Clinical Practice Ability Research Articles

The practice and exploration of the reform of cultivating master degree students of clinical medicine promoted by the synergy of medical education

Our university actively carried out the reform and innovation of the training mode of clinical medicine postgraduates. We implemented the standardized training of resident physicians throughout postgraduate training process, and carried out the comprehensive reform of the training mode of cultivating master degree students of clinical medicine and the standard training of resident doctors. Meanwhile, we trained the master degree students with the synergy of medical education and strengthened the cultivation of students' clinical practice ability, to cultivate qualified doctors for the country, and to improve the quality of postgraduate training. Key words: Clinical master degree; Standardization training of resident; The synergy of medical education

Effect analysis of rotated training for low seniority nurses in Psychiatric Department

Objective To Explore low seniority psychiatric nurses′ system, standard, professional training effect, improve the overall level of psychiatric nursing team. Methods A total of 68 healthy nurses, who recruited from October 2011 to June 2013, were selected and randomly divided into experimental group (n=34) and control group (n=34). Experimental group members had rotated training who went to different departments (each departments for 3 months and 1 year totally) including male ward, female ward, open ward and MECT room with specific teaching and counseling. The control group nurses given routine training. We compared the result of training by specialized theory knowledge assessment of psychiatric, technical operation evaluation, emergency ability and comprehensive quality assessment, nursing staff discussion, job satisfaction surveys and daily work of observation and measurement before and behind training. Results After Low seniority nurses rotated training, nurses in the experimental group compared with before training, specialized subject theoretical level, operation skill, emergency ability and comprehensive quality significant difference (t=-11.677, -3.049, -10.717, -12.581; P<0.01). The experimental group compared with control group, specialized subject theoretical level, comprehensive quality difference was statistically significant (t=3.916, 4.511; P<0.01), while operating skills, emergency ability (t=3.916, 4.511, P<0.01). After implementing of rotated training, nurses′ satisfaction was 94.12%, beyond 61.76% before the implementation, and the difference was statistically significant (χ2=10.350, P<0.01). Conclusions Implementation of rotated training can effectively improve psychiatric low qualification nurses specialized theoretical level and the comprehensive quality of the psychiatric clinical practical ability, communication and cooperation ability and the improvement of humanistic quality, etc. Key words: Nurses; Low seniority; Psychiatric Department; Rotated training

The application of medical cooperation mode in emergency team training advanced cardiovascular life support (ACLS)

Objective To improve the clinical practice ability and the comprehensive ability to assist in the rescue of the medical staff by the medical cooperation mode. Methods 30 nurses and 12 doctors in department of emergency were divided into 6 combinations and 4 combinations, each group consisted of 1-2 doctors and several nurses, who following the 2010 USA Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care and America Heart Association advanced cardiovascular life support curriculum (AHA ACLS) training method. Theory teaching and Sub skill practice and Comprehensive simulation training and Summarize and analyze the feedback pattern, training, exercises and assessment to rescue patients with sudden cardiac respiratory arrest of simulations were carried out with the team combat form in scenario. Results Implementation of health cooperation cardiopulmonary resuscitation team training exercise improved the rescue team support ability. 97.6% (41/42) trainees were considered to improve the order of the rescue while 100.0% (42/42) trainees were considered that this training model was worthy to popularize. Conclusions The medical cooperation cardiopulmonary resuscitation team training exercise improves the timeliness and comprehensive help rescue ability. Key words: Cardiopulmonary resuscitation; Team training; Medical cooperation

Dimensional psychopharmacology in somatising patients.

Despite the recent DSM-5 review of somatoform disorders, which are now called somatic symptom and related disorders, the categorical definitions of these syndromes have inherent limitations because their causal mechanism or presumed aetiologies are still unknown. These limitations may affect everyday clinical practice and decision-making abilities. As a result, physicians have limited information at their disposal to treat these patients. Furthermore, the clinical presentations of somatic disorders may vary a lot. The purpose of this chapter is to illustrate a psychopathological dimensional approach to the somatising patient. This approach is constantly unconsciously applied in clinical practice using continuous variables, such as rating scales. Moreover, treatment strategies might be improved by adding a dimensional approach, simply recognising the prominent components of the presenting psychopathology of a given patient and addressing them with drugs according to their different mechanisms, targeting circuits and neurotransmitters. Some authors have proposed a shift from the nosological to functional application of psychotropic drugs, in which functional psychopharmacology will be dysfunction oriented and therefore inevitably geared towards utilising drug combinations. Here, we present a summary of the advantages of functional/dimensional psychopharmacology for the treatment of somatic symptoms and related disorders.

