Table of Content

20 February 2019, Volume 5 Issue 1

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Research on effects of clinical skills training system to promote clinical practice ability of medical students

Wang Naiqi,Yan Yan, Li Jingnian, Yuan Liang, Cao Lihua, Gao Zhenming, Song Guijun, Gu Xueming

2019, 5(1):  1-4，12.  doi:10.3969/j.issn.2096-045X.2019.01.001

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With the widespread use of medical simulation technology, Dalian Medical University has actively explored and established a systematic clinical skills training system. Over the past nine years, we applied this system to train all clinical medical students, organized and participated in the medical students’ clinical skills competition and prepared for the national medical college students’ clinical skills competition, and achieved excellent results. At the same time, the medica undergraduates' clinical skills training assessment system have established by our university and the clinical practice ability of all the medical students majoring in clinical medicine are improved.

Application of flipped classroom combined microlecture mode in pediatric basic theory teaching

Wang Yingjie, Yang Liu, Zhang Li, Wang Yuqian, Sun zhao

2019, 5(1):  5-7,12.  doi:10.3969/j.issn.2096-045X.2019.01.002

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Objective To explore the application effect of the teaching mode of flipped Classroom combined with microlecture in the teaching of basic theory of pediatrics. Methods A total of 64 medical students of the five-year Grade 2014 were selected from clinical medicine of Dalian Medical University. Experimental group was teached by flipped classroom combined with microlecture teaching method; control group traditional teaching method. Each group have 32 students. After the completion of the teaching, the teaching results are evaluated through theoretical examinations and questionnaires. The questionnaire survey includes learning interests, learning effects, and students’ satisfaction with the teaching model.Results The scores of the skill operation test in the control group were (79.09±5.80) lower than those in the experimental group (82.78±3.00), and the two groups were statistically different (P<0.05).The test scores of the control group were (81.09±5.49) lower than that of the experimental group (87,47±3.78), and the two groups were statistically different (P<0.05). In the control group, 20 people were interested in skill operation, and 29 people in the experimental group. The difference between the two groups was significant (P<0.05).18 people were satisfied with the model of teaching in the control group, and 30people were satisfied in the experimental group. The difference between the two groups was significant (P<0.05). Conclusion Flipped classroom combined with microlecture teaching method has a good teaching effect and is worth promoting. This method can cultivate students’ analytical ability and clinical thinking ability, and can also improve students’ interest in pediatrics, so as to achieve better learning results and get classmates’ satisfaction.

Preliminary research on the combined application of intelligent classroom and task-driven teaching method in medical imaging teaching

Sun Haiyan, Hu Jiawei, Xu Nan, Kong Zixuan, Sha Lin, Cheng Honghai, Wang Shaowu, Dong Yang

2019, 5(1):  8-12.  doi:10.3969/j.issn.2096-045X.2019.01.003

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Objective To explore the teaching effect of the intelligent classroom combined with task-driven teaching method in medical imaging teaching. Methods Four classes taking themedical imagingcourse were selected from Dalian Medical University from September 2018 to December 2018. They were divided into the study group (64 students accepting the intelligent classroom combined with task-driven teaching method) and the control group (64 students accepting traditional granting teaching method). At the end of the teaching, the teaching effect was evaluated through the classroom test, which included objective theoretical knowledge assessment and subjective assessment of the students.Statistical analysis was performed on the data using SPSS 19.0 software. Results The objective theoretical knowledge assessment scores of the study group (82.39±9.59) were higher than those of the control group (70±11.55), and the difference was significant (P<0.05). In terms of arousing learning interest, developing the thinking ability and skills of image diagnosis, cultivating the ability of independent thinking and solving problems, improving autonomic learning and innovative thinking in scientific research, the study group were higher than the control group respectively by (82.9% vs. 10.6%), (91.3% vs. 5.6%), (88.5% vs.7.8%), (86.7% vs. 9.2%), and the differences were significant (P<0.01). There was no statistical difference between the two groups of students’ recognition or expectation of teaching reform (93.3% vs. 85.4%). Conclusion The intelligent classroom combined with task-driven teaching method can significantly improve the quality of medical imaging teaching, better stimulate learning interest, and help to cultivate imaging diagnostic thinking mode and reading skills.

