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Risk factors for cessation of viral RNA shedding in COVID-19 patients 新冠肺炎患者停止病毒RNA脱落的危险因素
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_87_21
P. Dhikale, S. Chavhan, B. Adsul, Chinmay N. Gokhale, Aniket R. Ingale, K. Kinge
Objectives: Our study aimed to evaluate the risk factors for the cessation of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) RNA detection in a cohort of inpatients of laboratory-confirmed coronavirus disease 2019 (COVID-19) cases. Materials and Methods: This was a hospital-based, cross-sectional study. All COVID-19 patients positive on the reverse transcription polymerase chain reaction (RTPCR) test of nasopharyngeal samples who were admitted in this Dedicated COVID Hospital (DCH) from April to June 2020 were included in this study. The deceased patients were excluded.Cessation of Viral RNA Shedding (CVS) was considered to have been achieved on the date of the first negative SARS-CoV-2 RTPCR result out of the two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs taken 24 h apart. Results: Of the 4632 COVID-19 patients, 3307 (71.4%) patients achieved CVS. Patients had a median (IQR) time from positive to negative PCR of 16 (11–23) days. In multivariate cox regression analysis, age group 41 − 60 years (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.63–0.91), age >60 years (HR [CI] = 0.63 [0.53–0.78]), female sex (HR [CI] = 1.08 [1.01-1.16]), cancer (HR [CI] = 1.87 [1.03–3.41]) were the independent risk factors for cessation of viral shedding. Conclusion: Patients older than 40 years, male patients were shedding viral RNA for more duration and can be considered for the isolation for a longer duration.
目的:我们的研究旨在评估实验室确诊的2019年冠状病毒病(新冠肺炎)住院患者中停止严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)RNA检测的风险因素。材料和方法:这是一项基于医院的横断面研究。本研究包括2020年4月至6月入住该新冠肺炎专科医院(DCH)的所有鼻咽样本逆转录聚合酶链式反应(RTPCR)检测呈阳性的新冠肺炎患者。死者被排除在外。在间隔24小时采集的鼻咽拭子上,连续两次严重急性呼吸系统综合征冠状病毒2型聚合酶链式反应阴性结果中,病毒核糖核酸脱落(CVS)被认为是在第一次严重急性呼吸道综合征冠状病毒二型RTPCR阴性结果之日实现的。结果:在4632名新冠肺炎患者中,3307名(71.4%)患者实现了CVS。患者从阳性到阴性PCR的中位(IQR)时间为16(11-23)天。在多变量cox回归分析中,41−60岁年龄组(危险比[HR],0.76;95%置信区间[CI],0.63–0.91)、60岁以上年龄组(HR[CI]=0.63[0.53–0.78])、女性(HR[CIC]=1.08[1.01-1.16])、癌症(HR[C]=1.87[1.03–3.41])是停止病毒脱落的独立风险因素。结论:40岁以上的患者,男性患者脱落病毒RNA的时间更长,可以考虑更长时间的隔离。
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引用次数: 0
Serum lactate levels in critically Ill patients: An early marker to be targeted 危重病人血清乳酸水平:一个早期的指标
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_113_22
Ruchi Kabra, S. Acharya, S. Sushanth Kumar
Hyperlactatemia (excess blood lactate) is common in severely unwell individuals. Although lactate levels are routinely used to indicate insufficient tissue oxygenation, they can also be elevated by mechanisms unrelated to tissue oxygenation. Increased glycolysis may be a major cause of hyperlactatemia, especially in critically sick individuals. Despite this, elevated lactate levels have serious consequences for the morbidity and mortality of hyperlactatemia individuals. Despite the widespread use of the phrase lactic acidosis, a substantial link between lactate and pH appears only at higher lactate levels. As a result, the phrase lactate-related acidosis is more suitable. In early resuscitation, two recent studies have emphasized the necessity of monitoring lactate levels and adjusting treatment to changes in lactate levels. Structured lactate measures should be included in resuscitation protocols since lactate levels may be assessed quickly at the bedside from a variety of sources.
