Clinical training

临床培训
  • 文章类型: Case Reports
    延长育儿假有时会对日本早期职业精神病医生的专业临床培训产生负面影响。在育儿假期间,呆在家里能够在考场学习会很有用。因此,我们开发了一种使用远程操作机器人(Sota)的培训系统,用于年轻的精神科医生,他们希望在育儿假期间留在家中时参加检查室。
    我们报告了一例自闭症谱系障碍(ASD)与图雷特障碍(P)共病的患者。一位年轻的女精神科医生(D)使用培训系统向董事会认证的精神科医生学习。在这种情况下,委员会认证的精神病医生,P,机器人被放在检查室里。D从家里遥控索塔,允许她与董事会认证的精神科医生和P交谈。她通过观察董事会认证的精神科医生的检查并听到患者的痛苦,了解了Tourette综合征的临床特征。P感到满意的是,他不仅被董事会认证的精神科医生看到,而且还被D看到。
    这些案例发现表明,我们的系统对于希望在育儿假期间在检查室中学习的年轻精神科医生很有帮助。未来的研究应包括一个单病例实验设计,其中包含有关关键结果变量和其他相关变量的信息,随着时间的推移定期收集。
    UNASSIGNED: Childcare leave extensions can sometimes negatively affect the professional clinical training of early-career psychiatrists in Japan. During childcare leave, being able to learn in the examination room while staying at home would be useful. Therefore, we developed a training system using a teleoperated robot (Sota) for young psychiatrists who wanted to participate in the examination room during childcare leave while remaining at home.
    UNASSIGNED: We report the case of a patient with autism spectrum disorder (ASD) comorbid with Tourette\'s disorders (P). A young female psychiatrist (D) used the training system to learn from a board-certified psychiatrist. In this case, the board-certified psychiatrist, P, and the robot were placed in the examination room. D teleoperated Sota from home, allowing her to talk to the board-certified psychiatrist and P. She learned about the clinical features of Tourette\'s syndrome by observing the examination of the board-certified psychiatrist and hearing the patient\'s distress. P was satisfied with the fact that he was seen not only by a board-certified psychiatrist but also by D.
    UNASSIGNED: These case findings suggest that our system is helpful for young psychiatrists who want to study in the examination room during childcare leave while staying at home. Future studies should include a single-case experimental design with information regarding key outcome variables and other relevant variables gathered regularly over time.
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  • 文章类型: Journal Article
    目标:回顾发展和维持太平洋精神卫生劳动力的挑战,以进行未来规划。
    结论:从殖民地精神卫生服务和培训范式中脱颖而出,当代太平洋岛屿国家和领土面临着巨大的劳动力教育和培训挑战,需要与区域情况相关的解决方案。
    OBJECTIVE: To review the challenges to developing and sustaining the Pacific mental health workforce for future planning.
    CONCLUSIONS: Emerging from a colonial mental health service and training paradigm, contemporary Pacific Island Countries and Territories confront significant workforce education and training challenges that require solutions relevant to regional circumstances.
