Basic Clinical Training Research Articles

Study on the effect of training base on promoting postgraduates in professional degree of clinical medicine

Clinical training base is playing an important role in the quality guarantee of postgradu-ates in clinical medicine. The clinical allocation, teaching resources and teaching staff are important fac-tors affecting the quality of teaching. Clinical training bases should define the teaching objectives and guar-antee the teaching orientation, organization and incentive system. Meanwhile, the clinical training bases should do well in teaching evaluation and continuous improvement, so that to promote the implementation of teaching objectives and ensure the quality of teaching. Finally, a training mechanism centering on the growth and development of postgraduates majoring in clinical medicine will be constructed, improving the training effect and cultivating excellent clinicians. Key words: Clinical medicine; Professional degree; Training base

Survey on education and evaluation methods of low-frequency electroacupuncture in basic clinical training

Survey on education and evaluation methods of low-frequency electroacupuncture in basic clinical training

日本補綴歯科学会第124回学術大会（大宮）基礎実習改善のための情報交換に関する報告

補綴臨床基礎実習は，診療参加型臨床実習の充実を図る上で重要である．各大学における補綴臨床基礎実習の担当教員を対象として，同実習の現状と問題点についての意見交換（ワークショップ）がすでに企画，報告されてきた．しかし，各大学における同実習の具体的な内容について，各大学の指導教員自身による確認と情報交換を希望する意見が少なくなかった．

Highlights for ESMO 40: celebration review for lifetime achievement awards

My work, my crucial achievement, has been in the management of the transition of the conduct of cancer research/management from basic researchers/surgeons to medical oncologists (figure 1). Figure 1 The Flower of Hope—the ESMO Lifetime Achievement Award. This transition can be divided into four categories: 1. The development, progression and consolidation of global Medical Oncology in Asian countries, especially in Japan. 2. Building a close collaboration with European Society of Medical Oncology (ESMO) and receiving strong support from ESMO, through (A) Adaptation of the ESMO/ASCO Core Curriculum in Medical Oncology,1 (B) Mutual ESMO/ Japanese Society of Medical Oncology (JSMO) joint symposia during their respective meetings, (C) making Annals of Oncology JSMO's official scientific publication,2 along with (D) my own work as an Associate Editor of Annals of Oncology (2011–2014), (E) my work as ESMO's National/Regional Representative and Membership Committee member (2005–2011). 3. Leadership of clinical research in Japan as a key opinion leader and primary investigator in IND (investigational new drug) trials and a chairman of the Japanese Clinical Oncology Group (JCOG; 2000–2009), organising a governmental clinical trial group; and the development of new gold standards in the treatment of malignant diseases, especially in thoracic malignancy by investigator-initiated randomised controlled clinical trials. 4. Encouraging translational research and the publication of numerous articles, especially in the area of the identification of molecular targets for anticancer drugs, as Chief of the Pharmacology Division in the National Cancer Center Research Institute. When I began my training in Medical Oncology, cancer research, including translational research, was conducted by basic researchers, and cancer treatment, including chemotherapy, was conducted by surgeons. There was no place for medical oncologists to play an active part in cancer research and treatment. ESMO was established 40 years ago and now has more than 10 000 professionals as members, and medical oncology has been recognised as …

Joint efforts of clinical medicine and community centers in standardized residency training in Shanghai

Introduction to the efforts made in Shanghai's clinical residency training.With joint efforts of both clinical training bases and community training bases, this approach integrates the instructional resources of medical schools, and hands-on training at community bases, in order to ease shortage of general practitioners, backup talents, and that of teachers.These efforts can effectively elevate competency of general practitioners. Key words: Shanghai; General practitioner; Standardized training; Joint base building; Joint efforts

Establishment of assessment criteria for general practitioner trainers in clinical training base

