Application of virtual reality technology combined with scenario-based simulation training in obstetrics and gynecology internship teaching / 中华医学教育探索杂志

Objective:To observe the effects of virtual reality (VR) technology combined with scenario-based simulation training in obstetrics and gynecology internship teaching.Methods:Ninety-eight medical students interned in the department of obstetrics and gynecology from June 2021 to May 2022 were included. Among them, 49 students received conventional clinical internship teaching of obstetrics and gynecology in the control group, while the other 49 students received scenario-based simulation training with VR technology in the observation group. The two groups were compared in terms of test scores, learning ability assessed by the Self-Rating Scale of Self-Directed Learning, post competency, and the degree of satisfaction with teaching quality. The data were analyzed through the chi-squared test and t test with the use of SPSS 20.00. Results:The observation group had significantly higher scores than the control group in theoretical knowledge [(35.51±2.21) vs. (32.17±3.22)], case analysis[ (16.52±1.51) vs. (13.37±2.03)], and practical operation skills (all P<0.05). After teaching, the learning ability and post competency were significantly improved in both groups (both P<0.05), which were significantly better in the observation group than in the control group (both P<0.05). The degree of satisfaction with teaching of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:VR technology combined with scenario-based simulation training can help improve teaching quality and enhance medical students' learning ability and post competency, with a high degree of satisfaction with teaching quality, which is worth promotion and application.

Application effect of SFPC teaching on the internship teaching of nursing students in department of obstetrics and gynecology / 中华医学教育探索杂志

Objective:To observe the application effect of standard management-flexible teaching-pay attention to comprehensive quality improvement-correct evaluation (SFPC) teaching on the internship teaching of nursing students in department of obstetrics and gynecology.Methods:Forty-five nursing students who interned in the department of obstetrics and gynecology from July to December 2019 were classified as the control group, and the traditional teaching was adopted. Another 47 nursing students who interned from January to June 2020 were taken as research group, and SFPC was applied. The rotation assessment scores, clinical communication ability and comprehensive ability before and after the internship, and satisfaction with teaching of these nursing students were compared between the two groups. SPSS 23.0 was used for t test, chi-square test and rank sum test. Results:The results of theoretical and operational assessment of obstetrics and gynecology in the research group were significantly higher than those in the control group[(94.28±5.77) vs. (83.91±5.19); (91.85±5.27) vs. (81.07±5.24)]. The scores of building harmonious relationship, identifying patients' problems, keen listening, passing effective information, joint participation and verification of feelings after the teaching were significantly higher than those before teaching ( P<0.05). The scores of ideological quality, teaching activities, ability evaluation and other activities in the comprehensive ability assessment were significantly higher than those before teaching ( P<0.05), and those of research group were significantly higher than those of the control group ( P<0.05). The were significant differences in the grade distribution of teaching satisfaction between the two groups ( P<0.05), and the total satisfaction rate of nursing students in the study group was higher than that in the control group (95.74% vs. 80.00%). Conclusion:The application of SFPC teaching in the clinical teaching of nursing students in department of obstetrics and gynecology can significantly improve the performances of nursing students, clinical communication ability, comprehensive ability and nursing students' satisfaction with teaching.

Research on the application of comprehensive simulated delivery room skill training combined with improved objective teaching in obstetric nursing teaching / 中华医学教育探索杂志