高乳血症(血乳酸过多)在严重不适的个体中很常见。尽管乳酸水平通常用于表示组织氧合不足,但也可以通过与组织氧合无关的机制升高。糖酵解增加可能是高乳血症的主要原因,尤其是在危重患者中。尽管如此,乳酸水平升高对高乳血症患者的发病率和死亡率有严重影响。尽管乳酸酸中毒这个短语被广泛使用,但只有在较高的乳酸水平下,乳酸和pH之间才会出现实质性的联系。因此,乳酸相关酸中毒这个词更合适。在早期复苏中,最近的两项研究强调了监测乳酸水平和根据乳酸水平变化调整治疗的必要性。结构性乳酸盐测量应包括在复苏方案中,因为乳酸盐水平可以在床边从各种来源快速评估。
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引用次数: 1
Iron and zinc deficiency in children with febrile convulsions aged 6‒60 months ‒ A 1-year hospital-based case‒control study 6至60个月热性惊厥患儿铁锌缺乏症——一项为期1年的医院病例对照研究
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_83_21
Jyothirmai Mallela, Tanmaya Metgud, M. Kamate, Deepti M. Kadeangadi
Context: Febrile seizures are one of the most common seizures in childhood. Febrile seizures occur in 2%–5% of children who are younger than 5 years of age. Studies have shown that iron, zinc, selenium, copper, and magnesium play a significant role in febrile seizures. This study was intended to study the relationship between iron and zinc deficiency with febrile seizures. Aim: To find the association of febrile convulsions with iron and zinc deficiency. Methodology: This hospital-based case‒control study was done in a tertiary care center in North Karnataka from January 2017 to December 2017. A total of 52 children fulfilling the inclusion criteria were included in case group. Control group contained 52 children who had fever without convulsions and matched for age, sex, and background disease with respective cases. Results: Both the groups were matched for age and gender. Majority of the children (76.92%) had a simple seizure. Cases had lower serum (Sr.) ferritin levels compared to controls with high odds ratio (OR) (25% vs. 1.92%; P < 0.001; OR = 17.00; P = 0.0075). Furthermore, cases had zinc deficiency compared to controls (84.62% vs. 25%; OR = 12.269; P < 0.001). The mean Sr. zinc levels (37.16 ± 22.07 vs. 75.75 ± 15.25 μg/dL; P < 0.001) were significantly low in cases. Conclusion and Interpretation: There was a significant association between febrile seizures with iron and zinc deficiency.
背景:发热性癫痫发作是儿童期最常见的癫痫发作之一。2%至5%的5岁以下儿童会出现发热性癫痫。研究表明,铁、锌、硒、铜和镁在高热惊厥中起着重要作用。本研究旨在研究铁锌缺乏与高热惊厥的关系。目的:探讨高热惊厥与铁锌缺乏的关系。方法:这项基于医院的病例对照研究于2017年1月至2017年12月在北卡纳塔克邦的一家三级护理中心进行。共有52名符合纳入标准的儿童被纳入病例组。对照组包括52名发烧无抽搐的儿童,他们的年龄、性别和背景疾病与各自的病例相匹配。结果:两组患者的年龄和性别匹配。大多数儿童(76.92%)有单纯的癫痫发作。与高比值比(OR)的对照组相比,病例的血清(Sr.)铁蛋白水平较低(25%对1.92%;P<0.001;OR=17.00;P=0.0075)。此外,病例的锌缺乏与对照组相比(84.62%对25%;OR=12.269;P<001)。例的平均Sr.锌水平(37.16±22.07对75.75±15.25μg/dL;P<0.01)显著较低。结论与解释:高热惊厥与铁锌缺乏之间存在显著的相关性。
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引用次数: 0
Efficiency of matrix rhythm therapy on pain, strength, and quality of life in forward neck posture: A randomized controlled trial 矩阵节律疗法对前颈姿势疼痛、力量和生活质量的疗效:一项随机对照试验
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_102_22
V. Naik, Mayuri Kerkar, Sazney Mascarenhas
Objective: To determine and compare the effects of the Dynamic Exercise Program (DEP) and matrix rhythm therapy (MaRhyThe©) along with conventional physiotherapy in asymptomatic subjects with forward head posture (FHP) on a craniovertebral angle (CVA), strength, pain, and quality of life (QoL) using CVA, pressure biofeedback unit, pain algometer, and short form (SF-36), respectively. Methodology: Sixty-five people were screened for the study, of which 30 were included (18 females and 12 males) who participated in the study. The study participants were randomly allocated to Group A (DEP) or Group B (MaRhyThe©). Preintervention outcome measures used were CVA for the neck position, a craniocervical flexion