General practitioner's learning experience-Professor ——xx is a scholar, and I often call him Teacher X because I feel closer. Teacher, answer questions in class. Teachers, the steps in the academic hall, let students step on his shoulders to explore, share his knowledge, views and experiences selflessly, and make his students become people like teachers.
We are committed to people's health, and we are exploring how to improve our general practitioners, make our general service more perfect, be closer to people's needs, solve people's diseases and benefit more people. Sounds like. Tall? But our general practitioners do work and serve like this every day. The highest incidence? A cold? Let's see, the one with the highest prevalence? Hypertension, diabetes? We are responsible for the health of women, children and the elderly, and we should be proud of ourselves. Although tired, but often need to have fun in the bitter.
What is general practice? What is a general practitioner like? What is a qualified general practitioner? Maybe we are? 5+3? A general practitioner who comes out of the escort mode, but the training place is a specialist in a general hospital, and the doctor is a specialist. After the training, we went to the community, and the psychological gap was very large. Australia has the most complete primary health care system in the world. What are their general practitioners? What is their general practice? Teacher Yang gave us the first lesson "Comprehensive Service Quality and Evaluation".
General practitioners in Australia also need training and examinations. Did they stay in the community clinic for three years? Mentoring? Conduct training. Training related medical knowledge, doctor-patient relationship, career development and community medical services. There is a clear training outline and content, and an independent evaluation agency evaluates the general medical service. In general practice in Australia, there are three steps: relationship building, disease diagnosis and treatment and disease management, to provide patients with knowledge that patients can understand and easy to obtain continuous services.
What is the focus of general practice in Shenzhen? Disease diagnosis and treatment? . The patient came to see the doctor, and we saw it? Little people? There is another serious illness? We pay more attention to the disease itself, but fail to do it? People-oriented? . We neglected the patient's gender, cultural background and family relationship, and failed to protect the patient's privacy.
Do we also need to establish a new general practitioner evaluation system, train our teachers, and let new general practitioners obtain general practitioner certificates in a more reasonable way? Who will be the teacher of general medical students, what knowledge and skills should students learn and what communication methods should they have. This is what we must explore. We can learn from Australia, learn from each other's strong points and establish the general practitioner standard in Shenzhen.
We are closest to the people and are busy with daily diagnosis and treatment. Looking back, it seems that we didn't do anything particularly meaningful. Scientific research is far away from us, but in fact, scientific research is around us. Teacher Yang's second lecture, research and design of basic medical service. ? Bold assumptions, careful verification? , choose the most interesting topic or the most troublesome problem to study at work.
With what? Picos? Design in the way of. P defines the research object, population and group, I defines what to intervene or what the problem is, C defines the control group and the control group, O defines the expected research results or the expected intervention results, and S defines the research time range. Chronic disease management, family doctor service, and the development direction of family sickbeds that plague us can all be used as topics. The residents of each community are different, and the social and cultural phenomena of the community are different, which can be studied and intervened as a specific group. A completely random, double-blind and triple-blind experiment is impossible in the community. We can compare gender, different age groups, patients themselves and even interview patients with sociological research methods. Interest is the driving force for research to persist, and the fundamental purpose of research is to benefit the community.
Based on the research and design of basic medical services, this paper discusses the introduction of general practitioner xxx to community health education of diabetes mellitus and the evaluation of prevention and treatment effect of traditional Chinese medicine, and the investigation of general practitioner Zhang Chen on the prevalence rate of mild cognitive impairment in the elderly registered in Luohu District and the research on its influencing factors. General practitioners ask questions about the design and research methods of the subject, and discuss with designers how to do it better. At last, Mr. Yang summarized and put forward the feasible research direction of each subject. Every opportunity is precious, and the intersection between people is different every time. Our energy is limited, it is impossible to cover everything, and we are not the people who make policies in the national government. What we need to solve is the problem of our residents, which is a practical and immediate problem.
