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.     

混合模式调查下的测量不变性：跨文化视角

混合模式调查收集数据的有效性需以模式间测量等同为前提.以往调查模式间的测量等同研究尚未考虑文化因素的影响.本研究通过两个自我创新能力评价量表,基于中美两国数据,运用多组确认性因子分析法考察了将由网络调查和纸笔调查构成的混合调查模式应用于自我能力和行为评估时的测量等同问题.结果在美国的样本中发现创新能力评价量表在两种调查模式下具有测量不变性,而在中国的样本中只发现强因子测量不变性,提示混合模式调查下测量不等同的出现是调查模式和文化因素共同导致的结果.我们认为,集体主义文化扩大与强化了纸笔调查和网络调查之间的匿名感知差异,进而受访者可能在网络调查中呈现出“满意决策”作答行为或在线下的调查中呈现出“社会称许性作答行为”,从而增加了出现测量不等同的可能性.     

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.     

On Some Affinities of Morin’s Complex Thinking with That of Chinese Classic Philosophy

Morin (1921) founded the complex mode of thinking in order to remedy the defects of the Western classic simple mode of thinking. In doing so, he approached to some degree the mode of thinking inherent to the Eastern civilization. This article elucidates that for some principles of Morin's complex thinking, such as correlation of opposites, recursive causality, and union of unity of multiplicity, there were similar ideas in Chinese classic philosophy. This shows that the complex paradigm of thinking, in a certain point of view, will be the fusion of Western and Eastern cultural factors. Besides, in integrating his theory of complexity with the reality of our time to find out solutions to the issues of globalization, Morin has become one of the representative thinkers of the planetary age of humankind.