endurance test for strength, a pain algometer for pain pressure threshold, and SF-36 for QoL. Postintervention outcome measures were recorded on the 6th day after intervention. Results: Data were analyzed descriptively with a priori establishment of success criteria of P < 0.05. Within-group analysis of both groups demonstrated statistically significant parameters of CVA, strength, and pain as P < 0.05. Between groups analysis demonstrated Group B to be statistically significant in all the outcome measures CVA (P < 0.0001), strength (P < 0.0001), and pain (P < 0.0001). SF-36 showed a positive effect on some subdomains as to emotional well-being (0.0320) and pain (0.0047*). Conclusion: It was determined that both deep exercise programs and MaRhyThe© when combined with conventional physiotherapy are effective in treating FHP. However, MaRhyThe© with conventional physiotherapy was found to be superior in reducing pain and improving range of motion, strength, and QoL.
目的:确定并比较动态运动计划(DEP)和矩阵节律疗法(MaRhyThe©)以及常规物理疗法对无症状前头姿势(FHP)受试者颅椎角(CVA)、力量、疼痛和生活质量(QoL)的影响,分别使用CVA、压力生物反馈单元、疼痛测量仪和短表(SF-36)。方法:65人被筛选为研究对象,其中30人(18名女性和12名男性)参与了研究。研究参与者被随机分为A组(DEP)和B组(MaRhyThe©)。使用的干预前结果测量是颈部位置的CVA,强度的颅颈屈曲耐力测试,痛压阈值的疼痛测量仪和生活质量的SF-36。干预后结果测量于干预后第6天记录。结果:对数据进行描述性分析,先验建立成功标准P < 0.05。组内分析两组CVA、力量、疼痛参数均有统计学意义,P < 0.05。组间分析显示,B组在CVA (P < 0.0001)、强度(P < 0.0001)和疼痛(P < 0.0001)的所有结局指标上均具有统计学意义。SF-36对情绪幸福感(0.0320 *)和疼痛感(0.0047*)有正向影响。结论:深度运动方案和MaRhyThe©联合常规理疗对FHP均有较好的治疗效果。然而,采用常规物理疗法的MaRhyThe©在减轻疼痛、改善活动范围、力量和生活质量方面表现优异。
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引用次数: 0
Evaluation of insulin resistance and beta-cell dysfunctions in newly diagnosed polycystic ovarian syndrome patients 新诊断多囊卵巢综合征患者胰岛素抵抗和β细胞功能障碍的评估
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_4_21
Vikrant Ghatnatti, S. Patil, H. Kour
Introduction: Women with polycystic ovary syndrome (PCOS) are at increased risk of developing glucose intolerance and diabetes attributed to increased insulin resistance (IR). However, it is not clear whether β-cell dysfunction has a central role in pathogenesis. The distinction has important implications for the prevention of type 2 diabetes in PCOS with interventions that ameliorate IR. This study aimed to find if IR differs among the various phenotypes of PCOS and perform a quantitative estimation of β-cell dysfunction versus IR in patients of PCOS participants. Materials and Methods: This case–control study was conducted for 1 year in the Endocrinology and Gynaecology outpatient departments at Gauhati Medical College. Fifty women newly diagnosed with PCOS, as per the Rotterdam criteria, were considered cases. Fifty, age- and body mass index-matched healthy females were taken as controls. Fasting and postprandial blood glucose, serum insulin, testosterone, and oral glucose tolerance test values were taken. Impaired fasting glucose, impaired glucose tolerance (IGT), and type 2 diabetes mellitus T2DM were diagnosed according to ADA 2011 criteria. IR and β-cell function were determined by “homeostasis model assessment (HOMA)”. Results: We observed an altered relationship between IR and insulin secretion, consistent with an intrinsic β-cell defect, wherein IR led to a decreased amount of compensatory insulin secretion in PCOS compared with normal women. The correlation coefficients relating HOMA%B to HOMA-IR were lower in PCOS, indicating less compensatory insulin secretion for a given increment in IR. Conclusion: PCOS patients are at increased risk of developing glucose intolerance and diabetes.
