In the past three years, the standardized training of residents in our department has achieved rapid development, with the increase of various medical operation indicators and the increase of special outpatient and emergency departments. At the same time, it also means that the clinical workload of residents participating in standardized training has increased significantly. The increase of clinical workload can greatly increase the opportunities of clinical practice, which is consistent with the general idea of resident training from the perspective of clinical ability training.
(1) Construction and management of training base
(1) In the past three years, residents have changed their major, including stomatology, oral and maxillofacial surgery, prosthodontics, orthodontics, emergency department, medical imaging department, general surgery, cardiovascular medicine, pathology department and other related professional departments. Changing majors broadens the horizons of doctors who have just joined the work and lays a good foundation for future work. At the same time, other departments also send residents to our department in turn, and we also teach them the knowledge of stomatology.
⑵ Arrange department professional knowledge lectures 12 times a year, including two lectures by the deputy chief physician, focusing on the management system of various sensory organs in the department, the diagnosis and treatment of common oral diseases, the cultivation of clinical thinking and the improvement of scientific research ability. Let residents who have just entered the hospital know about the hospital, patients and various diseases, and strengthen standardized management.
⑶ According to the requirements of standardized training for residents in Zhejiang Province, standardized training, strict "three basics" training and assessment were conducted for residents, and all of them passed the annual examination.
(4) Resident attendance registration, discussion of difficult cases, demonstration class of new oral instruments and materials operation, etc. At the same time, anonymous teaching evaluation activities were carried out to invite residents.
Assess the implementation of the rotation plan, the teaching of professional knowledge and skills, and the resignation assessment of the teaching teachers.
(B) the existing problems and countermeasures
Establish and implement quality evaluation and improve the evaluation system, including the evaluation and inspection of training quality and organizational management level, and carefully organize the evaluation of this department. The purpose of evaluation and examination is to test the participation of clinicians in training, and at the same time find out the shortcomings in training, so as to continuously improve in future work. At the same time, we also found some problems: ① The rotation of resident doctors can't meet the requirements, and the quality and quantity of teaching teachers can't meet the training requirements. ② It is generally believed that real patients or standardized patients should be used as much as possible in clinical skill assessment, and the assessment scheme, content, process and time should be designed as objectively and reasonably as possible, and humanities, ethics and law should be added.
(3) Work plan
The teaching teachers are also deeply touched by the standardized training of residents, and feel that the teaching work is a responsibility and honor. Put forward the work plan for the next stage: ① strictly follow the rotation plan and do not change it at will; ② Students are highly motivated and curious. Resident training can best reflect the high intensity of training, including clinical operations under the guidance of instructors, such as tooth extraction, minor surgery in oral and maxillofacial clinic, complete denture mold taking, etc. To master these skills successfully, it is an effective way to organize residents to strengthen their study and training. (3) Teachers should be strict in teaching, and residents should be strict in medical ethics and clinical skills besides professional knowledge. ④ Hierarchical teaching: Different teaching forms and contents are adopted according to different rotation requirements of clinicians. Use book knowledge to guide doctors how to walk to the treatment chair; Understand the typical clinical manifestations of typical cases; Establish correct clinical thinking and supervise its gradual progress.
Invasive surgery is difficult and risky. ⑤ Diversified teaching: We don't stick to "you talk and I listen", but present the teaching content flexibly. There are traditional teaching methods, such as lectures, clinical case discussions and literature reports. There are also innovative teaching methods, such as month-end review and patient education.
Residents who have participated in standardized training in recent two years are more active than the first session, and the business lectures and case discussions carried out in the department have achieved initial results. As a key link of lifelong medical education, standardized training for residents is an inevitable stage for the development of specialists, the only way for the formation of medical clinical experts, and an effective means to improve the level of medical services and ensure medical safety. I hope it will last forever.
Doctor self-evaluation 2 I graduated from * * University in 20xx, and it has been four years now. As an employee of * * Animal Husbandry and Fisheries Bureau * * Animal Husbandry and Fisheries Station, I have certain experience and knowledge in animal husbandry and veterinary work. Here, I will make an evaluation of my work in recent years and make a reference for my future development.
Implement compulsory animal immunization to ensure that the immunization coverage rate in * * area reaches 100%. During the period of bird flu, he completed the task well, was praised by his superior XXX* and trusted by the local people, and was interviewed by TV station XXX as a model.
Adapt to the situation and actively reform. According to the instructions of the superior, the benefit salary and contract system were first implemented in 20xx, which enhanced the positive economic income of employees.
Signed an agreement with the Animal Breeding Science and Technology Center of the Municipal Bureau, responsible for the improvement of pig breeds in surrounding towns and villages, and led the breeding market to be scientific and standardized by artificial insemination.