Objective:To explore the application of comprehensive simulated delivery room skill training combined with improved objective teaching in obstetric nursing teaching.Methods:A total of 84 nurses who practiced in the Department of Obstetrics of Nanjing Hospital of Traditional Chinese Medicine from August 2019 to August 2020 were selected as the research objects, and were divided into control group and research group according to the sequence of admission of practice nurses, with 42 nurses in each group. The control group adopted traditional teaching methods, and the research group adopted comprehensive simulated delivery room skill training combined with improved target teaching mode. The teaching effect of the two groups of practice nurses was evaluated by theoretical assessment, skill operation assessment and teaching satisfaction rate. SPSS 22.0 was used for t test and chi-square test. Results:The total score of theory assessment, single choice, multiple choice, blank filling, noun explanation, short answer and case analysis of practical nursing students in the study group were better than those in the control group, with statistically significant differences ( P<0.05). The results of practical skills operation and comprehensive quality ability evaluation of practice nurses in the study group were better than those in the control group, and the difference was statistically significant ( P<0.05). The teaching satisfaction rate of practice nurses in the control group was 80.95%(34/42), and that in the research group was 97.62%(41/42), with statistically significant differences ( χ2=6.10, P=0.014). Conclusion:The skill training of comprehensive simulated delivery room combined with improved objective teaching can improve the theoretical knowledge, practical skills and comprehensive quality of obstetric practice nurses, and improve the teaching satisfaction rate and obstetric nursing teaching quality of practical nurses.

Study and thinking of training system of obstetrics and gynecology residents in Taiwan region of China / 中华医学教育探索杂志

This paper introduces the historical development, training contents, the inspection mechanism and management regulations of obstetrics and gynecology residents training in Taiwan region, China. Drawing lessons from the experience and ideas of the standardized residency training system of obstetrics and gynecology in Taiwan region, combined with the present situation and deficiencies of the training system in the mainland China, this paper puts forward constructive suggestions for the standardized residency training of obstetrics and gynecology, so as to obtain more efficient and satisfactory training results and provide ideas for cultivating excellent obstetrics and gynecology specialists in mainland China.

Consensual coital vaginal laceration in hypovolaemic shock: A report of two cases

Background:Certain life-threatening complications and morbidities may occur following consensual sexual intercourse which may not be commonly experienced in clinical practice. One of such complications is hypovolaemic shock resulting from profuse bleeding.AbstractMethods:Two cases of vaginal laceration complicated by hypovolaemic shock following consensual sexual intercourse are presented.Results:Both patients had resuscitation with intravenous fluid, blood transfusion and subsequent examination under anaesthesia with repair of laceration in theater. Post-operative recovery period was uneventful and they were both discharged after proper counselling. Conclusion:Bleeding from coital laceration could be life threatening. Prompt treatment should be instituted in such cases

Practice and reflection of "Rain Classroom + QQ live teaching" in the teaching of obstetrics and gynecology / 中华医学教育探索杂志

Taking the Department of Obstetrics and Gynecology as an example, this paper expounds a series of practices of online education, in the process from pre-course training, platform selection, curriculum design, to student evaluation, etc. From that, we can provide a reference for carrying out online teaching in response to the epidemic for clinical medical colleges which have not been exposed to the online course. Furthermore, it is a new attempt to explore a way to make a change of the traditional teaching method and deepen the reform of clinical teaching in our hospital after the epidemic, not only in professional medical education, but also in the popularization of medical knowledge.

Effects of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein in patients of Department of Obstetrics and Gynecology / 中国基层医药

Objective To study the effect of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein (CRP) in patients of Department of Obstetrics and Gynecology.Methods A total of 158 surgery patients in Department of Obstetrics and Gynecology who were treated in the People ~ Hospital of Qing County from July 2015 to November 2017 were enrolled in the study.According to random number method,they were randomly divided into control group and observation group,with 79 cases in each group.The observation group received the treatment of cefuroxime sodium in the perioperative period,the control group was given cefuroxime sodium treatment after surgery.The differences of the probability of a nosocomial infection and CRP between the two groups who chose different medication time were compared.Results The observation group had 45 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (40.17 ± 10.35)h.The control group had 59 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (56.35 ±9.87)h,which of the observation group were less than that of the control group,the differences were statistically significant (x2 =5.513,P =0.019;t =8.163,P =0.000).The levels of CRP and procalcitonin of the observation group after surgery were (2.34 ± 0.66) mg/L,(2.48 ± 0.79) mg/L,respectively,which were lower than those of the control group [(3.46 ± 0.84) mg/L,(3.19 ± 0.96) mg/L],the differences were statistically significant (t =9.260,P =0.000;t =5.104,P =0.000).The observation group had 2 patients appeared incision infection after surgery,the control group had 9 patients appeared incision infection after surgery,there was statistically significant difference between the two groups(x2 =4.788,P =0.029).The hospitalization time of the observation group was (6.70 ± 1.04) d,which was shorter than (8.26 ± 1.25)d of the control group,there was statistically significant difference between the two groups(t =8.513,P =0.000).The quality of life score of the observation group after surgery was (85.63 ± 15.30) points,which was higher than (71.29 ± 11.07) points of the control group,there was statistically significant difference between the two groups (t =-6.748,P =0.000).Conclusion Using cefuroxime sodium in the perioperative period can reduce the probability of nosocomial infection in surgical patients,improve the level of inflammation in vivo,shorten the hospital stay and improve the quality of life of patients.

