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。     

我国转化医学发展现状的思考

转化医学在当今世界发展迅速,虽然在我国起步较晚,但取得了巨大的成就,建立了许多转化医学研究机构,积极开展合作交流,但不可避免地存在一些问题,诸如创新能力不足、顶层设计不够和人才缺乏等,为此提出相应对策和未来发展的前景,同时指出转化医学在我国不仅是学术问题,而且是社会问题.     

A Minister's Information-Handling

ABSTRACT

One of the roles which ministers perform is that of “caregiver.” Caregiving functions include such activities as visiting parishioners, hearing confessions, and counselling people. These functions are carried out within a legal context. In this paper, two aspects of the parish minister's information handling in respect to his/her role as caregiver are examined. Specific attention is given to the pastor's vulnerability, while carrying out pastoral duties, to civil lawsuits for malpractice and to her/his expectation of privilege against testifying in criminal proceedings. It is observed that in North America, considerable confusion exists over who actually owns and who can control the information a minister acquires and disseminates.     

Core Resources for a Cooperative Program in Diaconal Ministry

Abstract

This article provides an annotated listing of print and electronic resources to support a graduate Diaconal Ministries program based at the Lutheran Theological Seminary at Gettysburg, Pennsylvania. Suggested resources are categorized and related to all facets of the curriculum of the program that involve academic preparation in the areas of Lutheran theology, ministry and social service.     

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.     

Evidence-Based Practice in Psychology: An Ethical Framework for Graduate Education,Clinical Training,and Maintaining Professional Competence

Evidence-based practice is often acknowledged as the future state of psychology, yet those graduate students who will soon be applying such practices tend to hold several misconceptions about the major components within this framework. This review highlights implications for graduate education, clinical training, and professional competence in light of the movement toward evidence-based practice in psychology. These implications are discussed in relation to the close parallel between the major components of the evidence-based framework and the current Ethical Principles of Psychologists and Code of Conduct. The evidence-based framework is discussed as an ideology that promotes lifelong learning and best prepares graduate students for ethical clinical practice throughout their careers as psychologists.     

Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources for effective and ethical treatment of psychotherapy clients with intellectual disabilities.     

Barriers and Supports to Substance Abuse Service Use Among Homeless Adults

Although there is a great need for substance abuse services among the homeless, many homeless individuals do not use those services. This study examined barriers and supports related to service use. Participants recognized a need for treatment and significant barriers to accessing care.     

Organizational Commitment,Job Satisfaction,and Effort in the Service Environment

Investigations of the causal relationship between organizational commitment and job satisfaction have yielded contradictory findings. Little empirical research has looked at this complex relationship in the context of work effort. The purpose of this study was to determine how these variables interact in the service environment. Using a sample of 425 employees in two service organizations, the author tested two structural equation models. The hypothesized model with organizational commitment as a moderator between job satisfaction and service effort fit better than a model with job satisfaction as moderator did. Conceptual implications are discussed, and suggestions for future research are made.