引言:患有多囊卵巢综合征(PCOS)的女性因胰岛素抵抗(IR)增加而患葡萄糖不耐受和糖尿病的风险增加。然而,目前尚不清楚β细胞功能障碍是否在发病机制中发挥核心作用。这一区别对通过改善IR的干预措施预防多囊卵巢综合征患者的2型糖尿病具有重要意义。本研究旨在发现不同表型的多囊卵巢综合症患者的IR是否不同,并对多囊卵巢综合病患者的β细胞功能障碍与IR进行定量评估。材料和方法:本病例对照研究在高哈提医学院内分泌和妇科门诊进行,为期1年。根据鹿特丹标准,50名新诊断为多囊卵巢综合征的女性被视为病例。50,年龄和体重指数匹配的健康女性作为对照。取空腹和餐后血糖、血清胰岛素、睾酮和口服葡萄糖耐量测试值。根据ADA 2011标准诊断为空腹血糖受损、糖耐量受损(IGT)和2型糖尿病T2DM。通过“稳态模型评估(HOMA)”测定IR和β细胞功能。结果:我们观察到IR和胰岛素分泌之间的关系发生了改变,这与固有的β细胞缺陷一致,其中与正常女性相比,IR导致PCOS患者的补偿性胰岛素分泌量减少。PCOS患者HOMA%B与HOMA-IR的相关系数较低,表明IR增加时胰岛素代偿性分泌减少。结论:PCOS患者发生葡萄糖不耐受和糖尿病的风险增加。
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引用次数: 0
Association of SNP rs163550 in IL5RA Gene with Risk of Preeclampsia IL5RA基因SNP rs163550与子痫前期风险的关联
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_70_22
Nagarjuna Sivaraj, K. Rachel., T. Suvvari, Shilaja Prasad, Sriharsha Boppana, Vineetha Naidu, P. Vegi, Youssef Aboufandi, L. S. Simhachalam Kutikuppala
Background: Several research have looked at the significance of SNPs in inflammatory mediator genes and their link to preeclamptic pregnancies, but the results have not been conclusive enough to explain why SNPs in inflammatory mediator genes may increase the risk of preeclampsia. The goal of this study is to analyze the IL5RA SNPs in order to learn more about the possible link between preeclampsia and inflammatory genes. Materials and Methods: A total of 304 pregnant participants were a part of this prospective observational case-control study, out of which 152 had preeclampsia, and the other 152 participants had normotensive pregnancies. The “polymerase chain reaction-restriction fragment length polymorphism” method was used to genotype SNP rs163550. Results: The commonness of the IL5RA rs163550G allele has been linked to an increased risk for preeclampsia with P value: 0.0230 and odds ratio: 0.6818 (95% confidence interval: 0.489–0.9505). Conclusion: A prominent association among the IL5RA rs163550 SNP and preeclampsia in comparison to nonpreeclampsia has been observed in the study. The study stands first to report IL5RA Polymorphism association with the pathogenesis of preeclampsia's among the Indian population.
