ObjectivesTo systematically review the training needs of managing staffs in tertiary hospitals in China, to understand the requirements of in-service training for hospital managing staffs, and to provide references for the target and content of tertiary hospital managing staff training.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cross-sectional studies on the training needs of managing staffs in tertiary hospitals in China. The retrieval time was from inception to July 29th, 2018. Two reviewers independently screened literature, extracted the data and descriptive analysis was conducted on the training needs of managing staffs in tertiary hospitals.ResultsA total of 11 studies were included. The results of systematic review suggested that: as for the requirements of training content, hospital management, leadership, personnel training, human resource management and innovation awareness were the most demanding training contents. As for the training methods, experience exchange, case study and topic teaching were the most popular. As for the training time, 2 to 3 days of quarterly training was the most acceptable training time.ConclusionsThere are great training requirements for managing staffs in tertiary hospitals in China, with a large amount of training content and diversity methods. In future, training objectives and methods should be designed to meet the requirements of managing staffs, so as to enhance training quality and achieve training goals.
Objective To provide references and recommendations about emergency physician training for our country by analyzing the characteristics of emergency physicians training objective, subject, process, content, appraisal and assessment in the United States, the United Kingdom, Canada and Australia. Methods Such databases as Ovid, Proquest, MDConsoult and relevant websites of national emergency medicine were searched to include literature covering guidelines and documents on emergency education and training in the United States, the United Kingdom, Canada and Australia. According to the evidence-based scientific principles and methods, we graded and analyzed the included information. Results A total of 40 articles were included, covering 12 guidelines and documents, 2 reviews and 26 research documents. Each of the four countries owned a sound emergency specialist training access system especially on how they used competency as the core to design the training content, courses and appraisal and assessment system to improve overall ability and quality of emergency physicians. Conclusion Our country’s emergency physician training certainly has lagged behind those of the developed countries. We should learn from positive experience of the developed countries to standardize emergency physician training, improve the emergency physician training content and curriculum, strengthen access management and the construction of appraisal system, and cultivate the competency of emergency physicians.
ObjectiveTo compare whether the training process of commissioned training residents from Tibet and non-commissioned training residents have achieved homogenized.MethodsThe training time and operation frequency data of 170 commissioned training residents from Tibet and 96 non-commissioned training residents of grade 2016 during the 19 months from September 2016 to April 2018 were collected. The 25 operational data of 11 departments that are representative and comparable are compared.ResultsThe two types of trainees completed the rotation of 47 different departments within 19 months, of which 45 departments were the departments where both types of students were rotated. Among these 11 departments, the average training time of trainees from Tibet in the Departments of Anesthesiology was lower than that of non-commissioned trainees (Z=–4.543, P<0.001). There were statistically significant differences in 7 of the 25 operating data (P<0.05). The operation number of arterial puncture and ventilator management (Intensive Care Unit); patient treatment (Department of Emergency); arterial puncture, ventilator management and intraoperative monitoring (Department of Anesthesiology) of trainees from Tibet were lower than those of non-commissioned trainees (P<0.05). The operation number of lung and mediastinal examinations (Department of Radiology) of trainees from Tibet was higher than that of non-commissioned trainees (P<0.05).ConclusionsDuring the training of the two types of trainees, the rotation schedule was basically the same, but there were differences in the clinical practice operations. Trainees from Tibet have higher requirements for radiology training. Trainees from Tibet will return to Tibet with independent practice needs, so their requirements of medical imaging skills operation would be higher. Due to language and training time, the critically ill, emergency first aid, and surgical skills of trainees from Tibet are not as good as those of non-commissioned trainees, and they need to gradually strengthen and improve these skills in subsequent trainings.
Under the direct leadership of the Chinese Association Against Epilepsy (CAAE), the preparation of the “Training and examination syllabus of competency-based epilepsy education” was officially launched in March 2020. The Epilepsy Education Task Force of CAAE made reference mainly to the “Roadmap for a competency-based educational curriculum in epileptology” proposed by the report of the Epilepsy Education (EpiEd) Task Force of the International League Against Epilepsy, considered the actual situation of specialization in epilepsy at the different level hospitals in China, and finished the final draft after full discussion by the experts in relevant fields. The syllabus was divided into two parts: primary and intermediate level, in which a modular and layered design was adopted and the teaching requirements according to mastery, familiarity, and understanding were proposed. After the syllabus was finalized, it was used as a guideline in the subsequent online training and the primary and intermediate level examinations, which played an important role in cooperating with the smooth implementation of the “competency-based epilepsy education”.