Objective To develop an assessment criteria for general practitioner (GP) trainers in clinical training base. Methods Based on the extensive literature review and expert interview, a preliminary index system was established with 4 first-grade indicators and 45 second-grade indicators for GP trainers in clinical training base. During 2012 to 2013, a two-round Delphi consultation was conducted to establish the assessment criteria. Results Thirty seven experts engaged in clinical practice, training and managers of GP training program from clinical training bases, medical schools, or health bureau in Shanghai were invited for Delphi consultation. Among them 64.8 (24/37)% were engaged in GPs training over 5 years, 78.4%(29/37) worked as GP trainers, 70.2%(26/37) with high-level professional title. In two round consultations, the activity coefficient of the experts were 97.3% and 100.0%, authority coefficient were 0.817 and 0.855, and harmonious coefficient of importance of the evaluation were 0.188 (P<0.01) and 0.278 (P<0.01), respectively. The opinions among the experts were consistent from the first round to the second round. The assessment criteria for GP trainers in clinical training bases was established with 4 first-grade indicators and 27 second-grade indicators. The 4 first-grade indicators were professionalism, clinical practice components, teaching quantity & components, basic conception of general practice, with weight coefficient of 0.253, 0.253, 0.251 and 0.243, respectively. Conclusion The established assessment criteria for GP trainers is credible and comprehensive, which can be applied in evaluating the comprehensive capacity of trainers in clinical training bases. Key words: Teacher training; Criteria; Delphi technique; General practitioners

Оптимізація навчального процесу на заочному циклі інтернатури

&lt;p class="50"&gt;Завданням очної інтернатури є максимальне інформаційне насичення навчання, підвищення якості теоретичної підготовки з її корекцією на всіх етапах, контроль ефективності практичного та професійного зростання, формування навичок клінічного мислення та диференційної діагностики. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="Default"&gt;Заочне навчання проходить на клінічних базах стажування. ЗПСМ є інтегрованою дисципліною і включає елементи 23 спеціальностей. Тому основним завданням заочного циклу є формування практичного кругозору, ознайомлення з усім широким спектром нозологій, необхідним для проведення диференційної діагностики. Основним документом, який регламентує професійну підготовку лікаря-інтерна, є індивідуальний навчальний план. Його заповнення на очному циклі та базах стажування проводиться інтернами самостійно під контролем керівників інтернатури та відповідального викладача профільної кафедри. У звітних формах, які завіряються підписом керівника інтернатури та керівника закладу охорони здоров’я регіону, зазначається кількість проконсультованих та пролікованих пацієнтів, проведених маніпуляцій згідно з переліком практичних навиків, передбачених навчальним планом. На заочному циклі навчання інтерни зобов’язані опрацювати перелік обов’язкової та додаткової для вивчення літератури, написати низку рефератів. Такий підхід передбачає індивідуалізацію постійного професійного зростання теоретичної та практичної підготовки молодого фахівця, його відповідність сучасним запитам практичної охорони здоров’я.&lt;/p&gt;

Optimization of complex training for medical interns to sit an integraded exam “Krok -3” through introducing the elements of distance learning

The analysis of the structure and methodology of Ukrainian Step 3 exam for applicants of medical license has been carried out. Given the revealed features was developed an effective method of complex training for the exam, which includes various forms both classroom and extracurricular training. The proposed methodology of the training uses the questions of recent exams. Proposed the pilot testing is carried out under conditions similar to the real exam for the purposes of the psychological adaptation of interns. Developed software for local and remote training and further analysis of the results to identify poorly performing interns and disciplines that are in the need to improve the methodologies. Implemented mandatory remote training for interns was conducted as an internship in clinical training base in a period just before the test. The results show the high efficiency of the recommended integrated training and close correlation between the intensity of use of the proposed scheme and examination results in points.

Clinicians' Perspectives on Negative Effects of Psychological Treatments

Negative effects of psychological treatments is a fairly unexplored area of clinical research. Previous investigations have indicated that a portion of all patients experience negative effects in terms of deterioration and various adverse events. Meanwhile, evidence suggests that many clinicians are untrained in identifying negative effects and unaware of the current research findings. The objective of the current study is thus to investigate clinicians' own perspectives and experiences of possible negative effects of psychological treatments. An invitation to participate in an anonymous online survey consisting of 14 open-ended questions was distributed via three mailing lists used by clinicians that primarily identify themselves as cognitive behavior therapists. The responses were analyzed using a qualitative method based on thematic analysis. In total, 74 participants completed the survey. A majority agreed that negative effects of psychological treatments exist and pose a problem, and many reported having experienced both deterioration and adverse events among patients in their own practice. The thematic analysis resulted in three core themes: characteristics of negative effects, causal factors, as well as methods and criteria for evaluating negative effects. The clinicians recognize that negative effects exist, but many are unaware of the current research findings and are unfamiliar with methods and criteria for identifying and preventing deterioration and adverse events. The results provide evidence for further dissemination of the present knowledge regarding negative effects, particularly during basic clinical training, as well as the need for raising awareness of the available methods for identifying and preventing negative effects.

