Evaluation of medical students learning from teachers 1
Through a year's study with the teacher, we learned that Chen Ming, deputy chief physician, quietly paved the way for me to know Chinese medicine. I didn't understand at that time, but I was trying to learn Chinese medicine. There are many patients who study with teachers. They often go to see a doctor during the day and study by themselves at night. It was past nine when they got home by bus. Looking at the flashing night lights all over the street, watching the endless traffic, watching the passers-by in a hurry, thinking about my lover who is anxiously waiting for dinner at home, I can't help but sigh. But when I think about this day, I understand the truth of Chinese medicine and see a new self.
The illness deepened shallow views and corrected the wrong understanding in the past. The joy in my heart and my heartfelt thanks to my teacher are beyond words. Now the three-year study with the teacher is over. From beginning to end, I think that learning with the teacher does not lie in the word-for-word teaching of the teacher, but in the subtle way, let the disciples feel the spark of the teacher's thinking and wisdom. After much thought, he still couldn't figure it out. I discussed it with other colleagues, but there was still no answer. I found a suitable opportunity to ask the teacher. At this time, the teacher's words are the truth, and what I have learned from the teacher countless times is the patient's problem. The teacher's answer made me stunned. Below I will write down the experience of studying medicine with teachers accumulated in the past three years for the reference of my peers.
Before learning from a teacher, we must first have a comprehensive understanding of the teacher and achieve "two essentials", which is a necessary condition for success in learning from a teacher. First, it is necessary to know the development status of the hospital and discipline where the teacher works, who he studied with, whether it is a family heirloom or a teacher's inheritance, what medical theories he has studied intensively, what are his medical characteristics and what theories he is concerned about. By mastering these conditions, we can understand his academic origins and thoughts, and what theories and viewpoints he inherited and developed. In this way, when summing up its experience, there is a basis; The second is to understand the academic expertise and experience characteristics of teachers. And around this problem, we should collect information extensively, accumulate and master detailed and reliable first-hand information, which is the basic material and foundation of our future academic experience. To achieve the above-mentioned "two essentials", we must achieve "six more" in our daily study with teachers: ask more questions: ask more teachers about some key problems encountered in our study, ask questions in depth and make them clear as far as possible. For example, how many kinds of drugs does an experienced party have? What are the compatibility features? How does the dose change? What are the requirements for the decoction method? How to add, subtract, multiply and divide? For what reason? What doesn't apply? What are the taboos? What is the basis of prescription, etc. Never take it for granted. In the process of learning, asking more questions is an important way to make the questions deeper. Although the teacher has many years of experience, he doesn't always explain the problems thoroughly.
Some problems are shared by teachers themselves, but others may not know the mystery. Therefore, we should get to the bottom of it. In this process, learners often ask themselves: What experience have they learned from teachers? Will it be used clinically? Always ask the patient: Has the patient's symptoms improved, has there been any change, and has there been any uncomfortable reaction after taking the medicine, so as to realize the subtlety of the teacher's treatment experience in detail. Listen more: when following the teacher's clinical practice or listening to his stories, listen to the teacher's views and thoughts on each problem. It is one of the important parts of first-hand information to master his thinking method, academic thought and academic viewpoint and find out the law of dialectical medication. Read more: read more teachers' clinical diagnosis, prescriptions, papers and writings, and repeatedly understand the clinical application of their academic thoughts. At the same time, according to its academic origin, read the medical theories and works of sages who have great influence on it, so as to trace back to the source and master the theoretical basis; Read modern medical books related to this subject,
Proficient in the theory of Chinese and western medicine, comprehensive knowledge; Read all kinds of literature related to your major to understand the origin of medicine. Multi-recording: recording what you hear and see at any time is an important means to collect information. One is instant recording, that is, listening, watching and recording; The other is memory, that is, what you hear and see is recorded through memory. On this basis, it can be classified. In the past three years, my teacher and I have taken notes in this book. Multi-purpose: diligent in clinic, dare to prescribe medicine every time I encounter similar medical records, and even copy the teacher's methods and ask for advice in time when I find problems. This medical skill will improve quickly. Think more: classify the above questions, listen, watch, remember and use them, analyze and summarize them in an orderly and systematic way in your mind, and find out their regularity. This is the essence of teachers' experience, and it takes some time to sublimate and improve on the basis of the original materials. "The Analects of Confucius for Politics" said: "Learning without thinking is useless, thinking without learning is dangerous". Sorting out the experience of old Chinese medicine practitioners is both work and study. If you want to inherit the teacher's experience, you must work hard on "learning" and "thinking". More communication: communication and communication are the extension of asking more questions. In the process of following the teacher, more communication with the teacher and more clinical questions can improve the teacher-student relationship. I also have academic exchanges with doctors around me and share successful examples. Finally, as a modern Chinese medicine practitioner, we should use a variety of information exchange methods, such as Weibo and email. Communicate with medical colleagues to share some learning experience, teacher's experience and confusion. The above is a summary of my experience, and I hope it will be beneficial to everyone.