背景:一些研究已经研究了炎症介质基因中snp的重要性及其与子痫前期妊娠的联系,但结果还不足以解释为什么炎症介质基因中的snp可能增加子痫前期的风险。本研究的目的是分析IL5RA snp,以便更多地了解子痫前期和炎症基因之间的可能联系。材料与方法:本前瞻性观察性病例对照研究共纳入304例孕妇,其中152例为先兆子痫,152例为正常妊娠。采用“聚合酶链反应-限制性片段长度多态性”方法对SNP rs163550进行基因型分析。结果:IL5RA rs163550G等位基因的常见性与子痫前期风险增加相关,P值为0.0230,优势比为0.6818(95%可信区间为0.489-0.9505)。结论:与非子痫前期相比,本研究观察到IL5RA rs163550 SNP与子痫前期存在显著关联。该研究首次报道了IL5RA多态性与印度人群子痫前期发病机制的关联。
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引用次数: 0
Strengthening the process of implementation of coaching in medical education settings 加强医学教育环境中辅导的实施过程
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_55_21
S. Shrivastava, P. Shrivastava
The branch of medicine is quite complex and it requires a wide range of teaching–learning innovations, student support activities, and faculty motivation to ensure that the goals of medical education are accomplished. The purpose of the current review is to explore the role of coaching in improving the learning and skill acquisition in the field of medical education. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 22 articles were selected based on the suitability with the current review objectives. The ultimate aim of coaching in medical education is to unearth the real potential of the students to optimize their performance by helping them to learn instead of teaching them. Coaching is a strategy to help medical students to become competent and reflective practitioner. In addition, coaching plays an important role in the refinement of technical skills (like surgical skills) and nontechnical skills. To conclude, coaching in medical education has significant scope to improve the learning outcomes among students and even make them lifelong learners. The need of the hour is to implement a coaching system in each of the medical colleges after considering the local logistics and with the active support of faculty members.
医学的分支相当复杂,需要广泛的教学创新、学生支持活动和教师激励,以确保实现医学教育的目标。本综述的目的是探讨教练在提高医学教育领域的学习和技能获取方面的作用。在PubMed搜索引擎中对与该主题相关的所有材料进行了广泛搜索,根据与当前审查目标的适用性,共选择了22篇文章。医学教育指导的最终目的是挖掘学生的真正潜力,通过帮助他们学习而不是教学来优化他们的表现。辅导是一种帮助医学生成为有能力和有反思能力的从业者的策略。此外,教练在提高技术技能(如手术技能)和非技术技能方面发挥着重要作用。总之,医学教育中的辅导对提高学生的学习成绩,甚至使他们成为终身学习者具有重要意义。现在的需要是在考虑到当地后勤并得到教职员工积极支持后,在每个医学院实施教练制度。
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引用次数: 0
Role of proprioceptive neuromuscular facilitation exercises in post-COVID individuals: A randomized-control trial 本体感觉神经肌肉促进训练在新冠肺炎患者中的作用:一项随机对照试验
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_73_22
Divya Gohil, Merin Shaji, Gaurang D. Baxi, T. Palekar
Background: Pulmonary function, fatigue, and chest mobility are three important parameters which are impaired after COVID-19. Manual stretching procedures have the potential to improve pulmonary function, reduce fatigue, and improve chest mobility. However, evidence regarding their effectiveness in post-COVID-19 population remains unknown. This study explores the effectiveness of two different types of stretching techniques on pulmonary function, fatigue, and chest expansion in post-COVID-19 population. Materials and Methodology: Forty post-COVID-19 patients with mild and moderate impairment were divided into two groups (20 each). Group A received hold relax proprioceptive neuromuscular facilitation (PNF) pectoral stretching while Group B received chest mobility exercises for 20 min each for 7 sessions. The outcomes measures were pulmonary function test, fatigue, and chest expansion. Results: Significant within-group differences for all outcome measures were seen at the end of intervention. Between-group analysis showed a significant statistical difference in few parameters of pulmonary function testing and chest expansion in Group A than Group B. However, no statistical significance on Fatigue after the 7 sessions of intervention. Conclusions: In COVID-19 survivors with mild and moderate impairment, hold relax PNF stretching than chest mobility exercises has a significant effect on improving pulmonary function, reducing fatigue, and improving chest expansion.