Mobile app reading speed test

AimTo validate the accuracy and repeatability of a mobile app reading speed test compared with the traditional paper version.MethodTwenty-one subjects wearing their full refractive correction glasses read 14 sentences of...

간호대학생의 임상실습 만족도와 임상수행능력과의 관계

본 연구는 간호대학생의 임상실습 후 임상실습 만족도와 임상수행능력을 파악하기 위한 서술적 조사 연구이다. 연구대상자는 A대 간호학과 학생으로 임상실습을 경험한 3, 4학년 학생 전수인 118명 이었다. 수집된 자료는 SPSS/PC+ ver. 21을 이용하여 빈도, 평균, 표준편차, t-test, ANOVA, Scheffe test, Pearson's Correlation Coefficients로 분석하였다. 연구결과로, 대상자의 임상실습 만족도는 5점 만점에 3.36점, 임상수행능력은 5점 만점에 3.42점으로 나타났다. 임상실습 만족도의 하위영역은 교과만족이 가장 높고, 임상수행능력의 하위영역은 교육/협력관계가 가장 높게 나타났다. 대상자 특성에 따른 임상실습 만족도는 건강상태(F=3.896, p=.023), 대학생활 만족도(F=8.164, p<.001), 간호학 전공만족도(F=4.652, p=.011), 임상실습 여건만족도(F=11.889, p<.001), 임상실습량에 대한 만족도(F=13.504, p<.001)에서 유의한 차이가 있었다. 대상자의 특성에 따른 임상수행능력은 종교(t=6.682 p=.011), 대학생활 만족도(F=3.440, p=.035)에서 유의한 차이가 있었다. 간호 대학생의 임상실습 만족도와 임상수행능력(r=.297, p=.001) 간에는 양의 상관관계를 나타냈다. The purpose of this descriptive study was to investigate satisfaction with clinical practice and clinical performance ability for 118 of third and fourth year nursing students. The collected data were analyzed by using the SPSS/PC+ver. 21 program which determined frequency, percentage, mean, standard deviation, t-test, one-way ANOVA, Scheffe test, and Pearson's correlation coefficients. The results of this study were as follows : The satisfaction with clinical practice was 3.36 point out of 5 and the clinical performance ability was 3.42 point out of 5. In satisfaction with clinical practice, satisfaction of the curriculum was the highest and in clinical ability performance, education partnerships was the highest. Clinical practice satisfaction according to the general characteristic of the subjects was significant difference in health status(F=3.896, p=.023), satisfaction with college life(F=8.164, p<.001), nursing department(F=4.652, p=.011), conditions in clinical practice(F=11.889, p<.001), and practice workload(F=13.504, p<.001). Clinical performance ability according to the general characteristic of the subjects was significant difference in religion(t=6.682 p=.011) and satisfaction with college life(F=3.440, p=.035). The relationship between clinical practice satisfaction and clinical performance ability was positive correlation(r=.297, p=.001).

Application and evaluation of clinical path in clinical teaching in the department of gynecology and obstetrics

Objective To evaluate the effects of applying clinical pathway （CP） in clinical teaching of gynecology and obstetrics. Methods Totally 200 clinical specialist interns selected for the study were randomly divided into two groups （each 100）, respectively, using CP teaching and tradi-tional teaching. After the internship, professional assessment （clinical skills assessment, theory test, the respondent）were conducted to two groups of students and their professional examination scores were compared, while questionnaires were conducted in the CP teaching group. All date were analyzed by SPSS 17.0 software. Chi-square test was used for enumeration date while t test was used for mea-surement data. Results CP teaching team of professional test results [（80.01 ± 9.34） vs. （72.37 ± 10.79）], the passing rate（96%vs. 87%） were superior to the traditional teaching group（P=0.000 and 0.022）. The questionnaire showed that： applying CP in clinical teaching of obstetrics and gynecology can improve interns’ learning enthusiasm and initiative, improve their comprehensive analysis ability, clinical thinking ability, practical ability and many other capabilities and it got about 90% of interns’ recognition. Conclusions The application of the CP in clinical teaching of obstetrics and gynecology can help enhance the teaching effectiveness, standardize the teaching process, and improve the qual-ity of teachers teaching gynecology and obstetrics. Key words: Clinical pathway; Gynecology and obstetrics; Clinical teaching