Comments on the experience of medical students and teachers II.
Under the call of the Youth League Committee of our school, I participated in a 20-day social practice activity in my hometown from July 26th to August 65438+May 20th. The form of practice is to learn from the teacher and practice in the family planning service station of Qingshui Town, Renshou County, Sichuan Province.
My teacher is the stationmaster of the family planning station and will soon retire. She has rich clinical experience and understands both Chinese and western medicine. At his suggestion, I spent a week or so studying medicine, mainly about Chinese medicine. I first know the appearance of each Chinese medicine in the pharmacy, and then taste most of them, and have a certain understanding of their properties and tastes. In the process of understanding drugs, the following problems are summarized.
First, because most drugs are processed, most of them are sliced, and few herbs are used as medicine, so many drugs are sliced almost the same. For example, Radix Rehmanniae and Radix Scrophulariae have different medicinal properties and are both bitter and sweet products. Scrophularia is more bitter, slightly salty and sweeter. For example, Schizonepeta tenuifolia and mint, Peucedanum peucedanum and Bupleurum chinense.
Second, the actual taste results are different from the medicinal properties and tastes introduced in Chinese medicine books. Salty taste is not easy to taste, such as indigo naturalis and Scrophularia. However, the smell of patchouli slices is not as strong as that of its growth on the land.
Thirdly, due to local differences, the theory of Chinese medicine studied in Jilin is slightly different from that of wild herbs in Sichuan. In the practice pharmacy, even some herbs are not mentioned in the Chinese medicine class. Such as Chuanmingshen, silkworm excrement, Gan Song, gold essence and silver essence. Cloves are divided into male and female, and betel nuts are also divided into capers and flower betel nuts. Some of the medicines mentioned in books have never been seen in pharmacies. After all, there are thousands of Chinese medicines, and there are regional differences.
Fourth, teachers often use nicknames for some drugs when prescribing. For example, Ren Qian refers to plantain seeds; Fumao refers to the big belly, which is the shell of betel nut and so on. Right place, right person.
In addition to understanding Chinese medicine, I also have a preliminary understanding of western medicine. Since the study of western medicine pharmacology began in the last semester of junior year, this understanding is only a basic impression in my mind, and no higher requirements are required.
In the next ten days, I watched the teacher treat patients next to him, which was the focus of my internship. Because it is in the family planning station, most of the patients who come to see a doctor are gynecological and pediatric patients, and of course, exogenous patients also come here. Because the teacher has a good reputation in the local area, there are always many people who come to see a doctor, and the teacher has little time to explain it to me alone. So I have to record my own digestion, write down the results of listening, speaking and asking in a notebook, and then read the prescription prescribed by the teacher, regardless of whether I prescribe Chinese medicine or western medicine, and use my time at home to sort out my digestion at night. Of course, the key point is the prescription of Chinese medicine, and western medicine only understands it. Here, I also summarize my views as follows.
