ 2=16.183, P<0.05); but there was no change in body pain ( F=1.486, P=0.227). There was a weak correlation between patient activation and the general health ( r=0.099, P=0.013), vitality ( r=0.101, P=0.011), mental health ( r=0.099, P=0.013). Conclusion:General practice service based on network platform is feasible and effective for patients with multiple chronic conditions, after the implementation, the activation and the health outcomes are improved significantly.
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With the arrival of education informatization, the online elective courses have become an important means of teaching at universities. Problems, such as insufficient attentions from universities and low learning enthusiasm of students, are quite common. Based on the curriculum setting of online courses at a university, we performed a study to identify root causes of those common problems. Students' gender, major, current academic year and their school-year were collected and analyzed to detect any potential differences in the time spent in studying and course grades. With the results in hands, we propose that universities should promote online elective courses, guide students to scientifically plan study time, stimulate students' initiatives for study, shape out students' self-learning and life-long learning abilities, so as to fulfil the destiny of the online elective courses as a powerful complement to traditional teaching.
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Objective To get well-informed of the practical skills examination of residents' standardized training in order to detect problems and improve the quality of training. Methods A total of 4484 clinical medical examinees from 2010, 2013 and 2017 in Liaoning province were investigated by questionnaire, from which 4412 valid questionnaires were collected and the total survey efficiency was 98.39％. The survey included the standardized patient (SP) examination, the small station test, the computer simulated case (CCS) examination and the clinical skill operation test station with parts 20 projects. Excel was used to sort and record the data. SPSS 10.0 software was used for statistical analysis. Results All parts of the practical skill assessment was reasonable. The examinees' satisfaction with the test is showing an upward trend year by year, up to 73.93％in 2017. In the standardized patients examination, the key points of the role play (including the fidelity and simulated authenticity of the physical signs) need be strengthened (14.84％ in 2010). Examinees thought the difficulty of computer simulation case examination is increasing year by year. More than 2/3 examinees evaluated the clinical skill operation test station set was reasonable and the difficulty was moderately. Conclusions We should further deepen the exploration of standardized patients assessment model; strengthen the medical humanities in training; improve the residents' clinical thinking;take examination as the guidance and standardize clinical training.
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Objective The purpose of this study was to analyze and evaluate the educational measurement indexes from the undergraduates clinical skills competition in a medical university.The rationality of the competition was discussed in the view of education survey.Methods 84 students' results which selected from the China Medical University 2nd Clinical Skills Competition were the research objects in this study.The indexes of the difficulty,discrimination,reliability and criterion-reated validity of the competition were evaluated based on the Education surveying principle.The difficulty was calculated by subjective topic difficulty computing formula,and other indexes were carried out with SPSS 18.0 except the difficulty index.Results The average difficulty of the questions of this university was 0.61,the average discrimination was 0.77 and the overall reliability was 0.926.The OSCE scores of the participating students were taken as the criterion in this study.The calculated criterion-related validity was 0.416.Conclusion The college students' clinical skills competition has good reliability,discrimination and effective criterion-related validity.For the selective competition,the difficulty can be further improved while considering the scope of the topic.
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Objective The empirical validity of the National Medical Licensing Examination (NMLE) has rarely been studied. This is one of the first studies comparing NMLE and annual assess-ment scores. This study provided the criterion-related validity evidence for the NMLE. The NMLE can be used to test the abilities and skills of physicians. Method We evaluated the test 163 residents in 12 medical school-affiliated hospitals who had finished their first year of tralning and had taken the NMLE and an annual skills assessment. We used Pearson correlations to estimate the relationship be-tween NMLE scores and annual assessment scores. Results A total of 163 residents met inclusion requirements. Correlations between NMLE scores and annual assessment scores ranged from 0.300 to 0.843. Conclusions The criterion-related validity of NMLE was high, so it can be use to evaluate the residents clinical competence indeed.
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The Information and Management Platform of Standardized Training of Residents in Liaoning Province is a comprehensive management platform with information network , containing the whole process of the standardized training for residents. Liaoning, the populous province, has too many management staff in training residents, so it is very necessary to explore the information-based method for the training management. This platform has realized the whole-course network management of resi-dent training, and many common functions such as the application of training base , on-line registra-tion, on-line real-time monitoring of trainees' daily training state, on-line graduation exam arrangement, and inquiry of statistical information of trainees in the province . It saves human and management costs , improves management efficiency , and orderly pushes forward the standardized of residents training.
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Objective To explore and establish the effective model of assessment for residen-cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam (basic knowledge, professional knowledge and public knowledge) and objective structured clinical examination (OSCE) (standardized patient(SP), computer-based case simulations(CCS) and clinical skills operation). T test and variance analysis were used and P≤0.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination results (40.00%) and OSCE results (60.00%) and two students failed the examination. The mean score of OSCE was up to standard (66.58±5.50). The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig-nificant difference (t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013) and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment;it could be helpful to the clinical training of residents.