The correlation between personal knowledge management of nursing intern and clinical practice ability

Objective To explore the affecting factors of nursing interns' personal knowledge management (KM) ability and analyze the correlation between their KM ability and clinical ability.Methods A total of 345 nursing interns' KM ability and clinical ability were investigated by using two scales.Results Affecting factors of nursing interns' KM ability included being a cadre and being interested in nursing specialty or not.Factors affecting nursing interns' clinical ability were practice period,academic records,being a cadre,intention to have a nursing job,interest to be a nurse.It also showed significant positive correlation between their KM ability and clinical ability (r=0.761); KM ability could explain 59％ of variability of clinical ability(R2=0.599).Among the dimensions of KM ability,the highest positive correlation was knowledge management cognition (r=0.741).Conclusions To enhance nursing interns' clinical ability,we need cultivate nursing interns' interest to nursing specialty,ability to be a cadre and improve their knowledge management cognition ability. Key words: Nursing intern; Knowledge management; Ability of clinical

Cultivation of the general clinical ability of professional degree graduate students in stomatology

How to cultivate oral medical graduate students with solid general medical foundation is still under exploration. There are some systematic, comprehensive and relatively weak limita- tions for different departments＇ rotations in training general clinical skills for professional degree post- graduates in stomatology. With the establishment of a comprehensive teacher group of oral medicine, prosthodontics and oral ＆ maxillofacial surgery in department of general dentistry, students can be trained for general clinical thinking and skills, and the students＇ ability of general clinical practice has been strengthened via these programs. On the basis of postgraduate students＇ analysis of structures and learning interests and under the premise of upholding the uniform requirements, the individualized and hierarchical teaching has been conducted to the students, paying attention to stimulating their interest in learning. Besides, by way of a comprehensive assessment, students＇ academic performance has been objectively evaluated. ern Key words: Master of stomatological medicine; Professional degree; General clinical think- ing; Practical ability; Teaching patt

Survey and analysis of clinical practical ability for nursing graduates before and after internship

Objective To evaluate and analyze the clinical practical competence level of nursing graduates before and after internship and to screen its deficiency under current clinical practical ability training model and provide references for developing nursing graduates education of clinical practice ability and for improving clinical practical competence training pattern in clinical setting .Methods To implement the clinical practice guide tutor system to 160 graduate students in Shanxi Medical University from 2008 to 2011 , the students were asked to complete the clinical practical manual , which were designed to evaluate their clinical practical competence level using “OPSN” （ self-evaluation scale of oriented problem solving behavior in nursing practice） and “NPGA” （nursing practice goal attainment ）.Results In the dimension of “OPSN” scale, the scores of “to discover problems by organizing and applying information ” “to offer psychological support for patients problem solution” “to provide personalized care for patients” and “to evaluate for solved problems”were （20.28 ±2.78）, （17.23 ±1.92）, （26.81 ±2.59）, （20.76 ±2.59） after the internship, which were （17.82 ±3.47）, （14.53 ±3.03）, （24.82 ±3.44）, （18.31 ±4.40）, respectively, before the internship, and the differences were statistically significant （t=3.98, 5.40, 3.32, 3.43, respectively;P〈0.05）.The scores of “coordination of behavior between nurses and patients” were （16.76 ±2.72） and （17.51 ±1.96） before and after the internship, which had no significant difference （t=1.61, P〉0.05）.Each dimension of“NPGA” scale was not statistically significant before and after the internship （P〉0.05）.Conclusions There is still a gap between standard requirements and acquisition of practice ability under current clinical teaching environment .The project training for graduate students should be added according to the weak points in clinical practice ability training . Key words: Nursing; Graduate student; Clinical practice ability

Chicken and egg: peripheral nerve entrapment or myofascial trigger point?

