表现性测验在能力评价中的应用

相对传统的纸笔测验形式,表现性测验的突出特点是任务的真实性水平较高。表现性测验是一种认知导向的测验。在国外教育、医学、心理咨询与治疗等领域的能力评价中,一系列表现性测验已被开发出来并用于实践,获得了较好的心理测量学指标。表现性测验可用于国内学生、教师的能力评价,辅助人才选拔以及相关职业资格认证的实践。表现性测验开发过程中若合理应用概化理论、项目反应理论等现代测量理论,对于提高测验信度和效度都有一定积极意义。     

POSSIBILITIES AND LIMITS OF MEDICAL SCIENCE: DEBATES OVER DOUBLE‐BLIND CLINICAL TRIALS OF INTERCESSORY PRAYER

Abstract. This article traces the intellectual history of scientific studies of intercessory prayer published in English between 1965 and the present by focusing on the conflict and discussion they prompted in the medical literature. I analyze these debates with attention to how researchers articulate the possibilities and limits medical science has for studying intercessory prayer over time. I delineate three groups of researchers and commentators: those who think intercessory prayer can and should be studied scientifically, those who are more skeptical and articulate the limits of science around this topic, and those who focus primarily on the pragmatic applications of this knowledge. I analyze these contests as examples of what Thomas Gieryn calls “epistemic authority” as medical researchers engage in what he describes as “boundary‐work” or “the discursive attribution of selected qualities to scientists, scientific methods, and scientific claims for the purposes of drawing a rhetorical boundary between science and some less authoritative residual non‐science.” (Gieryn 1999, 4 (Gieryn 1999, 4)).     

Mind, Body, and Spirit: Family Physicians’ Beliefs, Attitudes, and Practices Regarding the Integration of Patient Spirituality into Medical Care

This study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.Michael M. Olson, Ph.D., is a member of the Department of Family Medicine, University of Texas Medical Branch in Galveston.M. Kay Sandor, Ph.D., R.N., is in the School of Nursing.Victor Sierpina, M.D., is in the Department of Family Medicine.Harold Vanderpool, Ph.D., Th.M., represents the Institute for Medical Humanities at the university and Patricia Dayao, M.A., is a graduate student there.Funding for this study provided in part by the John G. and Marie Stella Kenedy Foundation and the George Washington Institute for Spirituality and Health/John Templeton Foundation. Correspondence to Michael M. Olson, mmolson@utmb.edu.     

美式脊椎矫正学在临床康复应用中的前景

美式脊椎矫正学起源于1895年的美国,目前遍及世界许多国家,是被WHO认可的广为流行的一种自然疗法。在注重整体、强调各器官、组织的整体平衡方面与我国中医相同。不同的是美式脊椎矫正严格建立在以脊椎解剖学、生物力学、X线影像学的基础之上,被视为传统自然疗法与现代医学科学相结合的独立学科。     

临床医学金字塔上的长征及基础攀登

临床医生的成长是一个过程,从踏入医门起,医生们就在金字塔上进行攀登。医学大师们如吴阶平、王澍寰、吴英恺、裘法祖等,几十年的从医、治学、成长、奋斗之道,犹如“万里长征”。他们当年也是实习、住院医生,从打基础、学本领,学做好医生做起。最终取得成功的决定性因素,是其独特的思维方法,给年轻的医生们带来许多有益的启示。     

中西医结合临床思路浅谈——论辨证与辨病的关系

辨证与辨病是两种不同的思维方式,西医辨病又辨证,中医辨证又辨病,辨病与辨证是中医与西医都遵循的诊治过程,在临床中辩证运用中医与西医有利于中西医结合临床思路的建立     

骨质疏松症和细胞因子关系的新思考

在骨质疏松症患者体内,细胞因子的改变和雌激素减少是骨质疏松症发生、发展的启动因素,造成骨的代谢紊乱,致使骨吸收超过骨形成,出现骨重建平衡失调与骨转换加快。细胞因子的提出使骨质疏松症防治观念发生了根本的转变,提出了骨质疏松症防治新策略,对细胞因子与骨质疏松症的关系的认识,体现了循证医学的思想和创新思维的启动。     

我国中西医结合科研工作的回顾与思考

针对我国中西医结合事业现状,通过调研,结合文献,提出中西医结合科研工作的发展对策。试从研究方向、人才队伍、科研交流等方面进行阐述,以期有助于我国中西医结合科研工作的健康发展。     

国内外器官移植的比较研究

随着外科技术的改进,免疫抑制剂的发展,世界器官移植取得了巨大的发展。近年来我国的器官移植已取得了较大的进展,但要完全与国际接轨,还存在许多急需解决的问题。综述了国内外器官移植发展状况及趋势,分析了器官移植中尚待解决的伦理问题,从社会、伦理、经济、文化、心理、医疗等问题探讨了器官移植的新进展。     

倏忽与浑沌和中医与西医

中医“科学化”和“现代化”是西方医学传入我国一百多年来几代中医人的夙愿和奋斗目标,但在以感染和传染性疾病为主要矛盾的生物医学模式阶段,却一直难以取得突破性的进展。随着各种慢性疾病发病率的逐年增加、医疗重点的转移和生物-心理-社会医学模式的确立,中医的现代化发展正在面临着前所未有的机遇和挑战。借助《庄子》“倏忽为浑沌开窍”的故事,重点就新的医学模式下的中医现代化发展进行了一些方法论的探讨。