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Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.
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One hundred and forty-four medical students were enrolled in the study, the participants were randomly divided into experimental group and control group with 72 in each. All students attended the theoretical lecture of general medicine. Students in experimental group took part in the extracurricular teaching activities including the nutritional course and practice, the clinical case study and problem based learning ( PBL), students in control group did not have the extracurricular activities. The results showed that although there was no difference in general testing scores between two groups, the problem solving ability and assay-writing ability of experimental group were significantly higher than those of control group.
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Data were analyzed from self-filled questionnaires for the students who took the elective course of general practice in China Medical University. 95.5% of students thought it was necessary to study general practice in the college. 0-10 was used to score the degree of how they want to choose general practice as a career, the median was 0 before they had the class and the median was 5 after the class (Wilcoxon rank test, P<0.01). But there were still some places need to be improved in terms of curriculum design, teaching methods and community practice. The General Practice teaching need to be innovated and the teaching mode should be different from the traditional one.
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OBJECTIVE@#To investigate the relation of sudden deafness with hearing loss level and auditory threshold.@*METHOD@#A retrospective analysis was performed in 92 cases(97 years) of sudden deafness patients.@*RESULT@#In this group,the best hearing loss prognosis was the ascend type and the back type the total effective rate was both 100.0%. The second was the slow descend type. The total effective rate of this type was 70.0% (7/10). the total effective rate of full deaf is 66.7% (14/21), the sudden descend type is poor, the effective rate was 50% (4/8). although the full deaf groups total effective rate was high than sudden descend type, without one ear completely recovering, and only one ear from sudden descend type was completely cured. After treatment, there were 6 ears of fall deaf in full deaf group. There was one case rised 65 dBHL and one case rised 50 dBHL from the 21 cases full deaf sufferer. In this deaf level group, the light level and the middle level was one ear respectively. Although the total effective rate of this group was the highest, all the cases were not completely recovered. After treatment, the hearing rise 17 dBHL and 19 dBHL respectively. After chi2 text (chi2 = 1.459, P > 0.05), the total effective rate of the more heavier, heavy, and the heaviest to full deaf was no significant difference but after chi2 text (chi2 = 10.09, P < 0.01), the full recover rate was significant difference. The more heavier level group's full recover rate was the highest 38.5% (10/26).the second was heavy level group ,the full recover rate is 33.3% (12/36), the worst level to full deaf group was the lowest: 6.0% (2/33).@*CONCLUSION@#It was considered that the deafness level was no obvious relation to the total effective rate, but there was significant difference in fully recover rate. The different auditory threshold figure of the sudden deafness was closely related to the hearings prognosis.
Sujets)
Adolescent , Adulte , Sujet âgé , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Seuil auditif , Perte d'audition , Perte auditive soudaine , Diagnostic , Tests auditifs , Pronostic , Études rétrospectivesRésumé
To ensure the quality of building basic test bank and to effectively measure the quality of medical exam questions,now,we analyze the problems of the basic test papers from 13 north medical universities in many aspects such as cognitive rank,difficulty,conformity and core content etc.Having found the main problems of the testing papers,we supply the viewpoint for improvement and make better foundation for the construction of test bank.
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OSCE is an examination of objective evaluation of the clinical skills.This article introduced the development of OSCE at home and aboard,and compared the difference of the exam setting in America,England,Canada and China Medical University.The advantages and disadvantages of SP in OSCE were also analyzed.It was discussed that OSCE would be widely applied in China.
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This project studied the historical and the present situation about the personnel training model in medical education and its structure. It reestablished the objectives of the medical education and the standards of the training, modified the training program, and the curriculum system, and set up the new teaching plan and syllabus. Through three years of research and implementation, the training model of widening the basic science, breaking into three stages, integrating the courses, optimizing three phases, activating teaching methods and total adaptability had been constructed.And the project had been studied, applied and spread cooperatively with 16 Chinese medical schools.
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With the development of society, people request the doctors higher and higher, which advances a new project for cultivating the doctors in new century. In order to provide the basis for confirming the medical talent cultivating target of new century, we have finished the research on the request to the doctors in new century, and the purpose is to make our medical colleges cultivate more medical talents to meet the need of the 21st century.
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It is an essential component of medical exams to evaluate the clinical competency of medical students. After introducing Standardized Patients and non-Standardized Patients examinations into the final comprehensive examination, China Medical University continued to undertake the construction of computer-based case simulations examination system, a project of National Medical Examination Center. The article introduced the design and some crucial points in constructing the examination system.