Objective To explore the teaching ability of the neurology refresher doctors by case teaching method combined with flipped classroom teaching mode. Methods The refresher doctors who were studying in the infection group of Department of Neurology, Xuanwu Hospital Capital Medical University between March 2019 and September 2020 were selected. According to the time of admission, the enrolled refresher doctors were divided into control group (grade 2019) and observation group (grade 2020). The control group adopted the traditional teaching mode, and the observation group adopted the case teaching method combined with the flipped classroom teaching mode. A self-designed questionnaire was used to compare the teaching ability of the two groups of refresher doctors. Results A total of 44 refresher doctors were included. Among them, there were 24 refresher doctors in the control group and 20 refresher doctors in the observation group. The self-evaluation of the teaching ability of the two groups of refresher doctors and the evaluation of their teaching ability by the teachers showed that, except for the item “enthusiasm for teaching and willingness to spend enough time to participate in the evaluation of teaching work” of humanistic quality (P>0.05), the observation group was better than the control group in professional knowledge, teaching ability, teaching methods and humanistic quality (P<0.05). Conclusions Through the case teaching method combined with flipped classroom teaching mode, the teaching ability of refresher doctors can be cultivated, which is helpful for training more high-quality doctors for the country and promoting the sustainable and coordinated development of medical education. However, the awareness and enthusiasm of the refresher doctors to teaching work need to be improved.
ObjectiveTo briefly describe the specific contents of the “four-dimensional integration” standardized training model for neurology residents and analyze the implementation effects.MethodsSince September 2019, the Standard Training Center for Residents in Department of Neurology, Xuanwu Hospital of Capital Medical University trained residents under “four-dimensional integration” standardized training model, including primary knowledge teaching, basic skill training, clinical thinking training, and student group learning. The effect of the “four-dimensional integration” model was measured by comparing the midterm assessment results after four months of training of the resident trainees in Grade 2019 under the “four-dimensional integration” training mode (n=37) with those of the resident trainees in Grade 2018 under regular training mode (n=32). The midterm assessment was conducted through standardized and objective clinical examinations, including three evaluations (theory, skills, and clinical drills), and the pass rate of tests was evaluated through Fisher’s exact probability method for comparison between training groups.ResultsThere was no significant difference in the pass rate of theoretical assessment (100.0% vs. 96.9%, P=0.464) or the pass rate of Mini-Clinical Evaluation Exercise (100.0% vs. 90.6%, P=0.095) between the two groups. The pass rate of skill assessment in Grade 2019 was significantly higher than that of the students in Grade 2018 (94.6% vs. 71.9%, P=0.018).ConclusionThe “four-dimensional integration” standardized training model for neurology residents and it effect are worthy of recognition, which can provide a reference for medical teaching, especially for the standardized training of resident physicians.
The core idea of comparative effectiveness research (CER) refers to "study in the real-world" which can be considered as the extension of evidence-based medicine. So far CER has arouse wide concern. CER includes many intervention trials and observational studies, including systematic reviews/meta-analyses, effectiveness randomized controlled trials, and registry trials. Database is an important platform for CER. CER has better feasibility and can provide useful evidence for "real-world" decision-making. However, it also has limitations such as difficult control of confounding factors. It still needs to be further studied due to its immature methodological base. CER has been already applied in some neurological fields, with internationally-recommended research priorities for CER in neurology.
Clinical trial, an important research method, plays a crucial role in the development of medicine. It provides important decision support for medical workers. Medical research proposal should be posted at clinical trial registries. Researchers should update original data and research results, which contributes to data sharing. Clinical trial registration can avoid repetitive research and make clinical trials more transparent and standardized. This paper briefly introduces the clinical trial registration, including the definition, the significance, the history, the scope of registration, the organization of registration, and some common problems in the process of registration. Taking the application of clinical trial registration in the field of neurological research as an example, the article describes the current application status of clinical trial registration and explores it’s value and deficiency in specific clinical research, to provoke the awareness on trial registration, which can help to improve the quality of clinical trials.
It is an inexorable trend that evidence-based medicine (EBM) is being adopted at clinical medicine education in the 21st century. EBM neurology has been developing with the progress of the world of evidence-based medicine and clinical neurology. New requirements have been proposed in neurology education with the development of EBM. The adoption of EBM in modern clinical education will be a great influence: promoting the further development of neurology, cultivating talented doctors, and improving the quality of treatment.
This review describes the concept of artificial intelligence, introduces the working mechanism and the main structure of medical expert system, as well as the development history of medical expert system at home and abroad and its applications in the medical field. The concept of machine learning, commonly used algorithms and its clinical applications in medical diagnosis are briefly described. It mainly introduces the application of artificial intelligence in neurology. The advantages and disadvantages of artificial intelligence system in medical field are analyzed. Finally, the future of artificial intelligence in the medical field is forecasted.
