Why did the vivid hand ability of clinical medicine come down

Why did the vivid hand ability of clinical medicine come down
Red high green peak of a pair of the east of the red reporter of staff reporter's king The clinicians of doctor's education can not do the appendicitis operation, the clinicians of the undergraduate course education do not know the vein to puncture, such a situation is not an example. People can't help asking: Will not the present young doctor see the doctor more and more? In the present medical education, has the clinical practice been weakened even ignored? At the time of holding national medical educational reform working conference, the reporter interviews in many ways, attempt to look for the answer to the question. Manipulative ability really has a downward trend To that " present clinical medicine grows the statement that will not see the doctor more and more " ,Medical science department deputy managing director Ke Yang in Peking University has corrected at first. "First of all, it is a studying constantly, ripe course that people must see clearly medical education, this course includes education and life-long education after the school educate, graduate from, so, no school can train and just appear on the school door the doctor that can be guaranteed to cure all ills. But by the look of another aspect, compared with the situation that medical science of the same education in the past is grown, present clinical medicine grows practice ability really there is a downward trend. " Ke Yang says, clinical operative skill, interpersonal communication ability and group's cooperation consciousness, belong to the practice ability category that clinical medicine grows. Guarantee quality and result of the clinical practice involve a great deal of links, among them, offer students abundance, the norm to learn on the job on the length of schooling, practice time is the most important thing. "For example at the the intersection of clinical medicine and 5 course offered of -year system, it requires at least, guarantee time for 2 year use clinical study and clinic of rudimentary knowledge for learn on the job, practise. " Ke Yang says, at present because some schools expand and employ, can't guarantee the undergraduate's clinical practice, on the other hand, grow essential graduation as to medical science, educate, is divided in the educational reform into the various forms, the ones that have presented on the concept are fuzzy. According to the introduction of Ke Yang, at present, clinical medicine of our country educates and is mainly divided into 3 kinds of forms after graduating: Undergraduate course in hospital medicining graduate, standardized training, graduate student professional degree train and long length of schooling anaphase to practise while being clinical. These 3 kinds of forms though like terminal, it is not clear enough to require in the starting point, especially the last two kinds of forms are doing to a resident doctor in the capacity of student, school and tutor grasp differing to clinical practice content and time, this causes under training for service life too, students' clinical practice ability, assessment criteria are different. For example, at present no matter 5 -year system or 8 -year system medical science is grown, train resident's standardization again after graduating, so, some clinical medicines though is carrying " cap " of the doctor while growing ,But there are no too much motive force to carry on the clinical practice in the time at school. In addition, because the present country, to " clinical scientific degree graduate student " With " clinical professional degree graduate student " Cultivation content and method define clearly,so, should persistent for degree graduate students professional in clinical practice in a lot, attack in scientific research and thesis writing directly. An expert states outright especially, though Ministry of Education and Ministry of Public Health grow to 5 -year system, long length of schooling and medical science that the undergraduate course accepts graduate student's professional degree and trains after graduating, provide examination index and syllabus of practice ability. But because policy strong and the intersection of practical operation and aspect pay attention to, these originally overall and standard of system " perform practically no function " . Ke Yang says, the essence of the medical education is the higher vocational education, so the formulation of the policy should regard this as the starting point. "On condition that can not unify the length of schooling of education quickly at present, service life and content that clinical medicine grows training should require in unison at least. " Once the expert such as being new of benefit proposed that Beijing of the Chinese Academy of Medical Sciences coordinated the vice institute's headmaster of medical college, train standardized system and clinical professional degree graduate student to implement the resident at present " The double track is unified " ,Define the cultivation of the clinical professional degree graduate student is that the clinical skill is trained, perhaps ensure clinical medicine to grow practice ability and effective way of the quality. Once benefit was new to still emphasize, settled " the clinical professional degree was trained " well It is the task of top priority to practise students' legal operation identity and examine the entry problem on later stage in graduate student and long length of schooling of clinical medicine. Need " special resources " Ensure " practise the group clinically bigger and bigger, the experimental animal is smaller and smaller ". " An expert describes clinical medicine and grows the awkwardness met in practice so. Medical science department the people of Wang Wei, division chief of education department seem in Peking