Actively promote the immunization registration card system and immunization file system, so that our work can be followed in the future. Promote the development of epidemic prevention, quarantine and treatment.
Carefully select the purchase channels to win with high quality and low price. Issue convenience service cards to households, communicate with farmers in time, publicize technical services in depth, change the old image and improve competitiveness.
With the rapid development of economy and the destruction of environment, it has evolved into the spread of diseases. As a veterinarian, I will continue to work hard in the future, further study management, continue to strengthen the theoretical study and professional quality of veterinarians, and strive to be a qualified veterinarian!
3 male, 39 years old, director and deputy chief physician of the Department of Neurology. 19**, graduated from Henan Medical University with a bachelor's degree. After graduation, I gave up the opportunity to stay in a big city and voluntarily returned to my hometown to serve my hometown folks. He went to Henan Provincial People's Hospital, Military General Hospital and other places for further study, and went to Beijing, Xi, Jinan, Zhengzhou, Guangzhou and other places for academic activities many times. He won the third prize of the provincial science and technology achievement award and wrote more than ten papers. Over the past XX years, he has been conscientious and meticulous, studying his business seriously and striving for perfection. On the premise of standardized treatment of nervous system diseases, according to my years of clinical experience and the different situations of patients, individualized treatment under standardization has achieved remarkable results and brought good news to many patients.
Over the years, he has devoted himself to the cause of treating diseases and saving lives, devoted himself to medical and health undertakings in a down-to-earth and unknown way, and was extremely responsible for patients, thinking about their thoughts and anxious patients, especially the very difficult people. He always tries his best to make patients spend less money and cure difficult and critical patients. He always forgets to eat and sleep, asks about his medical history in detail, makes a careful physical examination, and closely observes the changes of his condition. He often said: "human life is the most precious, which money can't buy." I will try my best to save the patient's life. "
He is good at treating cerebrovascular diseases with vertigo, encephalitis, epilepsy and other nervous system diseases. He also has a unique skill, that is, treating neck dizziness. Nowadays, people have many unexplained "dizziness" and "headache" because of fatigue and tension at work. They are tortured by illness and even want to commit suicide. They go to many hospitals for treatment, and the effect is not good. As long as you find him, he always has a magic prescription to make you feel immediately and relieve your pain. People call him "vertigo buster". He is not only knowledgeable and comprehensive, but also kind and talkative. He not only cured many patients with common diseases, but also cured many patients with difficult diseases such as "acute myelitis" and "Guillain-Barre syndrome".
He just wants to be an ordinary doctor. He just wants to cure more patients, save more lives and bring them health and happiness in the future. He is such a person.
Male, 39 years old, director and deputy chief physician of the Department of Neurology. 19**, graduated from Henan Medical University with a bachelor's degree. After graduation, I gave up the opportunity to stay in a big city and voluntarily returned to my hometown to serve my hometown folks. He went to Henan Provincial People's Hospital, XXX General Hospital and other places for further study, and went to Beijing, Xi, Jinan, Zhengzhou, Guangzhou and other places for academic activities many times.
He won the third prize of the provincial science and technology achievement award and wrote more than ten papers. Over the past XX years, he has been conscientious and meticulous, studying his business seriously and striving for perfection. On the premise of standardized treatment of nervous system diseases, according to my years of clinical experience and the different situations of patients, individualized treatment under standardization has achieved remarkable results and brought good news to many patients.
Over the years, he has devoted himself to the cause of treating diseases and saving lives, devoted himself to medical and health undertakings in a down-to-earth and unknown way, and was extremely responsible for patients, thinking about their thoughts and anxious patients, especially the very difficult people. He always tries his best to make patients spend less money and cure difficult and critical patients. He always forgets to eat and sleep, asks about his medical history in detail, makes a careful physical examination, and closely observes the changes of his condition. He often said: "human life is the most precious, which money can't buy." I will try my best to save the patient's life. "
He is good at treating cerebrovascular diseases with vertigo, encephalitis, epilepsy and other nervous system diseases. He also has a unique skill, that is, treating neck dizziness. Nowadays, people have many unexplained "dizziness" and "headache" because of fatigue and tension at work. They are tortured by illness and even want to commit suicide. They go to many hospitals for treatment, and the effect is not good. As long as you find him, he always has a magic prescription to make you feel immediately and relieve your pain. People call him "vertigo buster". He is not only knowledgeable and comprehensive, but also kind and talkative. He not only cured many patients with common diseases, but also cured many patients with difficult diseases such as "acute myelitis" and "Guillain-Barre syndrome".
He just wants to be an ordinary doctor. He just wants to cure more patients, save more lives and bring them health and happiness in the future. He is such a person.
