医学研究生医学人文教育存在的问题、原因及对策

与医学本科生的医学人文教育相比,医学研究生的医学人文教育普遍得不到应有的重视,不能形成有效的医学人文教育体系,研究生导师在医学人文教育中往往处于严重的缺位状态。造成这些问题的原因,主要在于缺少明确的教育培养目标,缺少有效的教育主导平台,缺少必要的教育培养合力。解决这些问题,需要针对医学研究生自身的特点,构建适应医学专业需求的教育联动体系,优化注重精神引领的医学人文环境,提升强化实践融入的人文教育成效。     

临床医学专业学位研究生与“四证合一”并轨培养的模式探讨

2015年国家全面启动医学专业学位研究生教育改革,医学专业学位硕士研究生培养与住院医师规范化培训同时进行,这种并轨培养制度提高医学人才培养的规范性,同时使得医疗卫生和教育资源得以充分合理利用,是社会需求和研究生教育发展的必然要求。本文立足大连医科大学并轨改革实践,通过调研分析阐述并轨后研究生培养中的课程体系、临床培训、导师角色、临床基地的管理等现存问题,探索提升医学专业学位研究生培养质量的有效途径。     

论医学专业学位研究生的双导师制

医学专业学位研究生教育是为了向社会提供高层次应用型医学专门人才,以提高临床医疗队伍整体素质为教育目标.这项工作有其自身特点,同时也面临着各种问题的挑战.实行"双导师制"培养模式.有利于实现临床教学和科学研究的双向互补,有利于将研究生所学知识更好地应用到临床实践中,实施创新实践能力教育,更好地按照社会实际需要培养职业性人才.     

临床专业学位研究生教育与住院医师规范化培训并轨的实践研究

临床专业学位研究生培养与住院医师规范化培训为医学生提高临床能力的继续教育模式,但两者之间存在一定的重复性,造成医疗卫生资源的浪费,将两者并轨可提高医学人才培养的规范性和集约性并使医疗卫生事业资源得到充分利用。剖析住院医师规范化培训和临床专业学位研究生培养两种毕业后再教育模式的异同点及利弊,建立医学专业学位研究生培养与住院医师规范化培训在课程、临床培训、临床考核、科研训练、人文教育等方面的"双轨合一"人才培养模式,为提高临床实践能力的继续教育发展提供依据。     

比利时医学研究生导师制度的特点

随着我国医学研究生教育规模的扩大,研究生的培养质量问题备受关注.在研究生培养体系中,导师制度及导师队伍建设发挥着举足轻重的作用.比利时的医学研究生教育使用"导师小组负责制",导师队伍结构科学合理,学术水平高,并具有管理自主性强、国际化和企业化的特点.这些特色可为我国医学研究生教育改革提供借鉴和参考.     

医学人文教育属性探析

医学人文教育就是针对医学生培育医学人文精神、提升医学人文素质,培养与提高医学人文执业技能,使其成为具有较高医学人文素养的医务工作者的教育形式。医学人文教育具有双重属性:一方面,具有人文素质教育的特征,着眼于"培养完整的人",同时,教育内容体现了人文素质教育的要求;另一方面,医学人文教育属于医学专业教育范畴,这是由医学科学的人文本性决定的,是建构新的医学模式的需要,反映了医学人文课程的基本特征。     

中国医学人文学研究生教育初探

我国医学生的医学人文素质教育近年来有了较大的发展,但学界尚未对本领域研究生教育给与足够的重视.分析了我国医学人文研究生教育现状,描述了美国一些医学人文研究生项目,并指出在借鉴的基础上建构我国的医学人文学研究生教育决定着该领域未来的发展.     