University, the above-mentioned phenomenon actually contains deeper question, namely the present medical education " Special resources " In short supply. "Cure and study the speciality of clinical medicines of universities and colleges and recruit the students of 2000 3000 every year a little at more present, lead to the fact teaching quality is reduced. " Zeng YiXin says, " take dissection lesson of preclinical medicine as examples, as to a future clinician, it is undoubtedly a foundation in the foundation, however, study the universities and colleges, a dozen people and a corpse in some medicine at present, the student in the inner lane touches it, the student of the outer lane can only look. Watch the teaching video in enlarged class on some clear-cut collectives of universities and colleges, this loses meaning of dissecting the lesson. " Ke Yang says, medical science is to practise science, so, the animal, " (remain) on the whole Teacher " , " standard patient " It is extremely important to wait for the special education resource. However, with the increase that medical science grows in recent years, education funds are limited, these above-mentioned special education resource become " in short supply " . "The patient does not allow looking, students do not like looking. " It is the true portrayal that medical science grows the clinical practice now. With the issue of the relevant medical regulation, consciousness improving and nervous relationship between doctors and patients day by day that the patient safeguards the rights, medical science is grown to seem at a loss as to what to do in the clinical practice. Wang WeiMin says: "Medical science grew and studied the heart sound in the past, it was to hear on patient, a team of students were holding the stethoscope to listen to in turn, the patient cooperates very much. But now, don't mention the intern and want to check the body for the patient, even if a teacher makes the rounds of the wards bringing a team of interns, the patient is very repugnant too, it is unwilling too that medical science is grown ' saddle with a difficult task '. " Ke Yang calls upon, patients should understand the clinician's growth course. "In bring up, teach teacher go on under the strict guidance training process that clinical medicine grow, practice of student can from the easier to the more advanced too in operation, from small to being great to go on, will blindly ' make the experiment with the patient ' never. " The teaching hospital should give play to " The tape is taught " Act on the interview, a lot of experts praise Beijing for coordinating training mode and result of the -year system of medical college clinical medicine 8, but state outright " The higher one enters school in the threshold " , " smaller scale of the student body " And " historical accumulation of a century " Difficult to duplicate. As to this, once benefit was too new to deny. In his view, " coordinate " Medical grow in " Coordinate " In the strong academic atmosphere " Smoked " Come out, this especially embodies in and studies While making and on the cultivation of ability of clinical practice after graduating. "One of the outstanding tradition coordinated is that ' everybody is fond of teaching others ', everybody regards training students as a kind of obligation and responsibility consciously, have already been used to to morbidity mechanism, differential diagnosis and treatment method of disease of intern ' talks about ' around whenever and wherever possible. This growth that is grown to medical science is very favorable, it is a kind of outstanding and effective teaching culture too. " It seems in once benefit newly that such teaching mode, there is certain ideal color, but under the macroscopical environment of market economy, can make money in medical treatment, scientific research can promote the professional title, if there is no support of the system to the enthusiasm of teaching, will inevitablely be influenced, cause it really " Up to standard " Teaching hospital obviously insufficient. Ke Yang speaks without reservation about this: "No matter to educating in the length of schooling, or graduate, educate, the teaching hospital is regarded as ' low reaches ' of the roller chain of the medical education, all the most key position of education. However, the most teaching hospitals nationwide, collect ' medicine is taught and ground ' the large-scale general hospital inclusive at present. The doctor's existence pressure is too big, and the education function of the hospital is put into again insufficiently as the public beneficial task. So, most teaching hospitals just teach the tradition and sense of responsibility to grow and carry on education to medical science according to the tape. Compare other strenuous tasks, the teaching task that has no utility most is unavoidable ' come down '. " In addition at present no matter chief physician, professor, evaluation of professional titles of researcher, and issue the quantity as the rigid examination index with the thesis grade, all these are influencing the teacher to practise the input that ability educated to students more or less. For this reason, Ke Yang proposes, it is the important task of personnel management of each university at present to improve the evaluation of professional titles system, encourage the doctor to put into teaching. Once benefit proposed newly, in a situation that the present national macroscopical policy guidance can't change in short term, check strictly to the teaching hospital that checks on, set up the entry system that clinician's tape taught, teach quality to its work load of teaching and tape appraised objectively, and make it and performance salary and professional title promote the hook, set up good teaching incentive system, perhaps it is an effective settlement measure.

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