Application of a ASK model-based four-step training method combined with workshops in training on the prevention and control of nosocomial infection for medical students / 中华医学教育探索杂志

Objective:To explore the effects of applying a four-step training method based on an attitude-skill-knowledge (ASK) model combined with workshops in training on the prevention and control of nosocomial infection among medical students, and to provide a reference for reforming nosocomial infection prevention and control training for medical students and establishing a nosocomial infection prevention and control training system.Methods:Medical students from five medical schools entering clerkships during 2018 to 2020 were selected. They were divided into control group (218 medical students in 2018-2019 receiving conventional nosocomial infection control training) and experimental group (216 medical students in 2019-2020 receiving nosocomial infection control training based on the ASK model-based four-step method combined with workshops). The two groups were compared in terms of the compliance rate of hand hygiene, the pass rates of nosocomial infection control theory and skill examinations, the correct rate of medical waste disposal, the incidence of occupational exposure, and the degree of satisfaction with teaching.Results:All the indices of the experimental group were significantly better than those of the control group: the compliance rate of hand hygiene ( χ2=4.92, P=0.027), the correct rate of medical waste disposal ( χ2=5.13, P=0.023), the pass rate of nosocomial infection control theory examination ( χ2=4.03, P=0.038), the pass rate of nosocomial infection control skill examination ( χ2=6.71, P=0.010), and the degree of satisfaction with teaching [(98.03±2.16) vs. (92.53±2.01), P<0.001]. No one had occupational exposure in the experimental group, while there were three cases in the control group. Conclusion:The ASK model-based four-step method combined with workshops is effective in nosocomial infection prevention and control training for medical students. This innovative training method improves students' satisfaction with clinical teaching, providing a basis for the establishment of a training system for the prevention and control of nosocomial infection.

The modified Peyton's approach and students' learning style.

BACKGROUND: The aim of the study was to determine the predominant learning style and type of intelligence based on the VARK questionnaire and Multiple Intelligences Questionnaire respectively in second year medical students. Determining the relationship between individual preferences of students, based on their learning style and predominant type of intelligence and the perception of the modified Peyton's four-step approach used to teach cardiac auscultation. METHODS: The opinion of participants 236 of the modified four-step approach was attained through the use of anonymous questionnaires. Using the VARK questionnaire, the participants' learning style was defined. The predominant type of intelligence was determined by the Multiple Intelligences Questionnaire. RESULTS: The kinesthetic style was the predominant unimodal learning style in second year medical students (in Polish and international students). The most predominant type of intelligence in Polish students was visual-spatial and mathematical and logical, while in international students the predominant types were visual-spatial and mixed type of intelligence. Quantitative analysis indicated that the modified Peyton's approach is a valuable learning and teaching method for most students, independent of their predominant learning style or intelligence type. The exception was a small group of students with linguistic intelligence predominance according to the Multiple Intelligence Questionnaire, for which the Peyton method was more difficult. CONCLUSIONS: This study proves that the modified Peyton's approach is useful and effective didactic tool and can be successfully applied to most students. This is a new learning strategy for teaching cardiac auscultation in laboratory conditions in classes for a significant majority. Due to the fact that a group of students with a predominance of linguistic intelligence more often perceived the Peyton method to be difficult, it is worth combining traditional methods with new ones in class so that all students, regardless of unimodal learning style or prevailing type of intelligence, are taught satisfactorily.

The application and outcomes of C.R.P.C.four-step radical prostatectomy under extraperitoneal laparoscopy / 中华泌尿外科杂志

Objective To summarize the preliminary experience of extraperitoneal laparoscopic radical prostatectomy (C.R.P.C.four-step) for localized prostate cancer and the outcomes based on early follow-up.Methods A total of 102 prostate cancer patients were screened by prostate specific antigen (PSA) and diagnosed by prostate magnetic resonance imaging and prostatic puncture biopsy with cT1c-cT3b,with average age of (67 ±5) years old,average preoperative total PSA value of (45.32 ± 18.33) ng/ml,and average prostate volume was (42 ± 12)cm3.All these patients underwent extraperitoneal laparoscopic radical prostatectomy by the four-step technique,abbreviating as C.R.P.C.[C:control DVC (dorsal deep venous complex).R:recognize three anatomical layers (prostate and bladder junction,seminal vesicle,and Denonvilliers' fascia surface).P:preserve urethral sphincter and bladder neck.C:continuous anastomosis between urethra and bladder neck (4 key needles at 3,5,7 and 9 o'clock)].The operative time,estimated blood loss,length of hospital stay and postoperative complications were recorded,and the postoperative PSA was followed up.Results All the 102 cases were successfully treated by iaparoscopic radical prostatectomy.The operative time was from 55 to 156 min (mean 92 min),and the estimated blood loss was from 55 to 185 ml (mean 105 ml).There was no case converted of open surgery,only one case received blood transfusion for postoperative hemorrhage (0.98％),and positive surgical margin was found in 15 case (14.70％) by pathological examination.Postoperative urinary extravasation within one week occurred in 2 (1.96％) cases,and resolved after tensioning the catheter and prolonging the indwelling time.During the follow-up period of 12 to 45 months,2 cases were incontinent (grade I-II),and the other cases(98.04％) had no incontinence or dysuria.However,11 cases (10.78％) developed to biochemical recurrence within 6 months after the operation.Conclusions The C.R.P.C.four-step technique of lparoscopic radical prostatectomy is easily to be grasped and performed by the greenhand urologists,and was efficient and safe.