Objective To determine whether Xingnaojing injection can improve functional outcome without causing harm in patients with intracerebral hemorrhage. Methods We searched the electronic bibl iographic databases: Cochrane Central Register of Controlled Trials(CENTRAL, Issue 3, 2007), MEDLINE (1996 to November 2007),EMBASE (1984 to November 2007) and China Biological Medicine Database (1978 to November 2007). We also did handsearching to identify other publ ished and unpubl ished data. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The Cochrane Collaboration’s RevMan 4.2.10 was used for data analysis. Results Thirteen randomized trials involving 1 035 patients were included. The number of people who had died or were dependent at the end of long-term follow-up (at least 3 months) were reported in three trials. Eleven trials measured neurological deficit at the end of treatment. No severe adverse events were reported. The results of meta-analyses indicated that Xingnaojing injection might decrease the number of death or dependency compared to the control group, but the difference was not statistically significant (Peto-OR 0.57, 95％CI 0.32 to 1.01); and Xingnaojing injection were associated with a significant improvement in neurological deficit (Peto-OR 3.70, 95%CI 2.67 to 5.13). Conclusion The evidence currently available showed that Xingnaojing injection may decrease the risk of death or dependency, and can also reduce neurological deficit in patients with intracerebral hemorrhage. However, more high-qual ity trials are needed.
ObjectiveTo analyze the characteristics of outpatients in Neurological Department in different periods and to provide guidance on medical decision-making for Neurological Department. MethodOutpatients treated between August and September 1994 (group 1994) and between August and September 2012 (group 2012) in the Department of Neurology of a general hospital were included in our study. Group 1994 had 1 000 consecutive patients; while group 2012 had 18 995 patients excluding those repeat visitors, patients waiting to be treated (including dizziness), patients misdiagnosed to have severe mental diseases (such as schizophrenia), and patients with physical diseases. Then we compared the demographic and disease distribution of patients in the two groups, and performed statistical analysis. ResultsCompared with the year 1994, the year 2012 had more female, less young and more elderly patients (P<0.05). The constituent ratio of neurosis, cerebrovascular disease, internal medicine diseases with nerve damage, peripheral nerve disease, brain post-traumatic syndrome, intracranial space-occupying lesions reduced significantly while headache, epilepsy, extrapyramidal disease (such as Parkinson's disease) increased significantly (P<0.01) with no obvious change of constituent ratio of muscle disease, neuropathic muscular dystrophy, spinal cord, brain atrophy and dementia diseases. ConclusionsThere are significant changes in characteristics of neurology clinical patients between 1994 and 2012. Revelation of these differences can provide evidence for the optimization of outpatient resources allocation and the prevention policy.
Based on the situation of healthcare reform, new cooperative hospitals with private assets invested came into being. Our hospital carried out such practice and established the first new type hospital in the southwest of China in 2012. In the new cooperative mode, a new neurology ward was established. A series of unique and innovative means of operation and quality control were applied, including introduction of brand marketing strategy, promoting advantageous sub-professions, and pay special attention on talents and quality control. This article is aimed to share the management experiences.
Objective To investigate the ways of scientific research knowledge acquirement, and the situation of research capacity and demand of neurological nurses in Sichuan Province. Methods From May to June 2015, 153 neurological nurses from 7 hospitals of Sichuan Province were enrolled by convenient stratified sampling method. The ways of acquiring scientific research knowledge, research capacity, and research demand of the nurses were investigated by questionnaire. Results Among the 153 nurses, there were 50.3% with low level, 47.7% with moderate level, and 2.0% with high level of scientific research capacity, respectively. The total scores of nursing research capacity ranged from 4 to 101. The dimension of " capacity of generating the research ideas” was the highest, and the dimensions of " capacity of designing research protocol” and " capacity of analyzing research data and material” were the lowest. Of the respondents, 66.2% had never attended any research training program, 51.3% acquired scientific research knowledge by themselves, and 65.6% were willing to participate research training courses. The respondents tended to study on their own by internet. There were significant differences in scientific research capacity among neurological nurses with different initial education, attending the college entrance examination or not, having attended research training and self-study or not (P<0.05). Conclusions Most nurses acquire scientific research knowledge by themselves, and insufficient research training couldn’t satisfy the research demand of neurological nurses. The initial education degree and research study intention are related to research capacity. However, due to the limited amount of samples, the positive influence of self-study and research training on the research capacity still need to be further explored.