Objective To get known the existing problems in rural primary physicians training in Gansu province, so as to explore an appropriate training mode for Gansu province. Methods This study conducted a comprehensive analysis by combining literature analysis, on-site survey and interview. Such databases as CNKI, VIP and CBM were searched to include literature published before November 2011, and the references of the included literature were also retrieved. The qualitative analysis was performed after assessing the methodological quality of the included literature according to self-designed criteria. Additionally, the rural primary hospitals in Gansu province were classified according to their geographical position and economic development level, total 10 township hospitals were randomly selected by cluster sampling, and the following stuffs participated various trainings in past 3 years were on-site-investigated: clinical doctors, nurses, medical technicians, and medical administrators, in aspects of training time, place, contents, modes, and effects. Results The existing problems in primary physicians training modes in Gansu were as follows: uneven training levels, lack of targeted contents, neglect of skill training and process management, and absence of quality assessment of training processes and effects. Conclusion The training modes require that: a) specific plans and schemes; b) unified organization to integrate educational resources effectively; c) reasonable arrangement of implementation process, and d) innovation of training methods and contents to fully play the role of general hospitals and universities; and well control and feedback to promote the integration and perfection of training modes.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
Abstract： Objective To improve therapeutic outcomes for severe leftsided atrioventricular valve regurgitation (LAVVR) after repair of atrioventricular septal defect (AVSD) through discussing pathological changes of the valve and surgical management for these patients, and summarizing the medical experiences of perioperative managements. Methods We retrospectively analyzed the clinical data of 29 patients including 16 males and 13 females with LAVVR after repair of AVSD treated in Xinhua Hospital, Medical College of Shanghai Jiaotong University between January 1995 and December 2009. The age of these patients ranged from 4 to 62 years, averaging at 26.5. According the classification of New York Heart Association (NYHA), there were 10 patients of class Ⅱ, 17 of class Ⅲ and 2 of class Ⅳ before reoperation. Partial repair of AVSD had been carried out for 18 patients, and complete repair had been performed on 11 patients. At reoperation, valve rerepair was performed on 17 patients and mechanical valve replacement (MVR) was necessary in 12 patients. Results In the early period after operation, one patient died of multiple organ failure, one patient had a permanent pacemaker inserted because of complete atrioventricular block, and 1 patient aged 4 years got recovery after 56 hours of circulatory support for severe cardiac failure after reoperation. A mean follow-up of 8.2 years (6 months to 14 years) was done for 25 patients with 3 missing. During the follow-up for 14 patients undergone heart valve repair, there was no obvious acceleration of the forward blood flow of the leftside atrioventricular valve. Ten patients had mild or less LAVVR, 1 had moderate LAVVR and 3 underwent successful left atrioventricular valve replacement at 10 days, 3 years or 6 years after reoperation because of severe LAVVR. Clinical status, as assessed by the NYHA classification, improved after surgery for LAVVR in 25 patients who were followed up with 17 in NYHA class Ⅰ, 6 in class Ⅱ, and 2 in class Ⅲ. Podoid decreased significantly and cardiothoracic ratio was 0.53-0.67 (0.60±0.11) in chest Xray picture. There was no late death. Conclusion With timely surgical treatment, and appropriate surgical method, LAVVR after complete or partial AVSD repair can be managed with excellent shortterm and longterm outcomes.
Objective To provide references and recommendations about emergency physician training for our country by analyzing the characteristics of emergency physicians training objective, subject, process, content, appraisal and assessment in the United States, the United Kingdom, Canada and Australia. Methods Such databases as Ovid, Proquest, MDConsoult and relevant websites of national emergency medicine were searched to include literature covering guidelines and documents on emergency education and training in the United States, the United Kingdom, Canada and Australia. According to the evidence-based scientific principles and methods, we graded and analyzed the included information. Results A total of 40 articles were included, covering 12 guidelines and documents, 2 reviews and 26 research documents. Each of the four countries owned a sound emergency specialist training access system especially on how they used competency as the core to design the training content, courses and appraisal and assessment system to improve overall ability and quality of emergency physicians. Conclusion Our country’s emergency physician training certainly has lagged behind those of the developed countries. We should learn from positive experience of the developed countries to standardize emergency physician training, improve the emergency physician training content and curriculum, strengthen access management and the construction of appraisal system, and cultivate the competency of emergency physicians.