Application and exploration of average separation class in the teaching of traditional Chinese medicine diagnostics

Hu Shouyu, Tang Ling, Gong Xiaoyang, Sui Hua, Chen Jing, Wang Yanmin, Liang Lina

2019, 5(1):  13-16.  doi:10.3969/j.issn.2096-045X.2019.01.004

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To explore the application of average separation class in the teaching of TCM diagnostics. The average separation class teaching mode was applied in the teaching of TCM diagnostics, and the effects of average separation class wereevaluated by the students’ classroom performance and the questionnaire. The students generally accepted the teaching mode of average separation class.We found that the increase in students’ activity, the subjective initiative, the independent learning ability and the learning efficiency. It is helpful to boost students’ enthusiasm for the diagnosis of Chinese medicine,to improve their academic performance and teaching quality. It has certain promotion significance.

Construction of clinical practice evaluation system for nursing undergraduates

Jiang Jing1, Hou Liwen2, Sun li3, Zheng Yinghua1

2019, 5(1):  17-21.  doi:10.3969/j.issn.2096-045X.2019.01.005

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Objective To set up clinical practice evaluation system for nursing undergraduates. Methods A total of 24 nursing experts participated in the two-round consultation by Delphi technique. Results The clinical practice evaluation system for nursing undergraduates was established, and included 3 first-level indicators,10 second-level indicators and 48 third-level indicators. Conclusion In this study, the selected experts’ positive coefficient, authority coefficient and coordination coefficient are high.The clinical practice evaluation system is a scieutific basis for evaluating the effectiveness of clinical practice.

Comparative analysis of the effectiveness of pediatrics course teaching reform in Wuhan University Medical School

Gan Yuru, Deng Youping, Fan Jingyi, Zhao Dongchi, Lei Hong, Li Jinxin, Fang Lihui

2019, 5(1):  22-24，33.  doi:10.3969/j.issn.2096-045X.2019.01.006

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Objective To explore the effectiveness of this teaching curriculum reform by implementing a new pediatric theory class and bedside teaching method for medical students in Wuhan University. Methods Five-year students of 2010,2011 and 2012 clinical medicine majors were selected as subjects and were divided into the control class (328) and the experimental class (68). The control class is taught by the traditional teaching method, and the experimental class adopts the WUMER teaching reform mode with CPPT as the core to compare and analyze the teaching effects of the two classes.Results With the advancement of teaching reform, the differences in theoretical scores and skill scores between control class and experimental class in each grade were narrowed, but the differences in theories, skills, and case analysis between two classes were statistically significant (P<0.05). Conclusion From three aspects of teaching content, teaching methods and assessment methods, result of the teaching reform of the pediatric curriculum has achieved, which can improve students’ clinical thinking and practical ability.

Exploration on the comprehensive assessment model of preventive medicine pre-graduation practice based on students’ demand analysis

Li Weiming, Yuan Dan, Huang Qiaoyun, Shu Qunqin, Xu Chuanzhi, Chang Wei, Yin Jianzhong

2019, 5(1):  25-28.  doi:10.3969/j.issn.2096-045X.2019.01.007

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Objective To explore the assessment model of pre-graduation practice for preventive medicine majors in general undergraduate medical colleges based on students’ demands analysis. Methods A stratified cluster sampling method was used to select 310 students of five-year preventive medicine undergraduates from grade 2012 to grade 2014 in Kunming Medical University. The questionnaires and interview syllabus were used to investigate .The contents mainly include the knowledge, opinions and evaluations of the assessment content, assessment methods, and assessment subjects of preventive medical pre-graduation practice. Results The professional appraisal content of pre-graduation practice consists of professional quality, comprehensive knowledge and professional ability. The percentage of 98.21 of the students agree that it is necessary, and there is a statistically significant difference in the assessment of the appraisal content among students of different grades (P<0.05). The percentage of 76.80 of students think that the assessment method for graduation practice could be integrated. The results of the interviews revealed that students of preventive medicine majors welcome the more informative and varied assessment of pre-graduation practices. Conclusion It is more suitable for the training of preventive medicine talents to construct the assessment model of pre-graduation practice for preventive medicine majors with the guidance of diversification.

