医学英语查房(详细)

Misdeal 治疗不当
Resident: I assume that you blocked the neurogenic phase with atropine. How did you block the hormonal phase? Director: I put down a Levin tube, and the patient on constant gastric suction. Resident: This will keep the gastric contents from entering the duodenum and the production of secretin, which, in turn, would increase the liberation of pancreatic enzymes, thus adding to the insult.
Theory
Operation
3. Tertiary system ground
一级查房：经治医师查房，分晨、午、晚三次。普 查全组病人，为“医患对话”。 二级查房：主治医师查房，外称 Teaching Attending Rounds，每天一次。轮流检查所辖各组 病人，除医患对话，尚需“医医对话”。 三级查房：主任查房，外称 professor’s ground 或 chief’s round，每周二次;每次检查主治医师提供1 至2病例; 主要突出“医医对话”。 大查房：great rounds 英美普及，除本科室外， 其他相关科室均参加，国内称大型会诊讨论。
hear fine moist rale? Intern: Yes, I got it.
Director: Why didn’t you hear it?
Intern: (No response) Director: You only paid attention to the front
第38章
BED SIDE TEACHING
Making Ward Round 医学查房-床边教学模式
杨明山

Contents 1.一条路线
2.二个功能 3.三个等级
5.五个程序
6.六个人物 7.七个思路
4.四个入口
8.八个业务
1. Significance - bilingualism
2. Functions
THANK YOU
chest and neglect the auscultation on base of the back.
Misdirect 诊断不清
Visiting Physician: Is it necessary for us to do a liver biopsy? Intern: Maybe it’s unnecessary. Visiting Surgeon: Sorry. You should answer me it’s necessary because the confirmed diagnosis of hepatic lesion often depends on the liver biopsy in addition to ultrasound. However it will be decided by the director.
Requirements for play
Based on NEJM case record Simplify the case presentation (< 3m) 1个中心 2个功能 3级查房 4 个纠错 5个步骤 6个人物 7个思维 8个行为
THANK YOU
4. Functions – 纠错
解决学生实际问题

history: missing 不全


exam: mistake 不正
diagnosis: misdirect 不明 treatment: misdeal 不当
Missing 病史不全
Visiting Surgeon: Have you noticed his light color of his stool? Intern: Uh, I’m sorry I haven’t.
Mistakes 检查不规
Director: Dr Li, is there any rales that you
heard in this patient? Intern: I heard no rales in this patient.
Director: Please listen to it again. Can you
5. procedures
A. 交班 morning meeting：住院总医师；外称 Senior Resident’s Morning Report B. 引言 introduction：主治医师；提出重点查房病 例，简述棘手问题
C. 病史报告 case presentation：实习医生，可有 无诊断，诊治计划须系统 D. 教学查房对话 teaching dialogue：在上下级医 生之间进行；着重纠错
E. 小结 summary：主治医师对主任查房作应答， 提出整改措施
6. figures
Director 主任 Residents 住院医师 Visiting physician 主治医师 Interns 实习医师 Chief resident 住院总医师 Patient 病人