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  • 文章类型: Journal Article
    临床心理学家越来越多地敦促认识和理解社会因素的重要性,如边缘化经历,在他们自己以及他们所服务的个人和社区中。同时,该领域缺乏指导这一追求的研究,尤其是在欧洲背景下。我们进行了一项在线调查(N=646),以评估德国临床心理学家(研究生和受训人员)的社会身份以及他们在治疗和培训中的社会挑战。总的来说,我们的样本在人口统计学上相当同质和特权:临床心理学家倾向于白人(91%),非移民(77.6%),女性(74.5%),顺式性别(93.8%),异性恋(75.4%),健全(56.0%),并在具有学术背景的家庭中长大(68%)。尽管大多数参与者表示倾向于在心理治疗实践中考虑自己的身份,并认为讨论治疗中的社会挑战是相关的,只有一小部分(~5%)报告在治疗期间积极引入相关受试者或在初始病例概念化期间将其考虑在内(~8%).大多数参与者表示,在标准的临床心理学课程中缺乏相关主题的报道。解决这些主题的更大感知能力与临床医生开始讨论治疗中的边缘化或歧视有关。我们探讨了旨在促进公平,有效,以及对多样性敏感的治疗方法。
    Clinical psychologists are increasingly urged to recognize and understand the significance of societal factors such as marginalization experiences, within themselves and among the individuals and communities they serve. At the same time, there is a dearth of research in the field to guide this pursuit, and especially so in European contexts. We conducted an online survey (N = 646) to assess the social identities of clinical psychologists (graduate and trainees) in Germany and their incorporation of societal challenges in therapy and training. Overall, our sample was demographically rather homogenous and privileged: Clinical psychologists tended to be white (91%), nonmigrant (77.6%), female (74.5%), cis-gender (93.8%), heterosexual (75.4%), able-bodied (56.0%), and grew up in families with an academic background (68%). Although the majority of participants expressed a tendency to contemplate their identity when it came to their psychotherapeutic practices and believed that discussing societal challenges in therapy was pertinent, only a small proportion (~5%) reported actively introducing related subjects during therapy sessions or taking them into account during initial case conceptualization (~8%). The majority of participants indicated a lack of coverage of related topics in standard clinical psychological curricula. Greater perceived competence in addressing these topics was linked to clinicians initiating discussions about marginalization or discrimination in therapy. We explore the implications for future training aimed at fostering equitable, effective, and diversity-sensitive therapeutic practices.
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  • 文章类型: Journal Article
    背景:基于工作场所的学习(WBL)是一种将理论知识与实践经验相结合的方法,促进学习者自主性。由于公共和私营部门的临床资源不一致,南非的放射诊断专业学生面临挑战。临床资源不足会对学生的能力和技能信心产生负面影响。本研究探讨了诊断射线照相专业学生对临床资源的理解。
    方法:通过对MicrosoftTeams的一对一半结构化访谈,对南非一所高等教育机构(HEI)的21名参与者进行了定性的探索性描述和上下文研究。数据收集工具是一个采访指南。学生的叙述被转录和分析使用主题分析。
    结果:主题分析揭示了四个主题:主题一:在WBL中定义临床资源;主题二:在WBL中使用临床资源的经验;主题三:在WBL中使用临床资源,主题四:在WBL中定义临床资源。
    结论:临床资源对于射线照相学习至关重要,促进技能发展和独立工作。平衡这些资源与其他活动对于全面的WBL经验至关重要。然而,不平等的机会会阻碍学习。应探索专业成像技术的替代解决方案。在临床实践和HEI之间集成模拟和协作实践可以增强学生对现实世界场景的准备。
    BACKGROUND: Workplace-based learning (WBL) is a method that combines theoretical knowledge with practical experience, promoting learner autonomy. Diagnostic radiography students in South Africa face challenges due to inconsistencies in clinical resources from the public and private sectors. Insufficient clinical resources can negatively impact students\' competence and confidence in their skills. This study explored diagnostic radiography students\' understanding of clinical resources.
    METHODS: A qualitative exploratory-descriptive and contextual study with 21 participants at a single Higher Education institution (HEI) in South Africa was conducted through one-on-one semi-structured interviews on Microsoft Teams. The data collection tool was an interview guide. Students\' narratives were transcribed and analysed using thematic analysis.
    RESULTS: Thematic analysis revealed four themes: Theme one: Defining clinical resources in WBL; Theme two: Experiences with clinical resources in WBL; Theme three: Accessibility of clinical resources in WBL and Theme four: Defining clinical resources in WBL.
    CONCLUSIONS: Clinical resources are essential for radiography learning, promoting skills development and independent work. Balancing these resources with other activities is crucial for a comprehensive WBL experience. However, unequal access can hinder learning. Alternative solutions should be explored for specialised imaging techniques. Integrating simulation and collaborative practice between clinical practices and HEIs can enhance students\' preparedness for real-world scenarios.