It is always difficult to create new models or conduct innovative research. You can study a certain acupoint, a certain method, a certain prescription and a certain health education method, and the research method must be authentic and repeatable. I'm not impressed with this lesson. It is still necessary to involve interested people, and the atmosphere of discussion will be good.
Dr. Qiu's Individualized Intervention and Effect Evaluation of Community Elderly Diabetes Mellitus Complicated with Depression is not my own evaluation. However, it is enlightening that the elderly patients with diabetes often can't manage themselves well, and the elderly patients with depression have lost the ability of disease self-management, and he can't control the management of diabetes? Five carriages? At this time, we need someone, someone close to him, to manage the disease with him. We can let people around us gain knowledge, help and supervise patients, manage diet, exercise and take medicine on time. Community research does not have to use quantitative research methods, but can try to use qualitative sociological research methods and record them in the form of interviews. The evaluation of quality of life is very important. The improvement of the disease may not be quick, but the quality of life can be improved in a short time.
The people who benefit the most from scientific research and design are the people who design scientific research! Participation is very important. Participation is unique. Teacher Yang has tailored many research methods and research directions for it. The more participants prepare themselves, the more problems they will find, and they will want to solve these problems, look up the literature, and solve the literature that the literature can solve. Consulting experienced teacher Yang, if the literature can't solve it, you can always get a satisfactory answer. Because one of our scientific research projects reads 10 documents, Teacher Yang may read twenty or thirty!
Every appearance is serious! Teacher Yang is an advocate of general practitioners here. We are practitioners of general practitioners, and it is also our goal to be like Teacher Yang!
Learning experience of general practitioners II. After nearly a month's in-depth study of the relevant theories and methods of general practice, I feel that all students really have a deeper understanding of general practice from the theoretical level. Teachers in all subjects have their own teaching styles. Solid theory and interesting lectures not only enhanced the friendship between teachers and classmates, but also made everyone deeply realize that the harvest was quite fruitful.
As a student with more than 20 years of clinical experience, I really realize that it is necessary to develop general practice in China at present, and coastal areas with relatively developed economies such as Zhejiang have the responsibility to undertake and strengthen the promotion and implementation of general practitioners (family doctors). The training plan of Wenzhou and Hangzhou in our province to train 1000 general practitioners will be launched as scheduled, which will certainly provide good talent resources for the construction and development of the general practitioner system in our province.
Now I will talk about the teaching style of teachers in various subjects and the learning content of various subjects, and talk about my personal experience in this learning.
The teacher said that a doctor is a very ordinary profession, and his duty is to save lives; Doctors should also have certain ideological quality, professional quality and scientific quality, have a certain sense of responsibility, and regard the patient's life as their own; Doctors should have the ability of innovation and exploration and actively contribute to the future of medicine.
I am a doctor, engaged in clinical work for more than 20 years, and have been working in the front line of clinic. Originally, I always thought that as a doctor, I must think about the patient's illness and only think about curing the patient's illness, even if I am a qualified doctor. But in clinic, I often encounter such and such problems, which makes me puzzled. For example, I met such an elderly male patient. After many MRI examinations and consultations with many doctors, I made a decision. Advanced lung cancer with extensive systemic metastasis? Diagnostic results. The patient's family decided not to tell the doctor. Sign and agree. The patient continued to be hospitalized in our hospital, and his condition gradually worsened, and various symptoms were not effectively controlled. When making rounds every day, the patient explicitly asks the doctor to tell him that if he has lung cancer, he must make it clear to him and not let him die unsatisfied. If you understand? Cancer? He will go out for a walk and visit some relatives.
However, due to the signature of the patient's family, the patient's family has made relevant requirements in the patient's condition notification consent, and may not tell the patient the real situation. Results After a period of time, the patient became very critical and unconscious. His family demanded that he be taken home to die. Agree after signing. In this way, the patient didn't know what disease he had until he died, leaving a lifelong regret. After that, I thought hard, should I tell the truth when the patient is dying but still awake? Similar doctor-patient relationship and medical ethics problems often appear in daily medical activities, which will often confuse doctors for a long time if they are not handled well. After several lectures and short-term training by teacher Ke Ben, especially the simple explanation by the tutor, I understand some of the reasons.
