After perusing the paper by Kim et al,I discovered that this is an interesting manuscript and a successful study.Virtual reality(VR)is an emerging and promising technology employed in the domain of medical practice an...After perusing the paper by Kim et al,I discovered that this is an interesting manuscript and a successful study.Virtual reality(VR)is an emerging and promising technology employed in the domain of medical practice and medical education over the past decade.In the era of big data,VR is constantly progressing in the fields of medical education and clinical diagnosis and treatment.As a novel scientific and technological tool,VR not only overcomes multiple limitations of the traditional medical teaching mode but also reduces the reliance on personnel and equipment.VR can simulate the real clinical situation,stimulate the enthusiasm of young doctors and nurses for clinical study,and simultaneously safeguard and promote medical safety and doctor-patient harmony.Favorable outcomes have been attained in clinical teaching and diagnosis and treatment activities.While enhancing the training conditions of medical cosmetics and elevating the level of clinical practice and teaching,the risks resulting from improper clinical diagnosis and treatment have been circumvented.All of this is evident and comprehensible.展开更多
Objective:Entrustable professional activities(EPAs)is a newly emerging concept.This paper aims at analyzing the concept of"EPAs"to clarify the meaning and to identify its components for optimum understanding...Objective:Entrustable professional activities(EPAs)is a newly emerging concept.This paper aims at analyzing the concept of"EPAs"to clarify the meaning and to identify its components for optimum understanding of the concept for use in nursing education and future research.Method:Three databases-ProQuest,Ovid,and PubMed-were retrieved,and Walker and Avant's concept analysis approach was used to analyze the concept of EPAs.Results:Based on the analysis,three attributes of EPAs were defined,namely (1)EPAs should be restricted to a limited number of tasks;(2)reflect the experience curve;and (3)include acceptance of responsibility and accountability.The antecedent of EPAs is a holistic and integrated assessment approach.This will eventually lead to anticipated consequences such as a mastery of core competencies and an increase in the level of autonomy.Conclusion:The study may contribute to a reduction in the ambiguity of this concept to better apply it in nursing practice.展开更多
Objective:Ultrasound determination of chorionicity is poor in early pregnancy in China.In an effort to increase the accuracy rate of prompt chorionicity determination,clinical training was provided to primary care phy...Objective:Ultrasound determination of chorionicity is poor in early pregnancy in China.In an effort to increase the accuracy rate of prompt chorionicity determination,clinical training was provided to primary care physicians.This study assesses the effects of implementing clinical guidelines on chorionicity determination.Methods:A multi-centered cohort study was conducted between January 2014 and June 2017 in 12 hospitals without fetal medicine centers.In 2014,the obstetricians and ultrasound physicians were trained in clinical practice and ultrasound examination relating to chorionicity determination.Linear and binary regression analyses were conducted to identify the effects of introducing the new protocols,including the diagnosis rate of chorionicty and perinatal outcomes,taking the data from 2014 as a baseline.Pregnancy outcomes were additionally adjusted for maternal age.Results:During the period of this study,3,599 twin pregnancies from 12 centers were enrolled,and a total of 2,998 twin pregnancies were extracted.The rate of overall chorionicity determination,including antenatal and postpartum diagnosis,increased successively from 49.5% in 2014 to 93.5% in 2017(P<0.0001).The rate of ultrasonic chorionicity diagnosis before 14 weeks increased from 25.2% in 2014 to 65.0% in 2017(P<0.0001).These changes were associated with decreasing incidence of preterm birth,a lower risk of stillbirth,whether for one(P=0.0456 in 2016)or two fetuses(P=0.0470 in 2016;P=0.0042 in 2017)and a decreased rate of admission to neonatal intensive care unit(43.0% in 2014,37.4% in 2017;P=0.0032).Conclusions:The implementation of a clinical practice guideline improved both overall and early chorionicity determinations.Regular training workshops of antenatal care are recommended to further promote capability in clinical diagnosis and treatment.展开更多
文摘After perusing the paper by Kim et al,I discovered that this is an interesting manuscript and a successful study.Virtual reality(VR)is an emerging and promising technology employed in the domain of medical practice and medical education over the past decade.In the era of big data,VR is constantly progressing in the fields of medical education and clinical diagnosis and treatment.As a novel scientific and technological tool,VR not only overcomes multiple limitations of the traditional medical teaching mode but also reduces the reliance on personnel and equipment.VR can simulate the real clinical situation,stimulate the enthusiasm of young doctors and nurses for clinical study,and simultaneously safeguard and promote medical safety and doctor-patient harmony.Favorable outcomes have been attained in clinical teaching and diagnosis and treatment activities.While enhancing the training conditions of medical cosmetics and elevating the level of clinical practice and teaching,the risks resulting from improper clinical diagnosis and treatment have been circumvented.All of this is evident and comprehensible.