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  • 文章类型: Journal Article
    基于模拟的医学教育(SBME)是医学教育中广泛使用的方法。本研究旨在分析各国关于SBME的出版物,机构,期刊,作者,和关键字共现,以及确定SBME研究的趋势。
    我们从WebofScienceCoreCollection(WoSCC)数据库中检索了SBME上的出版物,该出版物从成立到2024年1月27日。MicrosoftExcel2019,CiteSpace,和VOSviewer被用来识别国家的分布,期刊,和作者,以及确定研究热点。
    我们从WoSCC共检索到11272种出版物。2022年发布的文件数量是过去几十年来最高的。美国,英国,和加拿大是这一领域的三个主要贡献者。多伦多大学,斯坦福大学,哈佛医学院是拥有大量出版物的顶级主要机构。Konge,拉斯是最有成效的作家,而McGaghie,威廉·C是被引用次数最高的作者。BMC医学教育在期刊中的出版物数量最多。SBME的基本主题是“病人模拟,\"\"延伸现实,“和”手术技能。\"
    SBME在医学教育中引起了相当大的关注。研究热点逐渐从传统的真人或人体模型模拟转向虚拟,基于数字的模拟和在线教育。将进行进一步的研究以阐明SBME的机制。SBME的使用将更加合理。
    UNASSIGNED: Simulation-based medical education (SBME) is a widely used method in medical education. This study aims to analyze publications on SBME in terms of countries, institutions, journals, authors, and keyword co-occurrence, as well as to identify trends in SBME research.
    UNASSIGNED: We retrieved the Publications on SBME from the Web of Science Core Collection (WoSCC) database from its inception to January 27, 2024. Microsoft Excel 2019, CiteSpace, and VOSviewer were used to identify the distribution of countries, journals, and authors, as well as to determine the research hotspots.
    UNASSIGNED: We retrieved a total of 11272 publications from WoSCC. The number of documents published in 2022 was the highest in the last few decades. The USA, the UK, and Canada were three key contributors to this field. The University of Toronto, Stanford University, and Harvard Medical School were the top major institutions with a larger number of publications. Konge, Lars was the most productive author, while McGaghie, William C was the highest cited author. BMC Medical Education has the highest number of publications among journals. The foundational themes of SBME are \"Patient simulation,\" \"extending reality,\" and \"surgical skills.\"
    UNASSIGNED: SBME has attracted considerable attention in medical education. The research hotspot is gradually shifting from traditional simulations with real people or mannequins to virtual, digitally-based simulations and online education. Further studies will be conducted to elucidate the mechanisms of SBME. The utilization of SBME will be more rationalized.
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  • 文章类型: Historical Article
    本简介概述了本期特刊,以纪念JeremyD.Safran的工作和遗产。出生于杰里米·赛峰纪念会议,4月2日,2023年,这个问题有来自该领域领导者的广泛贡献,以前的学生,和早期职业专业人士,他们的工作从事并发展了赛峰的工作的核心思想,并反映了他对自己的临床工作和奖学金的影响。主题围绕赛峰的主要贡献的三个领域:教育学;心理治疗整合;和佛教,灵性,和精神分析。我们在贡献中观察到与我们的朋友和同事的深层关系承诺的经验重新联系。
    This introduction provides an overview to this special issue honoring the work and legacy of Jeremy D. Safran. Born of the Jeremy Safran Memorial Conference, held on April 2nd, 2023, this issue features a wide range of contributions from leaders in the field, former students, and early career professionals whose work engages and develops central ideas from Safran\'s work and reflects on his impact on their own clinical work and scholarship. Themes center around the three domains of Safran\'s major contributions: pedagogy; psychotherapy integration; and Buddhism, spirituality, and psychoanalysis. We observe among the contributions an experiential reconnecting with the deeply relational commitments of our friend and colleague.
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  • 文章类型: Journal Article
    在本文中,我们介绍了基于研究的跨理论治疗和训练模型(4TM)的概念背景和临床意义.
    该模型实现了心理治疗结果的发现,process,并将研究反馈到对未来研究开放的临床和培训框架中。
    该框架基于针对患者行为过程的干预措施,认知,情感,动机,人际关系,和系统/社会文化水平。4TM还包括一个基于数据的决策支持和反馈系统,称为特里尔治疗导航器(TTN)。
    我们仅基于一种思想流派来讨论与临床取向相关的重要问题。然后,我们将这些担忧与包含正在进行的研究的临床和培训框架进行对比,作为基于过程的跨理论干预的指导结构。这种基于研究的心理治疗可以考虑传统和新颖的临床发展以及心理治疗研究的发现,并适应性地传播到各种患者人群。
    UNASSIGNED: In this paper, we present the conceptual background and clinical implications of a research-based transtheoretical treatment and training model (4TM).
