It is an inexorable trend that evidence-based medicine (EBM) is being adopted at clinical medicine education in the 21st century. EBM neurology has been developing with the progress of the world of evidence-based medicine and clinical neurology. New requirements have been proposed in neurology education with the development of EBM. The adoption of EBM in modern clinical education will be a great influence: promoting the further development of neurology, cultivating talented doctors, and improving the quality of treatment.
Within the context of the "Healthy China Strategy" and the "Biology-Psychology-Society" medical model, the goals, content and methods of medical education have undergone tremendous changes. To keep up with the pace of development of medical technology and medical concepts, medical education requires major reforms, and medical teaching models requires reconstruction. Based on previous investigations and discussions and considering the West China medical education as an example, this paper summarizes the difficulties that will be faced in the transformation and reform of modern medical education and discusses and analyzes the future direction of medical education reform.
ObjectiveTo investigate the distribution of human resources in primary healthcare system of Xinjin county in Chengdu in 2010, so as to provide the evidence for appropriate allocation of health manpower. MethodsWe collected the data of human resources in the regional health information and management platform, and the list of health workers and their registration information. Microsoft Excel 2003 and SPSS 13.0 software were used to analyze data. Resultsa) A total of 1 551 health workers were in Xinjin primary healthcare system in 2010, including 1 124 in tenure position (accounting for 72.5%) and 427 in contract (accounting for 27.5%). b) In county-level hospital (CLH) or community healthcare centre (CHC) or township hospital (TH), the proportion of health professionals were 83.2%, 79.0% and 80.0% respectively; and 28.8%, 27.2% and 28.7% for registered & assistant doctors; 39.3%, 22.7% and 16.2% for registered nurses; 6.7%, 8.3% and 4.7% for technicians; and 5.9%, 6.8% and 6.9% for pharmacists, respectively. c) Health personnel per 1 000 population in CLH, CHC, and TH were 3.10, 1.98, and 1.92, respectively; health professionals per 1 000 population were 2.58, 1.58, and 1.54, respectively; registered & assistant doctors per 1 000 population were 0.89, 0.54, 0.55, respectively; and registered nurses were 1.22, 0.45, 0.31, respectively. The nurse-to-doctor ratios were 1.36, 0.83, and 0.56 nurses per doctor in CLH, CHC, and TH, respectively. The bed-to-nurse ratios were 0.59, 0.38, and 0.19 nurses per bed respectively. d) Most health professionals were junior professionals (about 60%), in college-level education (about 50%), between 25 to 44 years old (20%-70%), work experience between 5 to 19 years (40%-63%). e) Temporary employees in TH accounted for 46.4%, among which 86.6% younger than 35 years old, 23.4% in internship, and 64.1% at clinical position. Conclusiona) The shortage of health personnel is very obvious in Xinjin county with inappropriate proportions of health professionals; b) The stability of health personnel is challenging due to the large proportion of temporary employees in THs; c) health professionals in Xinjin county features a younger population, and in lower professional positions; d)Therefore, the related policies should be adjusted and innovated to enhance the education and training, to maintain the stability of health personnel and to promote the healthy and sustainable development of primary healthcare services.
Objective To explore the impact of diagnosis-related group (DRG) payment method reform under total amount control on neurology and neurosurgery departments. Methods The DRG grouping data of the Department of Neurology and the Department of Neurosurgery of Panzhihua Central Hospital from January 2018 to December 2020 were collected, and the mature DRG evaluation indexes in China were selected. Using the interrupt time series analysis method, the DRG-related indexes of the two departments before and after the introduction of the performance appraisal plan in July 2019 were compared, to evaluate the intervention effects on the two departments. Results Both neurology and neurosurgery departments showed a slow downward trend in the overall medical service capacity under the DRG payment. The efficiency of medical services showed a slow upward trend and the consumption of medical expenses showed a slow downward trend in the Department of Neurology, while the efficiency of medical services showed a slow downward trend and the consumption of medical expenses showed a slow upward trend in the Department of Neurosurgery. According to the results of interrupt time series analysis, in the Department of Neurosurgery, the total weight showed a significant downward trend before intervention (β1=?5.526, P=0.003), and the downward trend became sluggish after intervention, with a statistically significant slope difference before and after intervention (β3=4.546, P=0.047); the case-mix index showed a downward trend before intervention (β1=?0.050, P<0.001), and no obvious trend after intervention, with a statistically significant slope difference before and after intervention (β3=0.052, P=0.001); the cost consumption index showed no obvious downward trend before intervention (β1=?0.006, P=0.258), and an upward trend after intervention, with a statistically significant slope difference before and after intervention (β3=0.027, P=0.032). The impact of this assessment plan on the Department of Neurology was not statistically significant (P>0.05), needing further observation. Conclusions The reform of DRG payment method under total amount control has different effects on the evaluation indicators of clinical departments of different natures. It is recommended to implement classified management and assessment for clinical departments of different natures.
The Second People’s Hospital of Yibin was taken over by West China Hospital of Sichuan University into its close hospital alliance, and simultaneously undertook the task of construction of regional hospital alliance in Yibin city. The article introduces the experiences of the Second People’s Hospital of Yibin in the high-quality development of novel healthcare system. Led by West China Hospital of Sichuan University and based on all-level medical institutions in Yibin, the Second People’s Hospital of Yibin preliminarily established a four-level hierarchical medical system as “province, city, county, village” model, according to the guide of governments within the whole region. It aims to propose a “Yibin model exploration” in hospital alliance construction based on the western regional situation.
Human society has entered the age of artificial intelligence(AI). Medical practice and education are undergoing profound changes. The government strongly advocates the application of AI in the field of education and it has been incorporated into the national strategy. The integration of medical education and AI technology is changing the paradigm of modern medical education. This paper introduces the current application status of AI in medical education, and analyzes the existing problems and proposes corresponding resolutions, so as to lay a foundation for promoting the integration of medical education and AI.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
Objective To provide a reference for the best evidence-based medicine (EBM) education modelby retrospective analysis and summary the EBM education model of the EBM center of Lanzhou University for medicalpostgraduates. Methods To utilize students’ spare time we changed the traditional teaching method, and instead used problem based learning and academic discussions to teach postgraduates how to design and apply research. Results Sixtytwo postgraduates were trained and completed 73 research papers and registered 33 Cochrane systematic reviews. Twentythree papers were published in foreign journals (SCI) as first authors, 34 papers were published in domestic journals. Five students received awards in the academic conference of Lanzhou University. Conclusion Medical students will benefit from taking part in EBM research. This education model will help them not only understand the methods of clinical research and EBM and improve the quality of their research and their cooperative skills, but also master related clinical knowledge.