Objective To explore the short term and long term effectiveness of the problem-based learning (PBL) in clinical skill training. Methods A total of 162 clinical medicine undergraduates in Grade 2003 (7-years study) and 2004 (5-year study) who were supposed to intern in the internal medicine departments were randomly divided into the PBL group (n=75) and the control group with traditional training (n=87) for having their clinical skills training. Then t test was applied to compare the two groups about the scores of intern rotation examination and graduate OSCE as well. Results About the baseline: the students in the two groups got similar scores in their internal medicine exam before clinical intern rotation (84.04±7.40 vs. 82.63±8.77, P=0.287). About the short term effectiveness: compared to the control group, the students in the PBL group got higher subjective evaluation from their supervised clinicians (P=0.006). In writing examination, the students of those two group got similar scores in knowledge part (54.17±9.26 vs. 51.67±9.56, P=0.92), while the PBL group won in case reasoning question (20.39±5.27 vs. 16.51±4.90, Plt;0.001). About the long term effectiveness: in the graduate OSCE, the two groups got similar scores in skills operation such as punctures and lab results analyses (P=0.567 and P=0.741), while the students in the PBL group had better performance at the case reasoning and standard patients treating (75.59±9.85 vs. 71.11±12.01, P=0.027). Conclusion With the great short term and long term effectiveness, the PBL applied in the clinical skill training improves the students’ ability of both synthesized analyses and the integrated clinical skills such as clinical thinking and interpersonal communication, but doesn’t aim at the basic knowledge and operation skills.
Objective To explore the current problems of training on ethics reviews in clinical trials in China. Methods We designed a quantitative survey to collect participants’ feedbacks on the training workshop on ethics reviews, which included contents, arrangement and structure, relevant to the workshop and their difficulties on ethics review work. Results A total of 60 questionnaires were sent and the response rate was 56.7% (34/60). A total of 120 participants from 18 provinces of China. Most of them were members of the virtual research center of evidence-base medicine of the Ministry of education. A total of 78.1% (25/32) participants thought they achieved their purpose after training, and 12.5% (4/32) did not meet their needs due to the poor language. The feedbacks of contents and quality of the workshop on ethics were shown in Table 1. The top useful contents (cents in 8-10) were: clinical trial registration, policies of WHO and China (93.8%, 30/32), data management and quality control in clinical trials, the roles of clinical trial registries and ethics committees (93.3%, 28/30), transparency in clinical trials (93.3%, 28/30), informed consent and beyond (91.8%, 31/34), and how to approach ethical review case studies (90.9%, 30/33), etc. Nobody considered workshop of less help.The majority (85.1%, 23/27) thought difficulties on ethic reviews existed and the main difficulties include: short of operational administrative rules (82.6%, 19/23), poor training opportunity (52.1%, 12/23), less supports from administrative (30.4%, 7/23) and financial (21.7%, 5/23), etc. The relevance (8-10 cents) to ethics workshop was: methods of teaching 75.9% (22/29), PPT 75% (21/28) and materials 42.9% (12/28). Conclusions There is some limitations in the first workshop on ethic reviews due to the lower response rate. However, it still shows the importance of training on ethics reviews. Training strategies should focus on different participants’ needs and the relevance to methods of teaching, and materials, etc. Workshopadopted lectures, cases studies analysis, more discussions and necessary translation will be welcome.