    UNASSIGNED: The model implements findings from psychotherapy outcome, process, and feedback research into a clinical and training framework that is open to future research.
    UNASSIGNED: The framework is based on interventions targeting patient processes on a behavioral, cognitive, emotional, motivational, interpersonal, and systemic/socio-cultural level. The 4TM also includes a data-based decision support and feedback system called the Trier Treatment Navigator (TTN).
    UNASSIGNED: We discuss important problems associated with clinical orientations solely based on one school of thought. We then contrast these concerns with a clinical and training framework that embraces ongoing research, serving as a guiding structure for process-based transtheoretical interventions. Such research-based psychological therapy can take both traditional and novel clinical developments as well as findings from psychotherapy research into account and be adaptively disseminated to a variety of patient populations.
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  • 文章类型: Journal Article
    临床培训在护理专业学生获得专业能力方面起着基础性作用。本研究旨在探讨护理专业学生在临床培训中面临的感知挑战。采用探索性横断面研究。一个比例,分层,随机抽样纳入了具有包容性标准的研究,包括护理学生(2-4年)和在地区医院实习的实习生。使用经过验证的电子问卷进行数据收集,由三个部分和29个项目组成。该部分重点介绍了护理专业学生在实践培训中遇到的困难,包括六个要素:教师,医疗保健专业人员,学生自己,任务,时间管理,以及培训的地点。另一部分询问了学生对临床培训好处的看法。应用了三点“李克特量表”。调查结果表明,轻度(24%),中等(62%),研究参与者感知到严重(14%)程度的挑战.临床培训期间总挑战的平均得分为2.00±0.28,并且等级之间的感知挑战存在差异。总之,在不同年级的临床培训期间,感知到的挑战存在差异。这些挑战与教师有关,卫生工作者,学生们,任务,时间,还有那个地方.建议加强护理课程与实践培训目标的一致性,注重在适当的指导下发展技术和人际交往能力,以及积极的临床设置,以帮助护理学生学习并增强他们对方法的信心。
    Clinical training plays a fundamental role in nursing students\' acquisition of professional capabilities. This study aimed to explore the perceived challenges nursing students face during clinical training. An explorative cross-sectional study was applied. A proportionate, stratified, random sample was enrolled in the study with inclusive criteria, including nursing students (2nd - 4th year) and interns who attended their internship in regional hospitals. A validated electronic questionnaire was used for data collection, which consisted of three sections and 29 items. The section that focused on the difficulties experienced by nursing students during their practical training included six elements: teachers, healthcare professionals, the students themselves, tasks, time management, and the location of the training. Another section inquired about the students\' perspectives on the benefits of clinical training. A three-point \"Likert scale\" was applied. The findings indicated that mild (24%), moderate (62%), and severe (14%) degree of challenges were perceived by the study participants. The mean score for the total challenges during clinical training was 2.00 ± 0.28, and there were variations in the perceived challenges among grade levels. In conclusion, there are variations in the perceived challenges during clinical training among different grade levels. These challenges were related to teachers, health workers, the students, tasks, the time, and the place. Enhancing the nursing curricula alignment with practical training objectives is recommended, focusing on the development of technical and interpersonal skills with appropriate guidance, alongside positive clinical settings to help nursing students learn and boost their confidence in their approach.