The modified Peyton approach in the teaching of cardiac auscultation.

BACKGROUND: The aim of the study was to evaluate the usefulness of the modified Peyton's four-step approach in the teaching of cardiac auscultation and to determine students' perception of Peyton's four-step approach. METHODS: The opinion of the participants on the usefulness of the modified four-step approach was attained through the use of anonymous questionnaires, voluntarily completed by students, and on the basis of semi-structured interviews conducted with a subset of students. 187 second-year students of our 6-year long curriculum were enrolled. They attended an obligatory Laboratory Training of Clinical Skills course. The average group size was 16 students. RESULTS: The survey findings identified that 88.1% of participants found it helpful in developing their understanding of cardiac auscultation. 89.8% of all participants claimed that the new modified four-step approach facilitated memorization. The modified Peyton's four-step method allows for better organization of classes in the opinion of 87.6% students. The advantages of the method were noticed by the majority of students. CONCLUSIONS: The modified Peyton's four-step approach in the teaching of cardiac auscultation under laboratory conditions was perceived by students to be a comprehensible method that facilitates understanding and memorization. This approach allows for improved organization of classes. From the student's perspective this method allows one to master the technique of cardiac auscultation in the classroom, through the increased demand of the participants' attention, activity and involvement.

The study on the clinical effect of modified four-step laparoscopic splenectomy and pericardial de-vascularization / 临床外科杂志

Objective To explore the clinical efficary of modified four-step laparoscopic splenec-tomy and pericardial devascularization.Methods The clinical data of 72 patients with portal hypertension who were admitted to our hospital were retrospectively analyzed.Patients were divided into modified four-step laparoscopic group(36 patients)and open group(36 patients). The clinical indicators(operation time,amount of intraoperative blood loss,hospital stay,total hospitalization expenses,and intraoperative bleeding rate)and the incidence of postoperative complications were compared among the two groups.Re-sults The intraoperative blood loss(755.16 ± 50.23),Intraoperative bleeding rate(13%)and hospital stay(14.77 ± 2.09)of open group was higher than the modified four-step laparoscopic group(462.02 ± 61.42,11.11%,9.45 ± 3.20,P<0.05).The median operation time(187.67 ± 32.10)and the cost of hospitalization(42368. 70)of open group was lower than the modified four-step laparoscopic group (265.79 ± 48.23,50143.46,P<0.05).There were no significant differences in perioperative complica-tion rate among the two groups(P>0.05).Conclusions The procedure of modified four-step laparo-scopic splenectomy and pericardial devascularization has safe,feasible and with good therapeutic effect.It can significantly reduce the blood flow and blood transfusion in patients with probability,shorten the hospi-talization,lower the incidence of postoperative complications to some extent.However,the cost of hospital-ization and the time of operation are still relatively high,and further improvement should be made on the clinical application.

Establishment of a "Four-step method" for extraction and separation of Candida albicans total proteins / 第二军医大学学报

Objective: To introduce a "Four-step method" for extraction and separation of Candida albicans total proteins. Methods: Proteins of C. albicans were extracted step-by-step with 4 kinds of solutions with different solubilities. After quantification, the protein samples were separated by isoelectric focusing electrophoresis and then by SDS-PAGE. Results: Proteins with different solubilities were successfully extracted step-by-step from C. albicans and were separated by two-dimensional gel electrophoresis. Conclusion: The "Four-step method" for extraction of C. albicans proteins is an effective approach to study C. albicans membrane proteome and lays a foundation for further investigation of the mechanisms of antifungal agents and drug resistance in C. albicans.

Establishment of a "Four-step method" for extraction and separation of Candida albicans total proteins / 第二军医大学学报

Objective:To introduce a "Four-step method" for extraction and separation of Candida albicans total proteins.Methods: Proteins of C.albicans were extracted step-by-step with 4 kinds of solutions with different solubilities.After quantification,the protein samples were separated by isoelectric focusing electrophoresis and then by SDS-PAGE.Results: Proteins with different solubilities were successfully extracted step-by-step from C.albicans and were separated by two-dimensional gel electrophoresis. Conclusion: The "Four-step method" for extraction of C.albicans proteins is an effective approach to study C.albicans membrane proteome and lays a foundation for further investigation of the mechanisms of antifungal agents and drug resistance in C.albicans.