I have been working in the inpatient department of internal medicine since I was a doctor 18. Although I sometimes use the concept of syndrome differentiation and treatment of traditional Chinese medicine to prescribe drugs in clinic, it is not always handy. Therefore, in most cases, western medicine is the main treatment, and there is no confidence in the efficacy of Chinese medicine. This year, I had the honor to learn from Mr. Chen, one of the top ten old Chinese medicine practitioners in Sichuan Province. Through dictation and careful guidance, I gradually realized the enduring charm of Chinese medicine and saw the profoundness of Chinese medicine and the places that modern medicine could not reach. Therefore, I am full of confidence in the cause of Chinese medicine, and I am determined to learn Chinese medicine well, use Chinese medicine well and inherit Chinese medicine well. After more than half a year's study, I have benefited a lot. Now I will summarize my learning experience as follows:
First, "take the great doctor's sincerity as the concept, and aspire to benefit your life."
"Those who want to practice medicine in the world in ancient and modern times should be treated first; If you want to cure your body, you should be upright first; If you want to be correct, you must be sincere and skillful. This is a doctor's kindness. As a doctor of medicine, in addition to superb medical skills, it is more important to have noble medical ethics. Chen Lao has set a good example for us in "benevolence, kindness and benevolence". He always takes every patient seriously and takes it as his duty to alleviate their pain; Be modest in the process of clinical diagnosis and treatment, patiently explain and analyze the patient's condition; Always think of the patient and never prescribe expensive tests and drugs; Sometimes patients are treated for free without registration fee ... every word and deed of the teacher deeply infects every student. I will inherit the teacher's sense of responsibility and love for patients, and I will definitely take Sun Simiao's "great doctor's sincerity" as my life criterion, so as to truly "ask for help when someone is sick, regardless of the rich and the poor, the old and the young, whether friends are friendly or not, and whether they are ignorant. "
Two, strengthen the theoretical research of traditional Chinese medicine, theory with clinical.
Theory comes from practice, practice is based on theory, and theory is the foundation of TCM development. Therefore, strengthening the theoretical research of traditional Chinese medicine in practice is of great benefit to improving clinical efficacy. The basis of clinical support of TCM is the basic theories such as Yin-Yang and Five Elements, Zang-Fu Meridian, Four Diagnoses and Eight Classes, Etiology and Pathogenesis, Treatment Principles and Methods. How to master and use it well undoubtedly requires understanding the connotation, extension and complex relationship of various related concepts, and constantly enriching and perfecting them through clinical practice, thus guiding clinical practice and pioneering and innovating. Of course, you need to read and remember the main provisions of the classics and understand the meaning of the whole book. If you don't use your brain to read Treatise on Febrile Diseases, Synopsis of the Golden Chamber and Treatise on Febrile Diseases, you can have a profound understanding of the theory of traditional Chinese medicine, and you will have running water at the source when you are in the clinic, so you won't be thirsty and poor in skills. Chen Lao also taught us that as a Chinese doctor, we should also be familiar with the knowledge of Chinese medicine and master the nature, taste and meridian tropism of drugs; And can be familiar with the processing of drugs; Only by identifying the quality and authenticity of drugs can the efficacy and safety of drugs be guaranteed. Therefore, I use all my spare time to strengthen theoretical study; Go to the Chinese pharmacy to identify medicinal materials; The organic combination of theory and clinic, continuous thinking and summary, has greatly improved the level of Chinese medicine.
Third, keep pace with the times and combine syndrome differentiation with disease differentiation.
Chen Lao believes that with the development of modern medical science and technology, the traditional disease differentiation and syndrome differentiation can no longer meet the needs of people to understand and treat diseases, and its limitations are gradually emerging in clinic. In order to make up for the deficiency of traditional methods of disease differentiation and syndrome differentiation, taking modern medical diagnostic indicators as a part of TCM syndrome differentiation can not only improve the objectivity and accuracy of syndrome differentiation, but also give new ideas to the traditional dialectical thinking mode. Chen Lao advocates 1. Combination of disease and syndrome. Clinically, the first thing is to diagnose what disease the patient has, and then treat it according to the theory of traditional Chinese medicine. Only by paying equal attention to disease and syndrome and combining them organically can the clinical effect be remarkable. For example, patients with chronic cholecystitis, gallstones and some gastric and duodenal ulcers can all show fullness or pain in the right rib, which can be treated by soothing the liver and regulating qi. However, due to their respective pathological characteristics, there should be similarities and differences in treatment. Chronic cholecystitis and cholelithiasis: Curcuma Rhizome, Herba Artemisiae Scopariae and Fructus Gardeniae are added. Gastric and duodenal ulcer: add Zuojin Pill and cuttlebone to make acid. 2. No symptoms. With the development of modern medicine, some diseases have no clinical symptoms in the early or late stage, but there are abnormalities in physical and chemical examination. For this kind of patients, take the method of treatment due to illness. 3. No symptoms. Disease-free refers to diseases that have not been diagnosed at present, such as dry mouth of unknown reasons, and no abnormalities have been found in various tests, but TCM syndrome differentiation has clearly manifested as stomach yin deficiency, liver and kidney yin deficiency and other syndromes. At this time, the indications should not be sick. Satisfactory results can often be obtained by using Yiwei Decoction, Guan Yi Decoction, Liuwei Dihuang Pill and other prescriptions. 4. the combination of Chinese and western. Traditional Chinese medicine and western medicine have different theoretical systems, but each has its own strengths. We should not attack each other's shortcomings, but learn from each other's strengths. A good Chinese doctor should learn modern medicine while studying Chinese medicine, serve Chinese medicine and improve clinical efficacy. Such as tuberculosis and chronic gastritis.