First, I don't know what is good and what is bad during my first clinical probation, so I can only keep a lot of things in my heart for the time being, and I dare not give it a wrong definition first. When I have an answer later, the good will become experience, and the bad will be lessons. Just like the teacher's prescription, almost all the prescriptions I have seen contain Sanguisorba officinalis. According to Chinese medical books, Sanguisorba officinalis has the effects of cooling blood, stopping bleeding, detoxifying and healing sores. It is mainly used to treat blood-heat bleeding in lower energizer, and is called an essential medicine for fire and water burns. Why is there a little Sanguisorba in every square? Later, the teacher told me that he used Sanguisorba as an adjuvant medicine, because he used a lot of bitter and cold products, which made the patient feel bad after eating it. Sanguisorba has astringent effect, and a little is used in the prescription to prevent it from being too bitter and too cold. The first time I heard this usage, I can't say it's not a harvest! Every doctor has his own method when dispensing prescription drugs. My teacher has many unique features, so I won't give examples here. I realized the difference between clinic and theory for the first time. In contrast, the clinic is more attractive, less rigid and more lovely. It just adds another layer to my learning journey. Flexible use and correct treatment really need to work hard!
Second, it is about the patient's thinking. During my internship, I met many different patients, such as old people, children, men, women, pregnant women and even babies. Among them, there are slightly rich bosses, middle-level farmers, and even elderly people who are poor and ragged. Everyone has a different view of the disease. Generally speaking, people's understanding of disease prevention has deepened and their concern for their own health has increased, which is the progress of our society. However, there are still a large number of people who have no food. If they are sick, they will drag on, and they will not come to see a doctor unless they have to. Because I am a trainee in a township, such patients should be more common than those in the town. Although there is medical insurance now, such protection has not really reached every citizen, especially the poor who look down on the disease. This is not just a question that doctors should think about.
Thirdly, I would like to talk about some views on western medicine from the perspective of "illiteracy of western medicine". During the internship, many patients came to see a doctor because of a cold. The teacher's first sentence always seems to be "Can I take penicillin?" If you can eat it, the first medicine on the list is amoxicillin. I know that I am a beginner, and I shouldn't be prejudiced against some things or things, but why do I always get more and more annoyed when I look at that "amoxicillin"? Most people know that amoxicillin is an anti-inflammatory drug and an antibiotic drug, which will have many side effects if it is used frequently or in large quantities. But what did you hear from western medicine? "What if you don't cure the inflammation first?" I don't hate western medicine. Of course, your amoxicillin will come soon when it is time to reduce inflammation, but there are always some doubts in my heart. Can you cure the disease without leaving too many side effects? Just like we treat nature, should we treat diseases with "sustainable development"? Let these questions stay in my heart, I don't think the teacher will necessarily answer them.
Fourth, briefly talk about the problem of doctors treating diseases. I once talked to a retired old man about this problem. The profession of doctor, which was so sacred in the past, suddenly dimmed a lot, with helplessness to society and more helplessness to myself. The old man said, for example, there are two kinds of doctors, one is to treat only the symptoms and the short-term effect is very good. Antibiotics are needed by almost everyone, regardless of the patient's future. A kind of doctor treats both the symptoms and the root causes, but the effect of treating the symptoms is slow, just like Chinese medicine. But it is often the former with more patients and the former with good reputation. Think about it in my heart, it's a little bitter. When I think about myself again, will I become my old self? Because life is stressful. I am so scared, afraid that I will become like that, afraid that my will has not been tempered enough, and once I am pushed into the big dye vat of society, I will become at a loss.
It is said that being a doctor is very hard. I don't think it is difficult to learn those medical knowledge. As long as you really love it, it should be interesting to learn. What is really hard is the tempering of his inner medical ethics.
The doctor who once dreamed of seems to have disappeared in this real life, and the glorious image of the old Chinese doctor who once thought his medical skills were very good seems to have been dimmed by an example of the old man. What kind of doctor should I aim at? Suddenly I'm so confused.
In fact, doctors who treat symptoms like that are not useless. At least they are also alleviating the pain of patients, and more directly. Looks like I should study. It's just that I don't want to aim at such a "medical" position. Is that to save the patient or harm the patient?
