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Objective:To investigate the common disease spectrum of grass-root troops, to provide a basis for meeting the needs for military medical support among officers and soldiers, and to improve targeted training of military general practitioners in grass-root troops.Methods:With reference to International Classification of Diseases (9th edition), a questionnaire survey was conducted to investigate 146 types of diseases among the military doctors in grass-root troops. SPSS 23.0 was used to determine the score of the common degree of each disease, and the mean score of each disease was ranked. At the same time, the Kendell consistency test was used to compare the scores of doctors between different altitudes and troops.Results:Most grass-root military doctors were male graduates aged 20-39 years, among whom 109 (51.90%) did not receive continuing education, and there were 140 doctors (66.67%) belonging to the health company, 11 (5.24%) belonging to the health platoon, 35 (16.67%) belonging to the health clinic, and 24 (11.42%) belonging to the health team. As for the location of the troops, there were 42 doctors (20.00%) in the temperate zone, 56 (26.67%) in the subtropical zone, 57 (27.14%) in the alpine region, 37 (17.62%) in the plains, and 18 (8.57%) on the islands. There were 173 patients with an age of 20-29 years, accounting for 82.38%. The Kendell consistency test showed Kendell's W=0.968 ( χ 2=711.51, P<0.001), suggesting a consistent evaluation of 146 diseases by grass-roots doctors from different altitudes. Conclusion:With reference to the investigation of disease spectrum, it is necessary to formulate characteristic training objectives and contents for the training of military general practitioners, explore the training models and methods for military general practitioners in grass-root troops, promote the construction of military general practitioners during the new military reform, and improve the post competency of military doctors.
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With the rapid development of information technology and the change in military education policy in the new era, online teaching has gradually become one of the main approaches to implement the clinical medical education in military teaching hospitals. In this study, the online teaching was performed mainly by pre-recorded teaching, supplemented by online live teaching. Massive open online courses (MOOCs) and the seminar-style teaching were advocated to be used in advanced disciplines. The quality of online teaching was guaranteed through infrastructure provision, teacher arrangement, teaching preparation, teaching interactivity, after-class test, teaching evaluation, supervision, and summary of teaching, which ultimately achieved a good effect. The results of the two-way questionnaires of 26 teachers and 129 students showed that 23.26% (30/129) of students and 65.38% (17/26) of teachers believed that students' learning ability was insufficient. 34.88% (45/129) of students and 23.08% (6/26) of teachers thought that the existing technology could not meet the requirements of online teaching. 55.04% (71/129) of students and 69.23% (18/26) of teachers held the view that the effect of online teaching was inferior to face-to-face teaching. 28.68% (37/129) of students and 57.69% (15/26) of faculty asked for the return of face-to-face education. Therefore, it is necessary to strengthen the construction of smart classroom platforms, establish a well-developed online teaching quality evaluation system, and integrate various innovative teaching modes with the online teaching. In these ways, it is expected to optimize the online teaching of clinical medicine and achieve the goal of online teaching.
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Objective:To understand the effect of standardized residency training for residents with different identity types, and put forward targeted optimization and improvement measures to achieve the homogenization of training effect.Methods:Combined with literature review and expert consultation results, a self-designed questionnaire was conducted for 324 residents who completed their courses in 2019 and 2020. The effective recovery rate of the questionnaire was 87.65%. By comparing the passing rate of first-time medical admission and completion examination of different identity types, and the training standards of six core competencies, the training effect conclusion was drawn. T-test and Fisher exact probability test were also made by SPSS 21.0. Results:The passing rates of first-time doctors and completion examinations were higher in professional masters and units than in the general population, with the highest passing rates reaching 100% (10/10) and 97.3% (72/74) respectively. There was no statistical difference between the passing rates of residents with different identity types. The overall standard of the six core competencies of the integrated professional masters was better than that of the society and unit personnel. There were statistical differences between the groups in the training standards of the four abilities of the residents with different identity types in professional literacy ( P=0.048), patient management ( P=0.030), communication and cooperation ( P=0.026) and learning promotion ( P=0.003). There was no significant difference in professional ability ( P=0.131) and teaching ability ( P=0.061). Conclusion:There is no difference in the passing rate of residents with different identity types in a military hospital, which achieves the goal of homogenization training to a certain extent. However, there are obvious differences in the standards of the six core competencies, and further optimization measures need to be explored.
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To strengthen the management of residents standardized training process, so as to further improve the homogenized construction of residents standardized training, we constructed a standardized assessment system for residents training process according to the principle of "teaching-examination separation", including a new independent team of examiners, standardization of the assessment process, and expansion of standardized test bank of practical skills and medical cases. Results showed that the rates of attendance, 360-degree evaluation completion, and post-department examination, and annual assessment were all improved. The new assessment system of "teaching-examination separation" for residents standardized training strictly ensures the training quality and plays an active role in promotion of training by tests, being fair and just, and improving the efficiency and homogenization of resident standardized training, which is worthy of further research and popularization.
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Objective@#To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery.@*Methods@#A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method. Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality. Students in both groups received assessment and questionnaires at the end of training.@*Results@#Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group (P<0.05). The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group (P<0.05). Students-teacher satisfaction degree in the research group was higher than that in the control group (P<0.05).@*Conclusion@#Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach, with good feedback.
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Objective To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery.Methods A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method.Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality.Students in both groups received assessment and questionnaires at the end of training.Results Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group(P＜0.05).The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group(P＜0.05).Students-teacher satisfaction degree in the research group was higher than that in the control group(P＜0.05).Conclusion Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach,with good feedback.