Fourth, sum up teachers' experience and apply what they have learned.
Teacher Chen has been a doctor for decades and has rich clinical experience. He is good at treating various common diseases, frequently-occurring diseases and intractable diseases in internal medicine, gynecology and pediatrics. In the short time of studying with my teacher, I have realized that Mr. Chen is a knowledgeable teacher. He often patiently explained the clinical skills that we need to learn and master in clinical practice, promoted clinical practice to theory to teach us, and let us improve ourselves from the practice-theory-practice model. I deeply realize that follow-up and medical record arrangement are effective ways to inherit teachers' experience. Follow the teacher's consultation, face the clinical cases, start with writing cases and four diagnoses, and repeatedly experience the teacher's dialectical thinking and medication experience, including how to grasp the main symptoms, dialectical analysis, treatment, medication experience and diagnosis and treatment skills. Medical records can reflect teachers' academic thoughts and clinical experience. I use my spare time to sort out the teacher's medical records, especially some difficult medical records and medical records with remarkable curative effect, and analyze the characteristics of the teacher's medication, from which I can get inspiration and guide my clinical diagnosis and treatment.
After more than half a year's study, I summed up that Mr. Chen advocated the second diagnosis, flexibly used the methods of "combining disease with syndrome", "treating disease without syndrome" and "treating disease without syndrome", and paid attention to "combining traditional Chinese and western medicine". For example, in the treatment of stomach diseases, teachers use drugs in combination with modern medical gastroscopy, which is the characteristic of teachers' medication and has definite clinical effect. If the patient's gastroscopy is accompanied by Helicobacter pylori infection, Rhizoma Coptidis, Scutellariae Radix, Cortex Phellodendri, Radix et Rhizoma Rhei, Fructus Gardeniae, Herba Violae, Herba Taraxaci, Rhizoma Alpiniae Officinalis, Fructus Amomi, etc. They are often supplemented, because they all have anti-Helicobacter pylori pharmacological effects to varying degrees, and they are used dialectically, and all anti-Helicobacter pylori drugs are listed together without departing from TCM syndrome differentiation, which deviates from the theoretical purpose of TCM syndrome differentiation.
Doctor's Self-evaluation Chapter 5 I. Scientific Management Model
The first is good teamwork and diversified nursing staff echelon. The nursing team in each ward has a head nurse, a specialist nurse and a clinical nurse. Everyone cooperates with each other while completing their own work to ensure the nursing quality of the ward. In addition, there are full-time nurses to assist patients with mobility difficulties in daily life and health services, and health service assistants are responsible for the replacement, replenishment and storage of nursing supplies; Nutritionist: A week's nutrition menu can be provided according to the patient's disease characteristics and personal requirements to help patients make a healthy diet plan.
Second, good service attitude.
I feel that the medical staff's pain and love for patients are from the heart, and they are very friendly to patients and their families, and they have truly achieved quality service.
Third, protect the privacy of patients.
In the ward, there is a slidable fence between each sickbed, and all medical treatment and operation are carried out in the fence, which not only protects the privacy of patients, but also effectively reduces unnecessary disputes. The patient's family members will also consciously avoid when the medical staff perform surgery, and will never come in to participate, and also express a respect for their loved ones.
Fourth, strict working attitude.
Strict implementation of the check system, there are corresponding flowcharts in various nursing operations, and these processes have assessment standards; Every year, the specialized nurses in the department and the staff in the nursing department discuss whether these operations need to be improved; Doctors and nurses should wash their hands strictly before and after operation, and be equipped with hand disinfectant. When the operation fails, the medical supplies must be replaced and cannot be reused. All used articles and instruments in the ward are not washed and soaked in the ward, but sent to the supply room for treatment to avoid environmental pollution.