A Cross Sectional Study Of Hellp Syndrome In Pregnancy Complicated By Severe Pre Eclampsia In A Tertiary Care Hospital

Background and objectives Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a dangerous and life threatening complication in severe preeclampsia. It remains as an important cause of maternal and perinatal morbidity and mortality globally. The objective of this study was to find out the incidence of HELLP syndrome in pregnancies complicated by severe pre eclampsia and to assess the maternal and perinatal morbidity and mortality in women with HELLPsyndrome secondary to severe pre eclampsia. Methodology A one year Cross sectional study was conducted in the labour room of KLE Academy of Higher Education and Research (KAHER), Belagavi for the period of one year from January 2016 to December 2016. Ethical clearance was obtained from the JNMC Institutional Ethics committee. The primary objective was to determine the incidence of severe pre eclampsia and HELLPsyndrome in patients of severe pre eclampsia. The secondary objective was to study the associated maternal and perinatal morbidity and mortality. Results During the study period, a total of 6236 number of deliveries were conducted in the hospital. Among them, 312 (5%) pregnant women developed severe preeclampsia and 33 women developed HELLPsyndrome(10.57%). The mean age was 25.18±3.81 years. Labour was induced in 21.21% of the women. Majority (66.67%) of the women had vaginal delivery, while the rest had caesarean section (33%) . The most common indication for LSCS was HELLP 81.82%. Majority (84.85%) of the women had complications of HELLP alone while 9.09% of the women had HELLP syndrome associated with abruption. The mean birth weight was 2.27±0.69 Kgs. All cases had live births. The requirement of NICU admission was noted in 18.18% and the most common cause of NICU admission was Meconium aspiration syndrome with fetal distress (50%). The perinatal mortality rate was 16.67%. Conclusion and interpretation HELLPsyndrome is one of the rare complications of severe pre eclampsia. This study shows 5% incidence of severe preeclampsia and incidence of HELLP syndrome in pregnancy complicated by severe preeclampsia as 10.57%. The incidence in our study is high as our hospital is a tertiary care centre that receives referral cases (high risk with poor prognosis) from North Karnataka for further management.

Exploration of Hierarchical Diagnosis and Treatment Mode of Ambulatory Surgery in Department of Obstetrics and Gynecology / 中国医院管理

In the view of the obstetrics and gynecology hospital,and through setting up a cooperative hierarchical diagnosis and treatment of ambulatory surgery in Department of Obstetrics and Gynecology in the secondary hospital,the feasible model of hierarchical diagnosis and treatment of specialty diseases is explored,and suggestions are put forward.Hierarchical diagnosis and treatment mode of ambulatory surgery can increase patients' efficiency and satisfaction of seeing doctors,and medical resource can be fully used.

Medical Ethics Reflection in the Practice of Obsterics and Gynecology / 中国医学伦理学

Through the treatment of difficult case in a gynecology and obstetrics and doctor-patient communication,this paper analyzed how obstetricians and gynecologists should start from themselves,properly treat the patients,reduce the disputes and conflicts and harmonize the relationship between doctors and patients.It is believed that doctors should get patients' trust through improving their own medical technology,enhance communication skills,use "Platinum Law" to understand patients'needs,respect patients' right of informed consent,adopt reasonable requests and suggestions of patients,thus to reach a harmonious consensus of both doctors and patients and seek the best way of treating disease.