Objective To get known the existing problems in rural primary physicians training in Gansu province, so as to explore an appropriate training mode for Gansu province. Methods This study conducted a comprehensive analysis by combining literature analysis, on-site survey and interview. Such databases as CNKI, VIP and CBM were searched to include literature published before November 2011, and the references of the included literature were also retrieved. The qualitative analysis was performed after assessing the methodological quality of the included literature according to self-designed criteria. Additionally, the rural primary hospitals in Gansu province were classified according to their geographical position and economic development level, total 10 township hospitals were randomly selected by cluster sampling, and the following stuffs participated various trainings in past 3 years were on-site-investigated: clinical doctors, nurses, medical technicians, and medical administrators, in aspects of training time, place, contents, modes, and effects. Results The existing problems in primary physicians training modes in Gansu were as follows: uneven training levels, lack of targeted contents, neglect of skill training and process management, and absence of quality assessment of training processes and effects. Conclusion The training modes require that: a) specific plans and schemes; b) unified organization to integrate educational resources effectively; c) reasonable arrangement of implementation process, and d) innovation of training methods and contents to fully play the role of general hospitals and universities; and well control and feedback to promote the integration and perfection of training modes.
Minimally invasive surgery is the development direction of surgery in the 21st century, and thoracoscopic or laparoscopic skills are essential skills that all surgeons must master. Thoracoscopic or laparoscopic skills training is an important part of surgical resident training. However, there are various methods for thoracoscopic or laparoscopic skill training internationally. The assessment is still in the stage of examiners’ visual observation and subjective evaluation. Here, we reviewed the current research status of thoracoscopic and laparoscopic simulation training and assessment, discussed the development experience and application achievements of Huaxi Intelligent Thoracoscopic Skill Training and Assessment System. We aimed to provide a theoretical basis and practical experience for the development of thoracoscopic or laparoscopic simulation education.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
We aimed to investigate the improving measures of the training of research ability in cardiothoracic surgical resident. We analyzed the current training status of researching ability in residents by reviewing relevant literatures and combing with the actual situations. There are still some aspects of the training program for research ability in cardiothoracic surgical resident needing further improvements, such as training system, assessment system. Scientific research ability is one of the basic abilities for cardiothoracic surgical resident. Strengthening the training of research ability for cardiothoracic surgical resident is propitious to the long-term development of the doctors' career.
ObjectiveTo discuss the present situation of emergency physicians' communicational ability and the intervention measures. MethodsWe investigated 66 students who participated in continuing medical education of "emergency physicians' communication skills training course" from 2010 to 2013. All students accepted systematic training. After the training, we did the investigation again, and then made a comparison before and after the training. ResultsA major 78.8% of the students in this training had never taken part in the training of communication skills before; 51.5% of the students thought that the improvement of communication ability could be achieved mainly through long-term accumulation of clinical experiences. Students' self-evaluation showed that communication problem occurred 2 times a year in 10.6% of them, 3 times in 22.7%, 4 times in 24.2%, and five or more times in 34.8%. Students' role playing score in the scenario training rose from 5.374±0.686 to 6.717±0.517 after the training, and the difference was statistically significant (P=0.024). ConclusionEmergency physicians lack knowledge of communication skills which needs to be improved. Through training, the skills can be improved significantly.
Abstract： Objective To improve therapeutic outcomes for severe leftsided atrioventricular valve regurgitation (LAVVR) after repair of atrioventricular septal defect (AVSD) through discussing pathological changes of the valve and surgical management for these patients, and summarizing the medical experiences of perioperative managements. Methods We retrospectively analyzed the clinical data of 29 patients including 16 males and 13 females with LAVVR after repair of AVSD treated in Xinhua Hospital, Medical College of Shanghai Jiaotong University between January 1995 and December 2009. The age of these patients ranged from 4 to 62 years, averaging at 26.5. According the classification of New York Heart Association (NYHA), there were 10 patients of class Ⅱ, 17 of class Ⅲ and 2 of class Ⅳ before reoperation. Partial repair of AVSD had been carried out for 18 patients, and complete repair had been performed on 11 patients. At reoperation, valve rerepair was performed on 17 patients and mechanical valve replacement (MVR) was necessary in 12 patients. Results In the early period after operation, one patient died of multiple organ failure, one patient had a permanent pacemaker inserted because of complete atrioventricular block, and 1 patient aged 4 years got recovery after 56 hours of circulatory support for severe cardiac failure after reoperation. A mean follow-up of 8.2 years (6 months to 14 years) was done for 25 patients with 3 missing. During the follow-up for 14 patients undergone heart valve repair, there was no obvious acceleration of the forward blood flow of the leftside atrioventricular valve. Ten patients had mild or less LAVVR, 1 had moderate LAVVR and 3 underwent successful left atrioventricular valve replacement at 10 days, 3 years or 6 years after reoperation because of severe LAVVR. Clinical status, as assessed by the NYHA classification, improved after surgery for LAVVR in 25 patients who were followed up with 17 in NYHA class Ⅰ, 6 in class Ⅱ, and 2 in class Ⅲ. Podoid decreased significantly and cardiothoracic ratio was 0.53-0.67 (0.60±0.11) in chest Xray picture. There was no late death. Conclusion With timely surgical treatment, and appropriate surgical method, LAVVR after complete or partial AVSD repair can be managed with excellent shortterm and longterm outcomes.