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Objectives To design an objective and structured evaluation system for the clinical competence of orthopedic postgraduates in the diagnosis and treatment of distal radius fractures, and to ana-lyze its reliability and validity. Methods 28 orthopaedic postgraduates representing six levels of surgical training were tested for competence in performing surgical approach for distal radius fracture on cadaver specimens during which four measures were used to assess competency: examination of basic theory based on network item bank, objective structured operation assessment,overall assessment and operation examina-tion results. In addition, the time for completion of the surgery was also recorded. Each assessment tool was correlated with the others as well as with the resident’s level of training. Results There was a significant correlation between the seniority of candidates and the score of theoretical examination (F=6.193, P=0.000), the score of structured operation examination (F=6.374, P=0.002), the score of overall assessment (F=2.321, P=0.030), and the passing rate of final operation examination (F=36.300, P=0.000). No significant differ- ences were found between seniority and time to completion of the surgical approach exposure (F=2.282, P<0.073). Conclusions The results of the present study suggested that both theoretical examination and cadaver testing discriminate between novice and accomplished postgraduates. However, although the theo-retical test scores could predict the operational test results, but the theoretical results can not guarantee excellent operational skills.
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Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.
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Developing the clinical thinking ability and therefore improving the clinical practice ca-pacity are the core of the quality-oriented education and in the current medical education reforms. The rea-sons for retarding the development of clinical thinking ability in dental clinical probation were herein dis-cussed. According to the similarity between mind mapping and clinical thinking, drawing mind map was used in the creation of the clinical knowledge system; various teaching techniques were used and classical clinical cases were shown; role playing as dentist and patient was used to mimic the clinical circumstance;dentist-patient communication was emphasized and methods to evaluate the clinical thinking ability were also developed. These strategies effectively developed the clinical thinking ability of the dental students.
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As the understanding of science creativity becomes more profound,people find out that organizational barriers are greatly deterring and discouraging the advent and development of science creativity.Drawing upon the Situation Theory of Creativity and earlier researches,we identified crucial organizational factors that imposed influence on science creativity and considered those factors as gauge to reflect on the current practice of science research management in China.The findings show that science research funding mode,collaboration and communication opportunities and accesses,science researchers' career development and evaluation system,research group leadership,size and diversity of research teams are all key components of the organizational barriers that failed to nurture and spur Chinese researchers to solve long existed and challenging problems with original approaches and creative thinking.Therefore,innovations of science research management are necessary and urgent.
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Objective To explore the changes of appendicular skeletal muscle (ASM) in peritoneal dialysis (PD) patients, and to analyze the relationship between ASM changes and dietary intake.Methods One hundred and fourteen PD patients were enrolled in Department of Nephrology, Peking University Third Hospital using convenience sampling.At baseline, and 6 and 12 months after PD, bioelectrical impedance analysis was used to assess the body weight, total muscle mass, and ASM of these patients, and three-day food record was used to assess the dietary intake.Demographics and clinical data were also collected at baseline.Results Compared with baseline, the patients' ASM at 12 months after PD decreased significantly [(19.27 ± 5.59) kg vs.(25.65 ±6.09) kg, P =0.000], the dietary protein intake and energy intake decreased significantly [(0.85 ± 0.21) g/(kg · d) vs.(0.90 ± 0.27) g/(kg · d), P =0.038;(128.37 ± 26.67) kJ/(kg· d)vs.(137.27 ±29.23) kJ/(kg· d), P=0.001].The patients were divided into three groups based on ASM loss, the mean dietary protein intake of the top-loss 1/3 group was statistically lower than that of the bottom-loss 1/3 group [(0.82 ± 0.18) g/(kg · d) vs.(0.91 ± 0.20) g/(kg · d), P =0.021].Conclusions With the continuation of PD, ASM of patients may decrease, which is likely to be mainly related to deficiency in protein and energy intakes.Dietary management should be strengthened in PD patients to alleviate the loss of ASM.
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The Third Military Medical University promotes the scientific research ability of the eight-year clinical medicine students through accurately fixing cultivation objectives,reasonably arranging teaching,implementing supervisor group for many-to-one teaching,carrying out plentiful innovative re-search projects,establishing reading system of scientific research papers,setting up scientific research innovation courses and setting up the credit system for innovative education. Eight-year program is signifi-cantly better than the five-year program in cultivating abilities of problem-discovering,researching and thesis writing.
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Rapid development in medical technology has posed new challenges to higher medical education,especially to education of eight-year program students.How to survive the challenges has thus become a question for medical institutions.By analyzing the features of medical development and the new demand of medical education,we proposed the following innovations for education in eight-year program.It should emphasize combination of different disciplines and construction of integrated medical course system.Research on translational medicine should be conducted,and cooperation between institutions should be promoted.
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Medical students face higher levels of stress compared to the general population. Statistical analyses of questionnaire surveys were made to compare the teaching effect between traditional teaching and PBL.The results indicate that the PBL teaching is more conducive to students to relief from the course-related stress in medical colleges.
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Eight-year program of clinical medicine is the necessary trend of economic rapid development.Based on the introduction of research on and practice of eight-year medical education in The Third Military Medical University,the article makes a consideration on pre-school medical education,bilingual teaching,dual-tutorial system and the requirement of thesis.In addition,it puts forward some problems needing further study.