In a word, this practice has gained a lot. Although many problems have been found, who can explain that these are not necessary on the long road of studying medicine? No matter how many difficulties there are, I believe that as long as we stick to our goals, no matter how difficult they are, we can overcome them. As long as we have our own principles, the confused road will have the right direction!
Comments on the experience of medical students and teachers 3
Time flies, and in a blink of an eye, two months of social practice life is coming to an end. It's really hard to forget what happened in the 359 Hospital of the People's Liberation Army. We don't have the responsibility of regular doctors, but we all have the same experience as doctors. Such an opportunity is really hard to come by.
During the two-month internship, we gained a lot. The summary report can only report the specific aspects of our internship in the hospital in written form, and it is difficult to express the excitement, tension and excitement of our internship in the hospital. At least we can't express it accurately and clearly. We have benefited a lot. The harvest during the internship will lay a good foundation for our future work and study. In short, I would like to thank the hospital for training us bit by bit, and also thank Jiangsu University for giving us this precious internship opportunity.
When I first came to practice, when PLA officers and teachers assigned departments to us, my classmates Yu Liang, Wang Linna and Wang Jiayin and I were assigned to internal medicine clinics, so we started a two-month internship. The teacher who took us is Dr. Zhou Jiahe, who graduated from Anhui Medical University. He is about our age. So it's easier to talk. We met many patients in the internal medicine clinic. Atrial fibrillation, enteritis, cold, combined with what we have learned in books, let us have a deeper understanding of this disease. After work, Teacher Zhou talked with us about the World Cup, which added some interest to the relatively boring work of internship.
During the internship, I will abide by the laws and regulations of the hospital and all departments of the hospital. Strive to improve the ability to think independently, solve problems independently and work independently, and strive to cultivate their lofty thoughts and good professional ethics of serving the people wholeheartedly. After a month's practice, I have mastered the writing of medical documents such as course records, consultation records and discharge records.
The internship experience in the internal medicine ward is also very meaningful. When I first entered the ward, I always felt at a loss I am in a strange state about nursing work, and I still don't have a formed concept about what I can do in such a new environment. Fortunately, we have a teacher to introduce the ward structure, work and rich experience in teaching teachers, which makes us adapt to the nursing work in the hospital quickly. Being able to adapt to the hospital environment as soon as possible has laid a good foundation for internship and work in the hospital, which should be regarded as the first harvest in the internship stage: learning to adapt and learn to grow and survive in the new environment. In the ward, we came into contact with the working environment of nurses.
A nurse's job is very heavy and messy. Although there were some feelings before and after, I really felt deeper after entering the ward. Indeed, the work of nurses is very fragmentary and messy, which can be said to be humble, but through the incomprehension of most people, we find that nurses have their unique charm. Hospitals cannot live without nurses, which shows the importance of nurses. Doctors can't do without nurses, patients can't do without nurses, and the whole environment can't do without nurses. This kind of trivial work has a complete system, which can be described as "the sparrow is small and complete", and it is precisely because of this that it can play its unique role and produce an indispensable role. Because of clinical practice, I have a more comprehensive and profound understanding of nursing work and a more detailed understanding of this industry. The second gain from entering the clinic: correctly understanding nursing and establishing correct professional ethics.
On the first morning of my internship in the ward, I came to the hospital early. The shift had not started at 8 o'clock. I followed the nurse to change the patient's sheets and take his temperature. At 8 o'clock, doctors and nurses handed over their shifts on time. The doctors and nurses on duty last night reported the patient's condition, and then the bed management doctors began to make rounds respectively. I followed them, listened carefully to how they examined patients and asked them. Looking at their meticulous work attitude, I can't help but be filled with reverence. First of all, the doctor will ask the patient's symptoms, such as fever, pain, diet, normal excretion, polyuria, oliguria and so on. Then, the doctor carefully observes the patient's signs, sometimes makes percussion, and finally gives orders. At this time, the nurses began to nervously control the doctor's advice and take the medicine according to the doctor's advice. Nurses check their body temperature every four hours and draw a temperature curve for doctors' reference. In addition, they patrol the room every half hour to check whether there is anything unusual.
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