In the classroom teaching, the teacher listed the development history of doctor-patient relationship and medical ethics in ancient and modern China and foreign countries, and dared to tell the truth. Dare to give examples and explain in class the incidents that violated the doctor-patient relationship and ethics in hospitals all over the country in the past. Even if doctors in local hospitals at all levels made mistakes and medical errors, we also communicated with students. In classroom teaching, I heard a Longyou student say that Mr. Ke Ben's personality and teaching style are somewhat similar to that of Mr. Lu Xun. I feel the same way. Mr. Lu Xun lived in a semi-feudal and semi-colonial era, and was able to sharply criticize the shortcomings of the times in order to promote social progress. He is a literary master deeply loved by the people of the whole country. With personal knowledge and talent, combined with the current medical environment, Mr. Ke Ben explained the related teaching contents of the doctor-patient relationship and medical ethics to the students. He is really a good teacher.
Then talk about the experience of listening to teacher Pan Jingyie's lecture. As Teacher Pan said in class, it is more important to know what kind of people are sick than to know what kind of people are sick (Hippocrates famous saying). As a doctor, we should have a clear understanding of our professional value orientation, otherwise we will be confused for life. By studying the Introduction to General Practice taught by Mr. Pan, we have a deeper understanding of general practice, a new first-class medical discipline. In class, Mr. Pan explained the course of general practice in a simple way according to his years of clinical work experience. He believes that professional knowledge only solves some diseases around patients, and more and more practical work needs general practitioners with rich general knowledge in our community to complete. Today, you are members of Zhejiang General Practitioner Training Course, and tomorrow, you will be the backbone and foundation of Zhejiang General Practitioner Training and Development.
After nearly a month's theoretical study of general practice, I deeply realized the importance of this teaching task. Because the learning content covers a wide range. Every student's basic level is different. Good students have graduated from Zhejiang University, while poor students may only have high school education. Therefore, it is quite difficult to bring these students well and learn well.
Theoretical study is a rather boring thing. It is not easy for us frontline workers in clinical and public health work to sit in the classroom all day and listen to the teacher's lectures, and it is even more difficult to listen to the teacher's lectures carefully. Therefore, we can only rely on the ability of each teaching teacher to play. In the past month, all the teachers, the Eight Immortals, showed their magical power, and none of them was careless, despite the variety of lectures and the lack of teaching materials for students. For example, Zhong Chongzhou, a teacher who teaches practical health statistics, does his best in class.
Because students really don't have much foundation when listening to practical health statistics, almost 50% of them can't understand or hear clearly. All the students looked confused, but Mr. Zhong took pains to tell them in class. Everyone is very busy with their own work and business, and we can explain it to all our students in an informal way in classroom teaching. Although the study time is very short, their serious attitude towards teaching deeply touched them. It is under such circumstances that almost all students can listen carefully in class. Even if their personal basic level is too poor and sometimes they can't understand the teacher's lecture, they still don't delay their homework and make mistakes in class. Actively follow the teacher's teaching ideas.
Fortunately, I participated in this research, and after studying, I realized that it is necessary to develop general practice in the whole country. Zhejiang 1000 General Practitioner Training Plan started as scheduled, which will certainly provide good human resources for the construction and development of the general practitioner system in our province. The students in this period will surely become the main force in the construction and development of general practice in Zhejiang. Finally, I want to thank head teacher Zheng Ya, teacher Cai Niangao and director Xu. In this teaching, Chunchun taught all the students to study hard and really spent a lot of effort to ensure that the learning tasks such as theory and practice can be carried out and completed as scheduled.
In addition, a little personal requirement is also the requirement of all students. It is to make different teaching plans according to the specific situation of each student, which is conducive to the individual to obtain greater benefits in this study.
I recommend it carefully.