医学生临床实习应掌握的几种哲学思维方式

为适应全球卫生事业的迅猛发展,面对医学教育落后于医学发展的现状,转化医学教育迫在眉睫。在第三代“以系统为基础”的教育改革中,培养医学生的哲学思维无疑是其重要环节之一。思维方式必须在医学生步入临床时就要开始正确培养,一旦开始阶段就养成不正确的思维方式、不但会导致医疗过程中的失误,而且再想改变将会有很大难度。本文通过对医学哲学重要性的探讨,剖析医学生哲学思维的不足,阐述了医学生,临床实习过程中应掌握的几种哲学思维方式。旨在提高医学生的哲学理念,促进以岗位胜任能力为导向的医学教育转型发展。     

构建高质量的外科医学教育体系

医学教育是贯穿医疗职业生涯全过程的行为,是伴随医学进步和发展的重要工程.医学教育的质量直接影响医疗的质量和医学人才的素质,尤其是外科学领域,是以有创性的手段、方法治疗疾病.医生的职业素养、医疗水平均取决于医学教育的结果.医疗质量不能简单地用医生的学历衡量,学历教育是载体,其中应充实培养能力的教育项目、内容,以适应未来就职、就业的社会需求.医疗质量、医疗水平对医院而言是生命线,是生产力.同时,医生的教育及教育的质量是医疗质量的基础与保障.随着医学的飞速发展,医疗技术的日新月异,医学模式的改变,构建新的医疗环境下的医学教育体系,显得更为重要.     

终末期肾病单病种付费方式患者满意度调查分析

本研究通过调查分析终末期肾病患者对当前单病种付费方式的满意度及影响因素,为医疗保险支付方式改革提供政策依据.研究采用典型抽样方法,对某市四家三级甲等医院257名透析治疗参保患者进行现场自填式问卷调查,调查结果显示,调查人员对终末期肾病单病种付费方式总体满意度为97.3％,对特约医疗机构的满意度高于对医疗保险政策的满意度.患者满意度的主要影响因素有治疗方式、文化程度和家庭收入.医疗保险部门应关注单病种付费政策的结算范围,增加医疗困难救助,加强对医护人员医疗保险政策的宣传,提高患者满意度.     

家庭成员间活体器官及组织捐赠的伦理问题

家庭成员间活体器官及组织捐赠是被绝大多数国家所允许的.虽然利益化减少了很多,但是目前发现其也存在许多的伦理问题.就家庭成员间活体器官及组织捐赠的伦理基础,以及就捐赠风险、种族差异、失衡之爱、操纵、拒绝、退出、潜在利益、特殊疾病等涉及的相关伦理问题进行综述,并就存在的相关问题的解决方法进行探讨.     

27种法学期刊2002年～2011年医事法论文统计分析

以北京大学第五版27种法学核心期刊2002年～2011年刊发的医事法论文为研究对象,分别统计分析其数量、作者、研究内容、基金项目、被引用等信息,据此指出我国近10年医事法研究中存在基础薄弱、缺乏深度、人才不足、资助不力等问题,并提出加快人才培养、搭建研究平台、开展实证研究、加大资助力度、促进医患沟通等建议.     

关于重大医疗纠纷行政干预认识的调查分析

为了解医患双方对重大医疗纠纷的基本认识,对上海市徐汇区35家医疗机构医患双方进行问卷调查.就医患双方对重大医疗纠纷的产生原因、救济途径、行政干预作用等方面的认知情况展开分析,从而得出为了有效解决重大医疗纠纷,需发挥行政干预作用、健全纠纷解决机制以及正确引导舆论导向的结论.     

医学教育发展的困局与突破

受“大跃进”思维模式影响,我国高等教育由精英化快速过渡到大众化,医学教育呈现出急剧膨胀的发展态势,在教育理念、培养体系、办学模式、学制结构、专业设置、教育质量等方面出现了许多新情况、新问题,陷入了发展困局.面对困局必须更新教育观念,加强统筹协调,推动医学教育科学发展.     

Shaping Medical Students' Attitudes Toward Ethically Important Aspects of Clinical Research: Results of a Randomized,Controlled Educational Intervention

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics.     

Review of "The Cultural Context of Sexual Pleasure and Problems: Psychotherapy With Diverse Clients," edited by Kathryn S. K. Hall and Cynthia A. Graham

A content and thematic analysis was conducted using forum messages from websites developed for wives of online gamers who play World of Warcraft. Blog posts from 50 women describing conflict in their marital relationship involving their husband's online game play were analyzed. Four overarching themes were identified and discussed in terms of the impact of online gaming on family functioning and relationships, emotional outcomes, and coping mechanisms. Results of ensuing issues arising from excessive gaming as perceived by the non-gaming spouse and ways in which they cope with these issues are shared.     

APP conference summary

This is an account of the extended assessment of a 22-year-old man who was initially sent for a court report, having been accused of setting fires. He had a history both of delinquency and, importantly, of childhood asthma. Although he proved unable to engage in psychotherapy, some management was provided, such as Winnicott advocates in cases of delinquency. This paper explores the symbolic meanings and functions of the patient's delinquent acts, drawing upon theoretical concepts from Freud, Aichhorn, and Deutsch. Of particular importance is the link between this patient's delinquency, his asthma, and the unresolved mourning for his dead mother which he carried not simply for himself but for his whole family.