Application of model based on clinical training base in transfusion room in training of rotary new nurses

Objective To investigate the application of mode based on clinical training base of infusion room in training of rotary new nurses, so as to find more effective, standardized, and practical training methods for the future. Methods Established a training assessment team, developed theory, hands-on training andsimulation scenario training program, conducted training in stages, implemented the assessment of related theory, operational skills and overall quality, and satisfaction on rotary new nurse was evaluated by nurses and patients monthly. Results All of the new nurses in the infusion room can timely completed the training program, and the difference was statistically significant in the assessment of theory [ （91.4 ± 6.3） vs （85.5 ± 5.7） ], operation[ （93.1 ± 5.4） vs （87.6 ± 6.7） ], first aid [ （90.7 ± 5.6） vs （ 84.7 ± 5.2） ], and the overall quality of evaluation [ （94.8 ± 4.2） vs （90.1 ± 3.9） ] between those new nurses and rotary new nurse in 2011 （ t = 5.00, 4. 60, 4. 14, 5.91 ; P 〈 0. 01 ）. After the training, nurses and patients＇ satisfaction rate respectively was 98.1% and 99. 1%, while that in 2011 respectively was 85.5% and 86.9%, and the differences were statistically significant （ t = 4. 379,8. 791 ; P 〈 0. 05 ）. Conclusions Rotary new nurses can comprehensively improve their overall quality through the clinical training base mode of infusion room, and that can establish a good nursing personnel reserve for the clinical specialist nursing posts. Key words: Transfusion room; Rotary new nurse; Clinical training base model

Prof. Dr. med. Otto Götze 1935–2013

Prof. Dr. med. Otto Götze 1935–2013

Continuing education and clinical research for the training of obstetricians and gynecologists in Europe

The need for doctors to develop in their profession and in science applies to all ages and at all hierarchical levels. This development can be sustained both via education and research. In this brief paper, we examine certain crucial aspects of education and research in obstetrics and gynecology (OB/GYN) as they are actually observed in Europe. The need for uniform development of continuing professional development (CPD) among all European countries is progressively becoming apparent. There is no single approach to CPD. Junior doctors should benefit from the teaching of senior obstetricians and gynecologists, especially those in a hierarchical system of training that must assure their progress. Hospital visiting organized by EBCOG enables OB/GYN departments of teaching hospitals to unify their teaching and learning approaches. Furthermore, improving the ability of trainees and specialists to conduct clinical research is vital, as this will transform the breakthroughs of basic science into clinical practice. A formal training period in research should be available to most competent trainees in OB/GYN in addition to their basic clinical training.

Perspectives on Curriculum Needs in Laboratory-Animal Medicine

Both the United States and Canada have projected shortages of qualified laboratory-animal veterinarians within the next 10 years. This gap is occurring because of retirement, increased regulatory requirements for research animal oversight, and insufficient numbers of veterinarians entering this field. One of the primary means of increasing student interest in nontraditional practice areas, such as laboratory animal medicine, is to ensure that they have appropriate exposure to the topic during their basic clinical training. We outline a recommended curriculum for laboratory animal medicine for North American veterinary medical colleges, which provides strategies for integrating comparative medicine material into the curriculum, incorporates flexibility for a range of delivery methods, and suggests potential resources that may be used to develop this material.

Basic clinical training in ophthalmology: the trainee's perspective

Basic clinical training in ophthalmology: the trainee's perspective

Basic clinical training in ophthalmology: correct misfires quickly!

Basic clinical training in ophthalmology: correct misfires quickly!

A comparison of medical students’ perceptions of their initial basic clinical training placements in ‘new’ and established teaching hospitals

This study has examined students’ perceptions of the factors influencing learning during initial hospital placements and whether differences in perceived experiences were evident between students attending new and established teaching hospitals. Five focus groups were conducted with Year III students at the University of Birmingham Medical School (UBMS): three with students attending three established teaching hospitals and two with students attached to a new teaching hospital (designated as part of the UBMS expansion programme). Extensive variation in student perception of hospital experiences was evident at the level of teaching hospital, teaching firm and individual teacher. Emergent themes were split into two main categories: ‘students’ perceptions of teaching and the teaching environment’ and ‘the new hospital learner’. Themes emerging that related to variation in student experience included the amount of structured teaching, enthusiasm of teachers, grade of teachers, specialty of designated firms and the number of students. The new teaching hospital was generally looked upon favourably by students in comparison to established teaching hospitals. Many of the factors influencing student experience relate to themes grouped under the ‘new hospital learner’, describing the period of adjustment experienced by students during their first encounter with this new learning environment. Interventions to improve student experience might be aimed at organisations and individuals delivering teaching. However, factors contributing to the student experience, such as the competing demand to teaching of heavy clinical workloads, are outside the scope of medical school intervention. In the absence of fundamental change, mechanisms to equip students with ‘survival skills’ as self-directed hospital learners should also be considered.