Application of self-directed learning and scene simulation in medical students’ skill training

Yang Jinjiang, Liu Fengqi, Ma Lifeng, Guo Ai, Wu Jie, Li Qiang

2019, 5(1):  29-33.  doi:10.3969/j.issn.2096-045X.2019.02.008

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Objective To research the result of self-directed learning and scene simulation in medical students skill training. Methods 60 medical students of grade 2012 were randomly divided into experimental group and control group.There are 30 students in each group. Before training, the students were assessed. There was no significant difference in their scores. The control group was taught by LBL and traditional teaching method, while the experimental group was trained by the method of self-directed learning and scene simulation. Two groups of students were trained for two months, then took the examination, and the examination results were analyzed. After the examination, we investigated the training satisfaction.Results The scores of skill test in the experimental group were significantly higher than those in the control group (P<0.05);the theoretical scores in the experimental group were higher than those in the control group, but there was no statistical significance (P>0.05); the satisfaction of training in the experimental group (90%) was significantly higher than that in the control group (77.8%) with statistical significance (P<0.05). Conclusion Self-directed learning and scene simulation can obviously improve the effect of skill training and the training satisfaction in medical students. It is a good skill teaching method and can be applied in skill training.

Application of building model based on knowledge module grid in the teaching of intern in department of nephrology

Zhang Xiaobo, Zhou Min, Wang Guoyi, Zhu Ying, Zhao Jinwen, Chen Min

2019, 5(1):  34-37.  doi:10.3969/j.issn.2096-045X.2019.01.009

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Objective To use the knowledge point module to build a teaching model, and observe its application effects of application in nephrology interns. Methods According to Internal Medicine (eighth edition) renal medicine teaching syllabus requirements, combined with the clinical characteristics of renal common diseases and frequently-occurring diseases, we carefully selected relevant knowledge points, focused on clinical theory, targeted at serving the intern training.We empahasied clinical relevance between the knowledge points, eventually constructed the diagnosis and treatment of grid analysis model. We use hematuria, proteinuria, hypertension, oedema, glomerular filtration rate as the breakthrough point,set nephrotic syndrome, systemic lupus erythematosus, diabetes kidney disease and acute and chronic renal failure as clinical knowledge points that must be mastered. Medical history, symptoms, physical signs and laboratory examination were used to train interns’ clinical thinking. The knowledge points in the diagnosis and treatment of the disease might help interns with renal medicine clinical knowledge in the limited kidney internal medicine internship. Results Fifty-one interns of renal medicine were selected for rotary grid model training in this one-year study, and they generally accepted that the model had good teaching effect, helped them sort out the kidney internal medicine clinical priorities, and grasp integrated theory and knowledge, open the interns’ medical vision, and facilitate learning other knowledge. Conclusion The grid model based on knowledge points has a good teaching effect on interns of renal internal medicine. Students can enhance their memory of the knowledge points in clinical renal internal medicine, and it can be further popularized in other medical departments.

Construction of stroke preventive medicine practice teaching system with Internet

Guo Xiuhai, Gu Chaoxiong, Zhang Xuxiang

2019, 5(1):  38-42.  doi:10.3969/j.issn.2096-045X.2019.01.010

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In recent years, the incidence of stroke in China is increasing, which has become a heavy burden to individuals, families and society. It is urgent to strengthen the construction of stroke prevention and control system. In the promotion of the grading diagnosis and treatment of stroke-specific diseases nationwide, the shortage of talents has become the biggest bottleneck. Internet+medical education has obvious advantages. Internet+medical education is characterized by high coverage, low cost, online and offline integration and improved training efficiency. The classic Internet + medical education modes, including remote lectures, remote surgery teaching, remote case discussion, distance teaching rounds, and remote international teaching, have been widely recognized. At present, relying on the National Engineering Laboratory of Network Medical Diagnosis and Treatment Technology and the advantages of two disciplines in the field of neuroscience and geriatrics, Xuanwu Hospital of the Capital Medical University has explored the eStroke national thrombolysis and embolectomy imaging platform, and completed the transformation of the new Internet+medical education mode, which has been widely recognized.