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  • 文章类型: Journal Article
    对数字健康的持续需求要求提供者调整思维过程,以在数字环境中实现合理的临床决策。提供商报告说,缺乏培训是提供数字医疗保健的障碍。体检技术和动手干预措施必须在安全、可靠,以及提供数字护理的可行方法,和决策可能会受到对这些技术的修改的影响。我们提出了一个框架,以确定是否可以修改程序以在数字环境中获得可比的结果,或者是否需要转诊到现场护理。该决策框架是使用数字物理治疗平台的计划结果开发的,旨在减轻提供者可能经历的提供数字护理的障碍。本文介绍了提供者在收集背景信息时必须考虑的独特因素,选择和执行程序,评估结果,并确定他们是否可以在数字环境中进行临床护理。
    UNASSIGNED: The continued demand for digital health requires that providers adapt thought processes to enable sound clinical decision-making in digital settings. Providers report that lack of training is a barrier to providing digital health care. Physical examination techniques and hands-on interventions must be adjusted in safe, reliable, and feasible ways to provide digital care, and decision-making may be impacted by modifications made to these techniques. We have proposed a framework to determine whether a procedure can be modified to obtain a comparable result in a digital environment or whether a referral to in-person care is required. The decision-making framework was developed using program outcomes of a digital physical therapy platform and aims to alleviate barriers to delivering digital care that providers may experience. This paper describes the unique considerations a provider must make when collecting background information, selecting and executing procedures, assessing results, and determining whether they can proceed with clinical care in digital settings.
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  • 文章类型: Journal Article
    背景:2021年,南非引入了为期6个月的家庭医学和初级保健新实习。这项研究旨在评估西开普省地区医疗机构的新轮换。
    方法:对实习生和主管的描述性调查,作为探索性序贯混合方法研究的第二阶段。问卷是从描述性探索性定性研究中得出的。使用社会科学统计软件包对数据进行了分析。
    结果:问卷调查由72名实习生(回复率21%)和36名主管(回复率90%)完成,10个培训项目。实习生感到更加独立(97.2%),自信(90.3%)和弹性(91.6%)。他们学会了管理未分化和慢性疾病(91.6%),转诊患者(94.3%)和进行手术(77.8%)。大多数实习生没有接受社区服务(68.0%)和连续性护理(54.1%)。白天(79.1%)和下班后(80.6%)的监督大多足够。许多实习生报告没有结构化的教学计划(41.7%-55.6%)。大多数监督来自医务人员和注册人员。主管将实习生视为临床团队的宝贵成员(100.0%),他们需要额外的支持和管理(42.5%)。大多数实习生(75.0%)和主管(72.7%)认为轮换是正确的时间,也是社区服务的最佳准备(67.6%)。
    结论:轮换符合南非卫生职业委员会的大多数期望。方案需要改善对面向社区的初级保健的接触,公共卫生医学,姑息治疗和持续治疗。实习生的监督和定位需要改进。供稿:这是对南非新的家庭医学实习方案的首次评价。
    BACKGROUND:  In 2021, South Africa introduced a new 6-month internship in family medicine and primary care. This study aimed to assess the new rotation at district health facilities in the Western Cape.
    METHODS:  A descriptive survey of interns and supervisors, as phase-two of an exploratory sequential mixed methods study. Questionnaires were developed from a descriptive exploratory qualitative study. Data were analysed with the Statistical Package for Social Sciences.
    RESULTS:  Questionnaires were completed by 72 interns (response rate 21%) and 36 supervisors (response rate 90%), across 10 training programmes. Interns felt more independent (97.2%), confident (90.3%) and resilient (91.6%). They learnt to manage undifferentiated and chronic conditions (91.6%), to refer patients (94.3%) and conduct procedures (77.8%). Most interns were not exposed to community-based services (68.0%) and continuity of care (54.1%). Supervision was mostly adequate during the day (79.1%) and afterhours (80.6%). Many interns reported no structured teaching programme (41.7% - 55.6%). Most supervision was from medical officers and registrars. Supervisors saw interns as valuable members of the clinical team (100.0%), who required extra support and administration (42.5%). The majority of interns (75.0%) and supervisors (72.7%) thought the rotation was the right length and the best preparation for community service (67.6%).
    CONCLUSIONS:  The rotation met most expectations of the Health Professions Council of South Africa. Programmes need to improve exposure to community-orientated primary care, public health medicine, palliative and ongoing care. Supervision and orientation of interns needs improvement.Contribution: This is the first evaluation of the new family medicine internship programme in South Africa.
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