Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-23 Cooperative journals: 《中国全科医学》
Abstract： Background The clinical reasoning of general practitioners is the key to providing quality medical services to patients，but it is not suitable for traditional methods to evaluate this ability because it is an abstract ability that cannot be directly observed. Objective This paper aims to improve the efficiency of general practitioners' clinical reasoning training and enrich the evaluation of medical education by optimizing the evaluation method of curriculum teaching. Methods From September to December 2022，38 master's degree students of the Medical School of Tongji University were divided into the in-service group（16） and residential training group （22）. The course consists of three modules，namely core，case and result，and adopts blended teaching method to carry out teaching. The content of quantitative evaluation is different kinds of rating scale，while the content of subjective evaluation comes from multi-source feedback. SPSS 22.0 was used for statistical analysis. Results The final course scores for the core and case modules were statistically significant for both groups（P<0.05），but the first course scores were not（P>0.05）. The quantitative evaluation scores of the whole class and the two groups of students in the first and last courses of the above two modules were compared，and there was statistical significance （P<0.001）. Subjective evaluation can be divided into positive evaluation and improvement evaluation. It is found that with the deepening of the course，the number and percentage of positive evaluation of core modules and case modules continue to rise，while the number and percentage of improvement evaluation continue to decline. Conclusions Programmatic assessment can enrich the evaluation system of general clinical reasoning，promote students' construction of general clinical reasoning in order，and also found that "flipped classroom" is a form of procedural evaluation.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-01-31 Cooperative journals: 《中国全科医学》
Abstract： Primary health care institutions undertake a range of crucial health-related responsibilities. With the continuous advancement in the medical field，community health service institutions have significantly improved their hardware conditions and effectively enhanced their capacity for health information systems，thereby highlighting the growing demand of individuals to receive specialist diagnosis and treatment within the community. This paper discusses the significance， connotation，implementation strategy，and method of constructing specialized disease diagnosis and treatment technology in the community. The article emphasizes that developing specialized disease diagnosis and treatment technology in community health services can enhance the proficiency of general practitioners，improve primary medical technology standards，elevate community health service levels，and meet public demands for specialized disease diagnosis and treatment. The development of comprehensive-specialty integration entails not only advancing specialized diagnostic and treatment technologies based on general practice work but also collaborating with higher-level hospitals to introduce a series of specialized technologies for joint diagnostic and treatment efforts. In terms of specific implementation strategies，it is essential to identify appropriate specialized technologies based on local diagnostic and treatment needs while conducting applied basic research on clinical method deficiencies throughrecruited expertise. Gradually establishing distinctive technical brands will help build momentum towards creating a specialization#2;focused development base.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-01-31 Cooperative journals: 《中国全科医学》
Abstract： The professional capacity and infrastructure of general practitioners in grass-roots medical and health institutions in China are relatively weak，and the energy of specialists in general hospitals is limited and resources are abundant， so we will further integrate the medical resources of community health institutions and general hospitals and strengthen the cooperation between general practitioners and specialists. In order to better protect the quality of medical care and promote the health of patients. This paper systematically sorts out the typical practices and experiences of the construction of outpatient clinics of combination of general practice and specialty，and takes the source，connotation，construction path and construction path of the concept of full-specialty combination of outpatient clinics Development effectiveness，existing problems and strategic recommendations are elaborated. Point out the challenges that may be faced in the construction of outpatient clinics of combination of general practice and specialty management model. In addition，in view of the innovative practices of each region，five aspects of suggestions are put forward in combination with existing problems: Improve the rules and regulations for the construction of outpatient clinics of combination of general practice and specialty，coordinate and unify the outpatient path of outpatient clinics of combination of general practice and specialty，pay attention to the protection of outpatient clinics of combination of general practice and specialty teams，clarify the population of outpatient clinics of combination of general practice and specialtyservices，and improve the health evaluation system for the outcomes of outpatient clinics of combination of general practice and specialty.In order to provide reference for the country to carry out the construction of outpatient clinics of combination of general practice and specialty in depth.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-01-17 Cooperative journals: 《中国全科医学》
Abstract： Background Mild cognitive impairment（MCI） is an age-related chronic noncommunicable disease facing a certain caregiving burden. At present，most studies focus on the caregiving burden and social support of caregivers of patients with moderate-to-severe cognitive impairment，but there are few studies on the social support and related factors of caregivers of MCI patients. Objective To explore the social support and related factors of caregivers of MCI patients，and provide evidence for feasible social support for caregivers of MCI patients. Methods A total of 102 family caregivers of patients initially diagnosed as MCI in Weifang Community Health Service Center，Pudong New Area，Shanghai from April 2020 to August 2021 were recruited. A cognitive impairment management group was established to investigate basic information，social support rate score（SSRS），positive aspects of caregiver（PAC） score and Zarit Caregiver Burden Questionnaire （ZBI） score of the caregivers of patients with MCI. The related factors of social support for the participants were analyzed. Results The average score of social support of caregivers of MCI patients was （31.26±6.87），including the average score of objective support as （7.02±2.10），subjective support as（17.93±4.62） and support utilization as（6.31±1.96）. Comparison of SSRS scores of caregivers with different marital status，monthly household income status，and understanding of MCI showed statistically significant differences（P<0.05）. Multiple linear regression analysis showed that marital status，relationship with patients，living together，and total PAC scores were the related factors of caregivers' objective support（P<0.05），while the relationship with patients，monthly family income，religious belief，and total PAC scores were factors influencing caregivers' subjective support（P<0.05）. Binary Logistic regression analysis indicated that the relationship with patients and monthly household income，awareness of MCI and total score of positive feelings were the influencing factors of social support of MCI caregivers（P<0.05）. Conclusion The total social support of family caregivers of MCI patients is low，and the distant relationship between patients and caregivers，low monthly household income，low awareness of MCI，and low positive feelings of caregivers are independent influencing factors on the social support of MCI caregivers. Caregivers should be supported in all aspects at the family，social and community levels，thus improving their happiness and also facilitating collaborative community management of MCI.
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