Research on regional health resource equity under Beijing-Tianjin-Hebei Integration

Xing Lihan, Jing Huiquan

2019, 5(1):  43-47.  doi:10.3969/j.issn.2096-045X.2019.01.011

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Objective To analyze the equity of health resources allocation before and after the new medical reform in the Beijing-Tianjin-Hebei region of China, analyze the reality and institutional reasons of the lack of equity in health services in the three regions, and provide suggestions for improving the equity of health resources allocation. Methods Concentration index (CI) is used to study the change trend of regional health resource allocation and equity under the background of integration of Beijing-Tianjin-Hebei region in China. Results After the Beijing-Tianjin-Hebei integration, the fairness of allocation of health resources has improved, while the fairness of medical resources in the three regions has gradually slowed down. Conclusion The Beijing-Tianjin-Hebei region should attach great importance to the allocation of high-quality medical and health talents in the region, and the relevant government departments should play their leading role in solving the problem of unequal distribution of medical and health resources.

Investigation on satisfaction of medical personnel in social hospitals in Beijing, basing on the two-factor theory

Yuan Hua, Wu Ping

2019, 5(1):  48-53.  doi:10.3969/j.issn.2096-045X.2019.01.012

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Objective To analyze the salary, occupation and overall job satisfaction of medical personnel in social hospitals in Beijing, to explore the influence factors and existing problems, and to provide decision references for health administrators as well as to improve the satisfaction of medical personnel in social hospitals. Methods We conducted the Questionnaire Survey in 10 social hospitals, used Descriptive Statistical Analysis to describe the basic working condition of medical personnel in social hospitals, adopted Spearman to analyze the correlation among salary satisfaction, career expectation and overall satisfaction, and used Ordered Logistic Regression Model to analyze influence factors of salary,career expectation and overall satisfaction. Results (1) 54.3% of medical personnel are satisfied with the overall condition of hospitals, 44.8% of medical personnel are satisfied with their career expectation in hospitals, but only 32.9% are satisfied with their salary and treatment in hospitals. (2) There is a positive correlation between career expectation satisfaction and overall satisfaction (P<0.001), and there is no correlation between salary satisfaction and overall satisfaction. (3) Age is the influence factor of career expectation, and professional title is the influence factor of overall satisfaction. Conclusion In order to improve the satisfaction, we need to motivate the career expectation and give full play to the positive role of health care factors, such as salary and treatment. Satisfaction should be improved according to different characteristics.

Investigation of the situation of resident physicians standardized training in Shandong Province

Zhan Jingyan, Lou Jingqiu, Zhou Shaoling, Song Shaojie, Chen Wei, Cheng Hongxia

2019, 5(1):  54-59.  doi:10.3969/j.issn.2096-045X.2019.01.013

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Objective To investigate the situation of resident physicians standardized training. Methods Class 2014 standardized training residents were selected for questionnaire survey. The contents of investigation were divided into theoretical training and clinical practice ability training, residents’ satisfaction on standardized training, and the whole cognition of standardized training. Results In training and assessment, we found with the passage of training time,the frequency of training and assessment requirements of the resident doctor gradually was decreased, the training time was favored on 15:30-17:00 (P<0.05), and the number of physicians in favor of various assessment forms has increased (P<0.05). In terms of residents’ satisfaction, the longer the training time, the higher the satisfaction of residents with training physicians and with the assessment of teaching and clinical skills training. For the whole cognition of standardized training,in 2015, 88.51% yet in 2017, 98.32% of resident physicians believed that their clinical skills have improved. Most resident physicians thought that the longer the training time was, the more they think high of the trainers. Conclusions To increase satisfaction, we should put emphases on improving the content of theoretical training, arranging training time properly,objective structured clinical examination combined with basic skills training and developing systems of teaching.