背景:肺功能、疲劳和胸部活动能力是新冠肺炎后受损的三个重要参数。手动拉伸手术有可能改善肺功能,减少疲劳,提高胸部活动能力。然而,关于它们在新冠肺炎后人群中的有效性的证据仍然未知。本研究探讨了两种不同类型的拉伸技术对COVID-19后人群肺功能、疲劳和扩胸的有效性。材料和方法:将40名患有轻度和中度功能障碍的COVID-19后患者分为两组(每组20人)。A组接受保持-放松本体感觉神经肌肉促进(PNF)胸肌拉伸,而B组接受胸部活动训练,每次20分钟,共7次。结果指标为肺功能测试、疲劳和胸部扩张。结果:在干预结束时,所有结果指标的组内差异显著。组间分析显示,a组在肺功能测试和胸部扩张的几个参数上与B组相比有显著的统计学差异。然而,干预7个疗程后,疲劳没有统计学意义。结论:在新冠肺炎轻中度损伤幸存者中,保持放松PNF拉伸比胸部活动训练对改善肺功能、减少疲劳和改善胸部扩张有显著作用。
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引用次数: 0
Health science exhibition as a tool for health awareness among schoolchildren and the general public 健康科学展览作为提高学童和公众健康意识的工具
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_285_22
Vishwanath M. Pattanshetti
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引用次数: 0
Advocating active and meaningful involvement of patients in the delivery of medical education 提倡病人积极而有意义地参与医学教育
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-09-01 DOI: 10.4103/jss.jss_80_21
S. Shrivastava, P. Shrivastava
The onus of knowledge acquisition and learning has demonstrated a paradigm shift in the field of medical education. The present review has been carried out to explore and understand the role of patient involvement in the training of medical students. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 26 articles were selected based on the suitability with the current review objectives. The involvement of patients in medical education has been linked with a wide range of proven benefits and learning progression. The patients can discharge multiple roles, namely a teacher, developing curriculum, assessor, and someone who can select students for the course. The role of actively involving patients in the teaching process is bound to have some challenges and barriers considering the different aspects in heterogeneous settings. The ideal approach to involve patients in medical education has to start with sensitizing the faculty members and the medical students about the benefits that can be derived out of such clinical interactions. The successful implementation will essentially require adequate resource support and faculty involvement. To conclude, the patient involvement in medical training is not a new practice, but the ground reality is that we are falling short to optimize the benefits of the overall practice. The need of the hour is to adopt a systematic approach and structure the overall program, so that we can derive tangible benefits out of the same and prepare the future generation of doctors in the delivery of patient-centered care.
知识获取和学习的责任已经证明了医学教育领域的范式转变。本综述旨在探索和理解患者参与在医学生培训中的作用。在PubMed搜索引擎中对与该主题相关的所有材料进行了广泛搜索,根据与当前审查目标的适用性,共选择了26篇文章。患者参与医学教育与广泛的已证实的益处和学习进展有关。患者可以扮演多种角色,即教师、开发课程、评估员和可以为课程挑选学生的人。考虑到异质环境中的不同方面,积极让患者参与教学过程必然会遇到一些挑战和障碍。让患者参与医学教育的理想方法必须首先让教职员工和医学生意识到这种临床互动可以带来的好处。成功实施基本上需要充足的资源支持和教师的参与。总之,患者参与医疗培训并不是一种新的实践,但实际情况是,我们未能优化整体实践的效益。现在的需要是采用系统的方法并构建整体计划,这样我们就可以从中获得切实的好处,并为未来一代医生提供以患者为中心的护理做好准备。
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引用次数: 0
期刊
Journal of the Scientific Society
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