教学和医疗查房中应重视伦理学相关问题

当前,在教学和医疗查房中多有忽视医学伦理学相关问题,因此,在教学和医疗查房中应将医学伦理学相关问题融入整合到教学和医疗查房中,这是教学和医疗查房的现实需要,医学模式和医患模式转变的客观要求,医学专业属性和人的属性的内在要求。融入整合的内容主要是教学和医疗查房所涉及的医学伦理实践教育内容和医学临床实践教育内容。融入整合的方法主要是借助病历报告、上级医师询问病历、病例讨论、正反案例分析、教师点评、总结等平台进行。     

OSCE医学人文考站的探索与实践

第三军医大学针对医学专业教育和人文教育"两张皮"的现状,探索在考试中医学人文素养评价方法改革的途径和方法。以设置客观结构化临床考试医学人文独立考站为着力点,围绕医患沟通能力这一核心素养评价指标,精心设计符合临床实际的案例库,采用统一培训的标准化病人和临床中常见设施构建标准化场景,开展了医学人文考试改革的研究与实践。结果表明,改革较好地发挥了考试在强化医学人文与医学专业教育相结合的教育过程中的诊断、反馈、激励和导向作用。     

临床实习生专业教育与医学伦理教育整合的探讨

当前有相当数量的临床学院、教学医院和临床教师仅重视医学生的专业教育而忽视医学伦理教育,专业教育与医学伦理教育严重脱节.应对临床实习生的专业教育与医学伦理教育的培养目标、教育内容、实践过程、教育路径、方式方法进行整合,使医学专业教育与医学伦理教育紧密结合、相互渗透、相互融合、实现整合.     

Seeing and hearing and space and space and time

A previous experiment had shown spatial location to be judged in terms of the framework provided by the modality in which stimuli were presented. In the present study, digits were either auditorally or visually presented, and in either form the three digits appeared successivly to the left, in the center, and to the right of the S. The digit which occurred temporally in the middle of the sequence was never central from the spatial viewpoint. The S was asked to indicate which digit was the middle one. Ss were blind, deaf, or normal. The deaf and two control groups saw visual displays, and the blind and their controls heard auditory displays. The former groups predominantly chose the spatially middle digit and the latter groups the temporally middle. It was concluded that modality of presentation was the trigger which switched in the coding dimension of time or space.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Law and Gospel,and Youth and Family Ministry

Abstract : If “faith comes through hearing” the word of God comprised in law and gospel, how do the imperatives that characterize ‘Youth and Family Ministry’ make such hearing possible? Here, literature delineating ‘Youth and Family Ministry’ is analyzed in light of its biblical foundations. The primary lens implemented in this analysis is the law/gospel hermeneutic advocated by Martin Luther and other reformers.     

Bob and Carol and Tess and Ali

Conflicting religious experiences in different traditions do not necessarily defeat the rationality of conflicting beliefs sustained by those experiences in those traditions. The circularity that protects religious beliefs from such mutual defeat is not vicious. Moreover, the lack of ‘epistemological humility’ exhibited by such believers poses no threat to world peace. In fact, a campaign for compulsory humility would itself constitute a much greater threat.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.     

Lmx and Job Tension: Linear and Non-Linear Effects and Affectivity

We examined whether linear or non-linear LMX–job tension relationships existed, and if these effects were consistent across levels of negative (NA) and positive (PA) affect. Results indicated that NA and PA moderated the non-linear LMX–job tension relationship. Specifically, the LMX–job tension association was best depicted by an inverted-U form for high NAs. Tension was highest when LMX was moderate and lowest when LMX was either low or high. Tension increased minimally for low NAs across levels of LMX. For high PAs, the relationship was linear and inverse. Conversely, a U-shaped form best represented the LMX–job tension relationship for low PAs. Implications, strengths and limitations, and directions for future research are discussed.     

Religiosity and Secular and Ascetic Deviance

According to the antiascetic hypothesis, religiosity should be strongly related to behaviors that violate ascetic standards (getting drunk and using marijuana), but only weakly related to behaviors that violate social standards (violence and stealing). Using the second wave of the National Study of Youth and Religion, I tested the antiascetic hypothesis using a question about the most important basis for deciding what is morally right or wrong. Contrary to the antiascetic hypothesis, individuals who believe that God's law is the most important for deciding what is morally right or wrong, compared to those who believe that society is the most important, are not less likely to get drunk or use marijuana. Furthermore, for getting drunk and marijuana use, differences in behavior are not the result of different ethical standards (ascetic or social), but rather differences in the willingness to uphold those standards (is it OK to break moral rules).