Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-01 Cooperative journals: 《中国全科医学》
Abstract： Background Teaching objectives are the soul and pillar of teaching activity and are closely related to the effect of teaching effects. Currently, there are few studies on the teachers’ cognition and formulation of teaching objectives in the standardized training of residency general practitioners (general practice residential training). Objectives To select outstanding domestic general practice teachers, to conduct in-depth interviews in the scene of teaching ward rounds, to understand teachers’ cognition, formulation basis, construction, writing, and other aspects of teaching objectives, to discuss how to better promote teaching through teaching objectives in the general practice residency training that is different from the college education and highly professional and focuses on job competency training. Methods The study subjects were outstanding general practice teachers who are in the region with good development of General Practice discipline, whose workplace is the General Practice department in an affiliated hospital of a well-known medical school in China and the department is a national residential training base for general practitioners, being the deputy chief physician or above, teaching General Practice for 5 years or above, have won related teaching honors on a college level or above, and are still participating in teaching ward rounds and setting teaching objectives in such teaching activities. From February to June 2022, the one-on-one semi-structured in-depth interviews were conducted through online video conferences. Using the NVivo 12 software, the topic frame analysis method was used to organize and analyze the data and to refine the interview topics. Results Totally 8 General Practice teachers were enrolled. Through the analysis of the interview data, totally 3 themes and four subthemes were extracted: 1) general practice teachers can grasp the principles of teaching objectives setting; 2) teaching objectives setting lacks institutional guarantees, including two sub-themes: the lack of theoretical foundation and the lack of normative setting environment; 3) general practice teachers have insufficient cognition of the role of teaching objectives in the cultivation of post competency, including two sub-themes: cognitive deficiencies in teaching objectives, and teaching objectives setting has little significance in guiding the teaching process.Conclusions Even the outstanding general practice teachers still have some problems in the cognition and formulation of teaching objectives, which may affect the teaching quantity and quality. It is necessary to strengthen and ensure the effective formulation of teaching objectives and to enhance relevant theoretical training. Meanwhile, taking teaching objectives as the starting point is to promote the homogeneous development of general practice teachers, so as to cultivate more qualified general practitioners.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-10-19 Cooperative journals: 《中国全科医学》
Abstract： Background The development of traditional Chinese medicine has become a vital strategy in our country, and to vigorously improve the service capacity of traditional Chinese medicine in primary health service centres is one of the important contents. At present, there are few studies on the disease spectrum of traditional Chinese medicine in community health service institutions. Objectives According to the "Classification and Code of Diseases and Syndrome of Traditional Chinese Medicine" (TCD), using the types, quantity, and characteristics of disease spectrum in outpatients’ diagnosis and treatments of traditional Chinese medicine from the residents contracted with family doctors in Community Health Centers (CHCs) in Shenzhen, to explore the diagnosis and treatment ability of traditional Chinese medicine in these CHSCs, so as to provide theoretical basis for promoting the development of grass-roots Chinese medicine in our country. Methods This study utilized the records of outpatient residents contracted with family doctors with medical expenses incurred in the CHSCs in 10 districts of Shenzhen from January 1, 2021 to June 30, 2021, Including gender, age, and disease diagnosis. Patients with diagnosis the treatment purposes of Chinese medicine, who generated matching diagnosis treatment costs and the first diagnosis being TCD-coded diagnosis, were selected to include in this study. Patients with multiple medical records and the same first diagnosis was classified according to the disease name in the same TCD case, mainly involving the category of the department, the classification of the specialist system, and the name of the disease in traditional Chinese medicine. Results A total of 385,138 cases of TCM diagnosis and treatment were included in this study. Among them, 170,077 (44.16%) were male, with an average age of 37.5±8.2 years; and 215,061 (55.84%) were female, with an average age of 36.7±9.4 years. The disease spectrum covers all of the 7 TCD categories, including: Internal medicine 56.98%, Pediatrics 20.56%, Otolaryngology 12.45%, Gynecology 7.95%, Surgery 1.51%, Orthopedics 0.37%, and Ophthalmology 0.18%. Apart from tumor diseases, cancer diseases, trauma diseases in Surgery and ophthalmology middle canthal disease, black eye disease, pupillary disease, traumatic eye disease in Ophthalmology, the disease spectrum covers all specialist system classifications under the 7 TCD categories. The disease spectrum is concentrated in several TCM disease categories in each specialist. Specifically, arthralgia, cold, cough, vertigo, insomnia, consumptive disease, diarrhea, and stomach ruffian account for 93.95% in Internal medicine; infant cold, infant cough, infant diarrhea, infant abdominal pain, infant vomiting account for 97.60% in Pediatrics; laryngeal paralysis, aphthous disease, milk moth disease, toothache, dental disease, rhinophyma, and Biyuan disease account for 98.71% of Otolaryngology; leucorrhoea, oligomenorrhea, and dysmenorrhea account for 94.40% of Gynecology; rash disease, eczema, breast addiction, and carbuncle disease account for 94.0% of Surgery; tendon disease and stiff neck disease account for 96.73% of Orthopedics; and the Tianxing red eye disease, storm fever, and needle eye disease account for 93.03% of Ophthalmology. The top 5 systems of the disease spectrum include, the respiratory system 54.19%, the musculoskeletal system 19.05%, the gynecological system 7.95%, the cardiovascular and cerebrovascular system 7.15%, and the digestive system 4.98%. Patients under 15 years and at 15-24 years mainly suffered from diseases related to the respiratory and digestive tracts. With the increase of age, paralysis, dizziness, headache, insomnia, fatigue, etc. gradually increased. Colds ranked the first for patients below 45 years, and the paralysis of muscle and joint pain ranked the first for those above 45 years. Conclusions In recent years, with the strengthening of grassroots and various favorable policies, the TCM diagnosis and treatment in Shenzhen CHSCs has a wide spectrum of diseases, but the types of diseases are relatively concentrated. It is necessary to strengthen the TCM diagnosis and treatment capabilities in CHSCs to better meet the residents’ health needs.
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