Intervention Effect of DRUGS System on Antibacterial Agents Use in Department of Obstetrics and Gyne-cology in Our Hospital / 中国药房

OBJECTIVE:To analyze intervention effect of Drug Rational Usage Guidelines System(DRUGS)on antibacterial agents use in department of obstetrics and gynecology in our hospital. METHODS:The application of antibacterial agents in depart-ment of obstetrics and gynecology in our hospital during Jan.-May(before intervention)and Jun.-Nov. 2012(after intervention)were extracted in respects of drug name,preoperative medication duration,perioperative additional condition,postoperative drug with-drawal time,drug combination,usage and dosage,average hospitalization stay,hospitalization cost. The intervention effects were analyzed. RESULTS:After intervention,the type of antibacterial agents were more in line with national regulations;the proportion of type Ⅰ incision surgery without antibacterial agents increased from 57.8% to 75.2%;the prophylactic application of antibacteri-al agents in type Ⅱ incision surgery within 0.5-2 h increased from 80.2% to 97.0%. The rate of reasonable antibacterial selection, drug combination,usage and dosage increased from 76.9%,64.9%,71.3% to 89.3%,84.6%,90.2%,respectively. The average hospitalization stay and antibacterial cost per capita decreased significantly. There was statistical significance among above indica-tors before and after intervention(P<0.05 or P<0.01). CONCLUSIONS:DRUGS effectively change irrational use of antibacterial agents in department of obstetrics and gynecology,which provide a new method for the management of antibacterial agents.

Clinical analysis of 72 cases of pregnant with oligohydramnios / 中国现代医生

Objective To explore the pregnancy outcomes and clinical treatment principles of pregnancy with oligohy-dramnios. Methods Clinical data of 72 cases of pregnant women with oligohydramnios were analyzed retrospectively from January 2010 to January 2012 in our hospital, and at the same time selected 72 cases normal amniotic fluid preg-nant women as the normal amniotic fluid group. Pregnancy complications, confining conditions begat outcome and mode of delivery were compared between two groups. Results The rate of prolonged pregnancy, gestational hypertension, postpartum hemorrhage, intrauterine growth retardation, oligohydramnios group meconium-stained amniotic fluid, fetal distress, fetal malformations and neonatal asphyxia amniotic fluid in were significantly higher than the normal group (P<0.05), cesarean section rate of oligohydramnios group was 58.33%, incidence of vaginal delivery was 15.28%, cesarean section rate of normal amniotic group was 27.78%and the incidence of vaginal delivery was 8.33%, there were significant differences (P<0.05). Conclusion The treatment method of oligohydramnios pregnant women in different peri-ods is different, non full term pregnancy oligohydramnios patients treated with increasing amniotic fluid, full-term preg-nancy oligohydramnios patients should given termination of pregnancy timely.

The clinical effect of transcather arterial embolization in treatment of a-cute obstetrics hemorrhage / 中国现代医生

Objective To investigate the clinical effect of Transcather arterial embolization in treatment of acute obstet-rics hemorrhage. Methods From January 2012 to October 2014 in our hospital,selected 91 patients with acute obstet-rics hemorrhage as the research object,were divided into operation group and the conservative group,the conservative group 41 cases were treated with conservative treatment(invalid to uterine resection or ligation treatment),the operation group 50 cases were treated with the catheter arterial embolization. The hemostatic time,hemostatic efficiency,uterine resection rate and the incidence of adverse reactions were compared between two groups. Results The time of hemostasis operation group was (1.43±0.65)h, and the conservative group's bleeding time was (7.48±1.62)h (P<0.01);operation bleeding control rate and hysterectomy rates of operation group were 92.00%,8.00%, was higher than optimal opera-tion group(51.22%, 48.78%)(P<0.01). Conclusion Acute obstetrics hemorrhage more common,conservative treatment ineffective, to transcatheter arterial embolization treatment has exact effect, the hemostatic rate and high safety, can be better to retain the uterus,is worth learning from.