Status analysis of medical students’ education of lifestyle and health education courses

Wang Yao, Jin Qianying, Yan Jiahui, Wang Xingyu, Liu Han, Ma Hanqiao, Ali Akbar, Chen Tianzuo,

2019, 5(1):  60-65,97.  doi:10.3969/j.issn.2096-045X.2019.01.014

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Objective To discuss the optimization direction of education courses on lifestyle and health from the perspective of medical students, and to apply the reformed courses to future clinical work. Methods Questionnaires are distributed among medical students on campus to survey learning needs and satisfaction for this course. Course contents include drug compliance, smoking cessation intervention, balanced diet, mental stress management, application of Chinese traditional rehabilitation medicine, health education of chronic infectious disease, health education of acute infectious disease, mobile health technology education, the guidance of exercise rehabilitation and the theory of health promotion.Frequency and constituent ratio indexes were used for statistical description, and Wilcoxon signed-ranked test and chi-square test were used to compare the correlation between course learning and length of schooling. Results Our results showed that for medical students there are statistical differences between demand and satisfaction of drug compliance, smoking cessation intervention, balanced diet, mental stress management, chronic infectious disease health education, acute infectious disease health education, mobile health technology education and the guidance of exercise rehabilitation (U ＝ 6.2、5.2、7.2、9.2、5.9、6.1、2.1、3.2，P ＜ 0.05); Concern about the needs toward course contents, five-year medical students and long-term medical students show differences on smoking cessation intervention, balanced diet, mental stress management, application of Chinese traditional rehabilitation medicine, chronic infectious disease health education, acute infectious disease health education, mobile health technology education and the theory of health promotion (U ＝ 2.4、2.2、2.5、2.3、2.4、2.4、2.3、2.0，P ＜ 0.05); For the health education toward chronic patients, the elderly, maternal, infectious disease, highrisk populations and occupational exposure population the difference of five-year medical students and long-term medical students is statistically significant (χ2 ＝ 8.9、14.2、9.9、6.9、23.9、17.8，P ＜ 0.05). In the method of teaching, fiveyear medical students and long-term medical students also show some difference on teacher lectures and group discussions ( χ2 ＝ 6.3, 9.5, P ＜ 0.05). Conclusion At present, the teaching of education courses on lifestyle and health fails to meet the demands of medical students, and the curriculum reform need to consider about the course content, teaching method and opening time.


Construction and practice of teaching mode based on learning motivation theory in colleges and universities

Wang Ling

2019, 5(1):  66-70.  doi:10.3969/j.issn.2096-045X.2019.01.015

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Based on the learning motivation theory and with the help of “rain classroom” teaching tools, this paper constructed a teaching model of “Goal + Sense of self-efficacy + Reinforcement”. The teaching practice of medical literature retrieval for undergraduate students was explored, and the teaching effect was investigated by questionnaires. The results showed that this teaching mode could stimulate students’ learning motivation and improve their learning effect, which was of great significance to other teaching reforms in colleges and universities.

Development of clinical skills for international students through clinical skills competition

Wang Jingjing, liu Zhen, Zhu Qingshuang, Wang Yajun, Jia Jianguo

2019, 5(1):  71-73.  doi:10.3969/j.issn.2096-045X.2019.01.016

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Practical knowledge in medical education is essential in training medical students. With this understanding,this article presents the clinical skills competition as a valuable part of training of medical students. It promotes the improvement of the clinical skills, clinical thinking, team cooperation and conscious level of the international students, as well as further elaborates the importance of clinical teaching through the analysis and results of the competition. Clinical skills contest should be targeted towards the adaptability, organization and development of clinical skills of international students.

Study on the simulation teaching of cardiopulmonary resuscitation for residents by using Sim Man3G simulator

Chen Guobing, Gong Meiling, Zhang Yixin, Yang Chaomei

2019, 5(1):  74-78.  doi:10.3969/j.issn.2096-045X.2019.01.017

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Objective To explore the application effect of SimMan 3G simulator in the simulation teaching of cardiopulmonary resuscitation (CPR). Method Residents who participated in the second year of the training were selected as the research subjects. The SimMan 3G simulator was used to carry out the scenario simulation teaching of cardiopulmonary resuscitation. The overall performance and individual skills of the students before and after the lectures were analyzed.The DASH scoring system was used to evaluate the effect of the simulation teaching. Results There was a statistically significant difference between the pre-class assessment and the post-test assessment (P<0.001). Students and supervisors have a good evaluation of the overall teaching. Conclusion Scenario simulation teaching can improve the quality of CPR training. Students and supervisors had high evaluation. Therefore, scenario simulation teaching can be applied to cardiopulmonary resuscitation and even other clinical skills courses to effectively improve students’ clinical competency.