We appreciate your interest in our work and the comments on our article Successful treatment of abdominal cutaneous entrapment syndrome (ACES) using ultrasound guided in the KJP. Pain physicians always face the challenge of discriminating myofascial pain syndrome (MPS) and nerve entrapment as the primary cause of pain. However, as you pointed out, controversies regarding the sequence of onset of MPS and nerve entrapment are still unresolved - Chicken and Egg. The diagnosis of ACES is based on the finding of a constant site of tenderness that is superficially located, with a small area of maximal tenderness that can be localized with a fingertip (trigger point). A small area with somatosensory alterations surrounding the trigger point is often found in ACES, possibly enabling discrimination between a myofascial and a radicular cause of pain [1]. According to previous reports, MPS and radiculopathy are less frequent causes of abdominal wall pain [2,3]. Owing to the special anatomical features of the abdominal wall itself, there is a greater likelihood of pain due to nerve entrapment than due to MPS. ACES is thought to be an ischemic neuropathy caused by entrapment of lateral or medial anterior cutaneous branch of intercostal nerves 7-12. The cutaneous nerve branches through the rectus abdominisis so variable and abrupt that ischemia can easily develop under circumstances such as increased abdominal pressure, which can cause entrapment of the nerves in the muscular foramen [4]. Furthermore, even though MPS is associated with the abdominal wall, it is very difficult to find the taut band that is essential to diagnose MPS. Locating it mainly depends on physician's ability and experience in clinical practice. However, even experts may find it difficult, if the taut band is small and exists deep within the abdominal muscle [5]. ACES diagnosis is confirmed by local subfascial anesthetic injection of an anesthetic agent. This injection has both diagnostic and therapeutic value in these patients. It has been hypothesized that the injected volume leading to release of an entrapped nerve [6]. This technique could be called rather than nerve block or trigger point injection (TPI). A previous finding on attenuation of pain levels in patients following saline injection may support this suggested mechanism [7]. Under ultrasound guidance, we injected 10 ml of a local anesthetic agent, and confirmed the hydro-dissection of suspected nerve entrapment area via the image. In general, we are in agreement with your comments regarding the Chicken and Egg question; however, for management of chronic abdominal pain, we suggest that pain physicians administer a new kind of concept of injection, so called under ultrasound guidance. We hope that the techniques used in our study aid pain physicians in gaining more knowledge of ACES: an intriguing syndrome that is very common, but largely unrecognized.

Preliminary exploration of OSCE-test on completion of a course to improve students＇ clinical competence

Objective To investigate the effective ways of improving medical students＇ clinical competence during the process of internship. Methods Totally 398 students of clinical medicine from 2006 and 2007 grade in Soochow University were enrolled as research objects. Forty objects distribut- ed to the First Affiliated Hospital were taken as experiment group while 358 objects distributed to other hospital as control group. In experiment group, objective structured clinical examination （OSCE） was introduced during regular internship, innovation was made on test on completion of a course and autonomous learning and clinical practice was advocated and enhanced. Traditional practice and ex- amination method was used in control group. SPSS 19.0 was used to do statistical analysis on the test scores of students. Paired sample t test and independent sample t test were employed. Measurement data is expressed as x ＋ s and P〈0.05 signifies statistically significant differences. Results Clinical practice ability of students in experiment group was enhanced to various degrees after internship com- pared with that before internship. ECG interpretation, heart and lung auscultation, interrogation tech- nique, medical and surgical operation performances of students in experiment group were promoted significantly （P〈0.05）. Students＇ overall competence in the final graduation skill test was better in ex- periment group than in control group （P〈0.05）. Conclusions OSCE-test on completion of a course not only make intern management more effective, but also make students＇ aim more definite, therefore it is conducive to enhancing clinical competence. Key words: Objective structured clinical examination; Practical competence; Clinical in- tern; Test on completion of a course

Effects of a collaborative clinical practicum on clinical practice ability and teaching effectiveness among nursing students

Background : This study investigates the effects of a collaborative clinical practicum for adult health nursing on clinical practice ability and teaching effectiveness among nursing students, using a non-equivalent control group pre-test-post-test design. Methods : Participants were 52 junior nursing students taking a two-credit clinical practicum course for adult health nursing at a nursing college in South Korea. Students in the two intervention groups participated in a collaborative clinical practicum, which included a 16- or 32-h preceptorship with the usual practicum, whereas those in the control group received the usual practicum by only the instructor. Results: The intervention group with a 32-h preceptorship had the highest score for clinical practice ability and teaching effectiveness. Conclusions: The results justify an increase in the number of preceptorship hours for junior undergraduate students in an adult nursing practicum.