文摘Objective:Entrustable professional activities(EPAs)is a newly emerging concept.This paper aims at analyzing the concept of"EPAs"to clarify the meaning and to identify its components for optimum understanding of the concept for use in nursing education and future research.Method:Three databases-ProQuest,Ovid,and PubMed-were retrieved,and Walker and Avant's concept analysis approach was used to analyze the concept of EPAs.Results:Based on the analysis,three attributes of EPAs were defined,namely (1)EPAs should be restricted to a limited number of tasks;(2)reflect the experience curve;and (3)include acceptance of responsibility and accountability.The antecedent of EPAs is a holistic and integrated assessment approach.This will eventually lead to anticipated consequences such as a mastery of core competencies and an increase in the level of autonomy.Conclusion:The study may contribute to a reduction in the ambiguity of this concept to better apply it in nursing practice.
基金supported by the Shanghai Key Program of Clinical Science and Technology Innovation(17411950500,17411950501,18511105602)National Science Foundation of China(81741047,81971411)+2 种基金Shanghai Medical Center of Key Programs for Female Reproductive Diseases(2017ZZ01016)National Key Basic Research Plan of China(973 Plan)(2015CB943300)The Major Program of the National 13th Five-Year Plan of China(2016YFC1000400).
文摘Objective:Ultrasound determination of chorionicity is poor in early pregnancy in China.In an effort to increase the accuracy rate of prompt chorionicity determination,clinical training was provided to primary care physicians.This study assesses the effects of implementing clinical guidelines on chorionicity determination.Methods:A multi-centered cohort study was conducted between January 2014 and June 2017 in 12 hospitals without fetal medicine centers.In 2014,the obstetricians and ultrasound physicians were trained in clinical practice and ultrasound examination relating to chorionicity determination.Linear and binary regression analyses were conducted to identify the effects of introducing the new protocols,including the diagnosis rate of chorionicty and perinatal outcomes,taking the data from 2014 as a baseline.Pregnancy outcomes were additionally adjusted for maternal age.Results:During the period of this study,3,599 twin pregnancies from 12 centers were enrolled,and a total of 2,998 twin pregnancies were extracted.The rate of overall chorionicity determination,including antenatal and postpartum diagnosis,increased successively from 49.5% in 2014 to 93.5% in 2017(P<0.0001).The rate of ultrasonic chorionicity diagnosis before 14 weeks increased from 25.2% in 2014 to 65.0% in 2017(P<0.0001).These changes were associated with decreasing incidence of preterm birth,a lower risk of stillbirth,whether for one(P=0.0456 in 2016)or two fetuses(P=0.0470 in 2016;P=0.0042 in 2017)and a decreased rate of admission to neonatal intensive care unit(43.0% in 2014,37.4% in 2017;P=0.0032).Conclusions:The implementation of a clinical practice guideline improved both overall and early chorionicity determinations.Regular training workshops of antenatal care are recommended to further promote capability in clinical diagnosis and treatment.