Situation of three-year program medical students' after-department examination during the internship in the department of obstetrics and gynecology and its assessment / 中华医学教育探索杂志

Objective To explore the unified assessment methods based on present situation of after-department examination during the internship in the department of obstetrics and gynecology.Methods The present situation of after-department examination in the department of obstetrics and gynecology in 36 comprehensive hospitals of Chongqing Three Gorges Medical College were investigated through interviews and research papers including 12 grade A hospital of the first class hospital (33.33％),19 grade A hospital of the second class(52.78％) and 5 grade B hospital of the second class(13.89％).Totally 137 students of clinical major in 4 grade A hospital of the second class were enrolled and were divided into study group(n=72) and control group(n=65).hems of theoretical examination and skill examination as well as the evaluation standard were established combining with the syllabus of the licensed assistant doctors and the talent training scheme requirements.Students in study group were trained according to the practice syllabus,skill examination requirement and evaluation require-ment while those in control group had no cmresponding requirement.After-department examination was organized by school at the end of internship.The full score of theoretical examination and skill examination score was 50 respectively.Smvey results of after-depamnent examination were analyzed by Fisher's Exact Test and the results of after-depamnent examination were analyzed by t test.Results The hospitals having the after-department examination accounted for 80.56％(29/36).The hospitals having the after-depamnent examination according to the practice syllabus requirements accounted for only 20.69％(6/29).After the intervention,theoretical examination scores of study group and control group were 40.31 ± 3.47 and 35.78 ± 4.92,respectively,with statistically significant differences(t=6.26,P=0.000).The skills assessment scores of study group and control group were 40.42 ± 3.02 and 34.05 ± 5.18,respectively,with statistically significant differences(t=8.90,P=0.000).Conclusions The after-department examination in hospital is in a state of randomness,so unified assessment methods are necessary.

Application of problem-based learning in clinical nursing teaching in obstetrical and gynecological department / 现代临床护理

Objective To investigate the feasibility of using problem-based learning in nursing clinical teaching in the obstetrics and gynecology department.Methods Sixty-six nursing students were randomly divided into PBL group and lecture-based learning(LBL)group .At the end of their internship,the two groups were compared in terms of examination performance,learning attitude and aptitude,and their feedback on the two learning modes.Results The students in the PBL group were significantly better than those in the control group in terms of examination performance,learning attitude and aptitude,and their feedback on the learning mode(P<0.001).Conclusions PBL may be effective in the improvement of their attitude to learning and aptitude,the comprehensive ability.It can provide an environment to promote internal learning motivation for students.

Application of diversified clinical teaching methods in department of gynecology and obstetrics / 中华医学教育探索杂志

Diversified clinical teaching methods which include theoretical teaching by multimedia,specific chapter explains with PBL,contacting with clinical diseases and integrating theoretical knowledge by case discussion,solving learning problems and introducing new progress by seminars,can improve the quality of teaching in the department of obstetrics and gynecology.

Application of Kappa (κ) index in clinical training for eight-year program medical students / 中华医学教育探索杂志

Objective To screened out items with large proportion of technical analysis in obstetrics and gynecology physical examination by using statistical parameters Kappa index and to evaluate effect and clinical significance of Kappa index based on objective data and students' and teachers' subjective feeling.Methods We made Kappa index screening with double-blind method and established the Kappa index table for teachers and students.Students were randomly divided into conventional teaching group (n =26) and teaching reform group (n =29).Students in conventional teaching group traditionally followed the teacher to carry on the practice while those in teaching reform group received training according to the numerical value index and had examination after training.We paid attention to each student's weak points,provided personalized guidance and communicated with students actively.Results We found that it was uneasy for beginners to quickly grasp four step obstetrics palpation in-spection according to Kappa index.There were statistical differences in operation of gynecological physical examination between two groups (P =0.016).Conclusions Application of Kappa index can help us screen out skills in the operation suitable for training for eight-year program medical students.With quantitative evaluation,we can improve quality of clinical practice teaching in department of obstetrics and gynecology and guide educational reform.