Exploration on enhancing medical students' clinical practice ability

Clinical medicine is a practical discipline.Students combine theoretical knowledge with practical operation and develop clinical thinking at stage of clinical practice.From the perspective of education administration,a series of measures were carried out throughout the whole teaching in clinical internship in our university.Students were trained to gain the abilities of combing knowledge with practice,analyzing and solving issues individually and thinking logically and scientifically.Through years of research and practice,remarkable achievements were gained and both clinical skill and comprehensive quality of our students were greatly enhanced. Key words: Clinical internship; Practical ability; Quality of teaching

Application of European position paper on rhinosinusitis and nasal polyps in clinical teaching for Otorhinolaryngology postgraduates

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally. Key words: Otorhinolaryngology; Postgraduate education ; European position paper on rhinosinusitis and nasal polyps

Deferred Imitation and Social Communication in Speaking and Nonspeaking Children With Autism

Deferred imitation and early social communication skills were compared among speaking and nonspeaking children with autism and children developing typically. Overall, the children with autism showed a lower frequency on measures of deferred imitation and social communication compared with typically developing children. Deferred imitation was observed at a significantly lower level among the speaking and nonspeaking groups of children with autism. However, when comparing the speaking autism group with the typical group, many differences in observed social communication disappeared. These results underscore the importance of considering children’s verbal ability in autism research and clinical practice, and indicate that there are specific difficulties in deferred imitation in autism but that the social communication deficits that are observed are greatly influenced by low level of verbal ability.

Thinking and practice of training paths of clinical practice ability for medical students

Aiming at the existing problems in the teaching hospital,teachers and practical students during clinical practice teaching,we explored actively in talent training and teaching base construction and promoted the improvement of clinical practice ability for medical students. Key words: Ability of clinical practice; Mode of talent training; Construction of teaching base

Investigation and exploration on the reform of practical teaching system in stomatolgy

Reform of practical teaching was performed by school of stomatoly in Shandong university.Lab teaching,training and evaluation on head simulator were strengthened.The psychological and technical transformation from students to dentists was accelerated through technical training before clinical practice.Comprehensive clinical practice strengthened clinical skill training and improved comprehensive ability cultivation.Three sections of practical teaching including lab teaching,technical training before clinical practice and comprehensive clinical practice were organically combined and a complete practical teaching platform was constructed,which provides guarantees for the improvement of clinical practical ability of undergraduates in stomatology. Key words: Stomatology; Practical teaching; Lab teaching; Technical training before clinical practice; Comprehensive clinical practice

Using a Montessori method to increase eating ability for institutionalised residents with dementia: a crossover design

To investigate the efficacy of applying a Montessori intervention to improve the eating ability and nutritional status of residents with dementia in long-term care facilities. An early intervention for eating difficulties in patients with dementia can give them a better chance of maintaining independence and reduce the risk of malnutrition. An experimental crossover design was employed. Twenty-nine residents were chosen from two dementia special care units in metropolitan Taipei. To avoid contamination between participants in units using both Montessori and control interventions, two dementia special care units were randomly assigned into Montessori intervention (I1) and routine activities (I2) sequence groups. A two-period crossover design was used, with 15 residents assigned to Montessori intervention sequence I (I1, I2) and 14 residents assigned to Montessori intervention sequence II (I2, I1). On each intervention day, residents were given their assigned intervention. Montessori intervention was provided in 30-min sessions once every day, three days per week, for eight weeks. There was a two-week washout period between each intervention. There was a significant reduction in the Edinburgh Feeding Evaluation in Dementia score for the Montessori intervention period but not for the routine activities period, while the mean differences for the Eating Behavior Scale score, self-feeding frequency and self-feeding time were significantly higher than those of the routine activities period. Except for the Mini-Nutritional Assessment score post-test being significantly less than the pre-test for the routine activities period, no significant differences for any other variables were found for the routine activities period. This study confirms the efficacy of a Montessori intervention protocol on eating ability of residents with dementia. Adopting Montessori intervention protocols to maintain residents' self-feeding ability in clinical practice is recommended. Montessori-based activities could provide caregivers with an evidence-based nursing strategy to deal with eating difficulties of people with dementia.

Some Research on the Medical Materials

Curriculum, teaching methods, clinical practice ability, dissertations and assessment methods were investigated to discuss and analyze the present cultivating situation and its problems of clinical professional degree graduates in order to provide the basis for reform of cultivation modes. Methods: Clinical professional degree graduates, supervisors, training institutions and employing units were treated with sample surveys, interviews and literature research. All the data were dealt with statistical analysis. Results: The cultivation mode of clinical professional degree graduates has been constructed gradually. But there still existed some difficulties and problems in terms of course construction, cultivation methods and assessment system and so on, which were needed to be strengthened.