Use of interaction cards to evaluate clinical performance

Currently in-training evaluation in Kuwait depends on the use of the global rating scale at the end of clinical rotation clerkships. Such a scale is inconsistent, subjective, and suffers from deficiencies such as positive skewness of the distribution of ratings and poor reliability. The aim of the study was to assess the inter-rater variation and the reliability of the recently introduced Interaction Card (IC) method for evaluating clinical performance and to measure the agreement between trainees’ overall performance evaluation by the currently used global rating scale and the IC summative evaluation. In the study, 370 evaluators encountered 50 trainees during their basic clinical training rotations (internal medicine, surgery, obstetrics and gynecology, and pediatrics) at six hospitals. A total of 9146 encounters were conducted focusing on six clinical performance domains: clinical skills (taking history, case sheet, and physical examination), professional behaviour, case presentation, diagnosis, therapy and handling of emergencies. The method demonstrated significant inter-rater variation in the overall IC ratings according to specialty, rank of evaluator and hospital (p < 0.001). The Interaction Card was found to be reliable, as shown by the internal consistency between the six domains (Cronbach's alpha = 0.914). There was low correlation (Spearman rank correlation coefficient, rs = 0.337), and low agreement (Kappa = 0.131) between the global rating scale and Interaction Cards summative evaluations. The IC method provided instantaneous formative feedback and summative evaluation for clinical performance to trainees. The method can be generalized to encompass training and examinations programmes for all categories of trainees in most clinical specialties.

Central Asian republics: A case study for medical education reform

Social, political, and economic changes in the former Soviet Union precipitated both the collapse of a once-centralized medical education system in the region and the development of individual models in its place. In the context of rapid globalization and international concerns about health, this development of "nation-based" models for the structure, content, language, and duration of instruction generated concerns about regional accreditation; workforce planning; student qualifications; residency training; continuing education; and infrastructure, such as access to literature, an adequate clinical training base, and links to certification and licensure. The World Health Organization acknowledges that the development of human resources for health is a complex and key element in reforming health systems. In Central Asia, international donor agencies facilitated the development of a regional council of rectors and a partnership consortium of medical academies as reform vehicles. International medical education organizations provide counsel and share their organizations' models, greatly facilitating the reform progress. The groups work to address both the political and regulatory environment and the professional and academic environment that affect the quality of medical schools. The council of rectors is establishing credibility as a regional nongovernmental organization that can advise governments about workforce planning, budgeting, admissions policies, accreditation, and licensure. The group sponsors faculty development workshops, bringing together regional educators around educational and institutional issues of mutual concern. Partnership academies collaborate to develop institutional and individual professional capacity, focusing on standardized evaluation, structure and content of the curriculum, pedagogy, and leadership development.

Technological Aspect of Basic Clinical Training in Primary Care Medicine

Technological Aspect of Basic Clinical Training in Primary Care Medicine

Relieving medical officers in Queensland country hospitals.

Evaluation of training and preparedness of Queensland country hospital relieving staff to perform their duties. A postal survey of 208 medical graduates who graduated in 1983 and were first enrolled on the Queensland Medical Register in 1985. Among the problems described was a lack of practical training in obstetrics, anaesthetics, paediatrics and emergency services. Most respondents (83%) stated that their total experience had been inadequate to provide the services required of them as relievers. Unsupervised services were provided by inexperienced junior doctors. Seventy-two per cent of all obstetric relievers, and 57% of all anaesthetic relievers, had completed three months or less of supervised postgraduate training at the time of the survey. This was reflected in poor levels of confidence to perform basic procedures, despite the fact that a high percentage of respondents had been called upon to do this. Both undergraduate and postgraduate training was felt to be inadequate. Suggestions made by respondents focused primarily on the provision of supervised "hands-on" clinical experience, with longer and more practically oriented training at both levels, decentralisation of teaching, and more readily available formal non-specialist qualifications in obstetrics and anaesthetics. Most respondents claimed that they were inadequately prepared for the relieving experience. The provision of supervised hands-on basic clinical training and that of competent country relievers might both be achieved by longer rotations to provincial centres on a regular basis in the early postgraduate years.