Practice and exploration of the second classroom based on chemistry experiments

Zhao Guang, Li Jun, Zhu Mingyue, Peng Yuting, Zhang Jianing, Zhang Yan

2019, 5(1):  79-83.  doi:10.3969/j.issn.2096-045X.2019.01.018

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The traditional chemistry experiment teaching methods need to be reformed. The activities in the second classroom as the continuation of the first classroom, can be used to improve students’ initiative and enthusiasm. The subject of soap handmaking can combine with the hot issues in production and life practice, with the consideration of environmental protection and health benefits. The handmade soaps were made by adding natural plant oil. The influence of material liquid ratio, hot-process soapmaking, cold process method, soap making time and so on is compared. The surface tension of the solution of handmade soap was determined by maximum bubble method. Producing Fe3O4 nanoparticles is another subject.Fe3O4 nanoparticles were prepared by co-precipitation method. The effects of molar ratio and pH are investigated. When the final products are finished, the students’ interest is stimulated. The second classroom can cultivate the students’ scientific thinking and innovation ability.

Discussion on preliminary effect in establishing clinical center of medical university

Li Jisheng, Li Wenbin, Lv Li, Wang Songling

2019, 5(1):  84-87.  doi:|10.3969/j.issn.2096-045X.2019.01.019

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Under the framework of Medical University, this paper proposes to integrate and enhance the resources of the dominant disciplines of clinical medical schools, to build an open, shared and cooperative multi-disciplinary platform, to create a clinical center based on a certain disease or syndromes. It is propitious to promote the ability and process of Medical University to solve the critical difficult miscellaneous diseases, to enhance the overall clinical diagnosis and research level of the Medical University, to enhance the social service capacity of the clinical medicine of Medical University, to innovate the diagnosis and treatment technology and mode of clinical medical schools in Medical University, and to lay a solid foundation for the Medical University's clinical medicine to be first class in the country and to be first class in the world.

Influence and suggestion of comprehensive healthcare reform policy on the economic operation in public hospitals.

Yang Li, Zhang Xiao, Wu Yuqun, Wang Guowei

2019, 5(1):  88-91.  doi:10.3969/j.issn.2096-045X.2019.01.020

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This paper is based on the comprehensive healthcare reform in Beijing in 2017 and analyzes the financial and business data of twenty three-level public hospitals in 2017. We analyze the effects of healthcare reform policy and the impact of the implementation of comprehensive healthcare reform policy on the economic operation of public hospitals.Public hospitals are faced with opportunities and challenges, and this paper puts forward the coping strategies and the policy support from government departments.

Comparative analysis of hospital expenses and influence factors of lung cancer surgery patients between B specialized hospital and Z general hospital

Chen Li, Zhang Ning

2019, 5(1):  92-97.  doi:10.3969/j.issn.2096-045X.2019.01.021

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Objective To study the change trend and composition of lung cancer hospitalization expenses between B specialized hospital and Z general hospital. Methods Data analysis was conducted by descriptive analysis, chi-square test, multivariate linear regression analysis and other methods. Results The factors influencing the hospitalization cost of patients with lung cancer surgery were the proportion of operation expenses, the proportion of disposable consumptive material, hospital types, accompanying diseases, the proportion of examination and treatment expenses, payment methods,hospitalization days and the proportion of drugs. Conclusion It is an important measure to adjust the cost structure of hospitalization and strictly control the use of disposable materials.

Exploration of implementing precise assistance in retired personnel with PDCA model——Take Xuanwu Hospital of Capital Medical University as an example

Yang Yuping, Xue Jing, Ma Nan

2019, 5(1):  98-101.  doi:10.3969/j.issn.2096-045X.2019.01.022

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This paper presents the application of PDCA model in precise assistance for retirees. We explore the four stages of PDCA cycle: finding problems, setting goals, formulating plans, system guarantee, information guarantee, accurate identification, standardization process, focusing on the effect of assistance and improving the details of assistance. After that,the retirees’ satisfaction and positive energy guidance function will be enhanced. PDCA model promotes the development of precise assistance for retirees. The application of PDCA model to precise assistance is the focus of retired cadres’ work and an important way to promote the initiative of retired cadres’ work.