Objective To explore the challenges of training workshops on Cochrane Systematic Review (CSR) in 2006–2008 and to identify strategies to meet better the needs of the participants. Methods We designed a quantitative survey for all participants and collected their feedback on the arrangements and challenges of the workshop, and on their needs. Results The overall response rate was 82.6% (138/167). The training on CSR evaluated more highly from 2006 to 2008. A total of 167 registered participants from 21 provinces in China took part, and 71.3% (119/167) of them were graduate students. Only 10.9 % (15/138) selected their topics before training. After training, most of the participants were satisfied with the arrangement of the workshop, and thought the most helpful contents were: meta-analysis and statistics 83.7% (113/135), trials selection, inclusion and extraction 79.4% (108/136), literature evaluation 78.1% (107/137), and results analysis and explanation 72.8% (99/136). Some participants desired more time for practical exercises and for advice on keeping track of the development of their reviews. Conclusion The training on CSR has been gradually improved in the past 3 years. Cochrane systematic reviews have become an important research topic for graduate students in this time in China. Most of the participants benefit from the CSR workshop. More time on exercises is needed and the trainees’ further development should be followed up.
Objective To evaluate the effect of maternal and child health care training at the primary levelin Chongqing, and to detect and solve the existing problems so as to provide evidence for the further training andmonitoring. Methods The rural maternal and children health staff of Rongchang County, Chongqing were trained. A test and, in-depth interviews and field observation wereused to evaluate the training process and results. Results Seventynine members of the Clinical Skill Group (CS) and 73 members of Health Education Group (HE) have taken the test. The median score of CS before training was 11 while it was 23 after training (Plt;0.01); the median score of HE was 18 before training while it was 25 after training (Plt;0.01). The scores change of thetest before and after training showed that the training had a good result. Conclusion Primary level health staff members had poor knowledge of maternal and children health care. This training enhanced their knowledge of maternal and child health care improved their skill. Organizers should ensure that the training contents are rich,novel, and varied. Maternal and child health staff should be willing to join the training.
ObjectiveTo investigate the effects of problem-intervention-outcome (P-I-O) teaching method on the normalization training of new nurses. MethodsA total of 101 new nurses from 2011 to 2013 were included in this research. Forty-two new nurses who were invited from August 2011 to July 2012 were distributed into group A, and 59 new nurses who were invited from August 2012 to July 2013 were distributed into group B. Both groups accepted normalization training. Group B accepted P-I-O teaching at the same time. We assessed the differences in operating, theory, attendance, the rates of harmful events and the degree of satisfaction between the two groups. ResultsTheory and operating between the two groups had significant differences (t=3.44, 2.86; P<0.05). Attendance, rates of harmful events and the degree of satisfaction all had significant differences between the two groups (t=2.94, χ2=8.45, Z=-2.05; P<0.05). ConclusionThe application of P-I-O teaching method in the normalization training of new nurses can stimulate their study interest and enthusiasm, transit their role faster, as well as reduce the rates of clinical harmful events and elevate the quality of care. Thus, it is worthy of being popularized in clinical nursing care.
ObjectiveTo explore the implementation of standardized training of general practitioners system in China. MethodsA total of 25 bases of training general practitioners and its collaborative community service centers, which were located in the east and western region of China, met the inclusion criteria; qualitative interviews and questionnaires were done between November 2012 and November 2013, including 456 teachers, 281 students, and 166 teaching management staff. Survey content involved implementation of standardized training system, teaching method and so on. ResultsSatisfaction rate of training general practitioners training system with teachers, students, and administrators was 76.2%, 71.3%, and 86.3%, respectively (χ2=92.372, P<0.001). The average satisfaction rate of training model, teaching programme, teaching materials, teaching arrangements, the examination system, the quality of training, and supporting policies was 95.7%, 92.1%, 73.8%, 65.7%, 72.5%, 86.8%, and 48.9%, respectively (χ2=813.196, P<0.001). Satisfaction rate of teaching method with teachers, students, and administrators was 81.1%, 74.4%, and 67.7%, respectively (χ2=40.159, P<0.001). ConclusionSatisfaction rates of training general practitioners training system and teaching method with teachers, students, and administrators are low. The main impact factors are:the syllabus and textbooks are not practical, qualified teachers are short, teaching arrangements is unreasonable, teaching content is specialization, government support is inadequate and so on.