全科医生应掌握的操作和手术2.ppt

Core Procedures in Family Medicine全科医学中的核心操作 Developed by STFM ( Society of Teachers of Family Medicine)家庭医学教师协会制定 Approved by AAFP ( American Academy of Family Physicians) Commission on Education 得到美国家庭医学会教育委员会认定 Referred to RRC (Residency Review Committee) 转给住院医师评估委员会 Core Procedures in Family Medicine全科医学的核心操作 Category A: all residency programs must provide training A类：所有住院医师项目必须提供的培训 Category B: procedures within the scope of family medicine and require focused training B类：全科医学范畴内，需有针对性地培训。 Category C: within the scope of family medicine and may require additional training beyond the usual 3 year C类：全科医学范畴内，需在住院医师培训外额外培训的操作 Category AA类操作 A0: residents will have ability to perform these basic procedures. No need for specific number tracking. 住院医师可单独执行的一些基础操作。无需特别的数量的记录。 A1: residents must be able to perform these procedures independently by graduation住院医师毕业时必须能独立做这些操作。 A2: residents must have exposure and given opportunity to be trained 住院医生必须接触过这类操作，并得到机会练习。 Procedures taught in residency 1997 Survey of Family Physicians Performing Procedures in 20052005年全科医师执行操作调查 Challenges挑战 Very little hands on experience很少亲自去经历 Lecture, Lecture, Lecture讲座、讲座、讲座 Procedure Skills very lacking非常缺乏操作技巧 Equipment装备 Enable能力 Encouragement鼓励 Informed Consent知情同意 Informed consent is the process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the physician to involve the patient in her health care. 知情同意是病人在完全知情的情况下可参与关乎她医疗照顾的选择。知情同意依据病人有主导她的身体的法律和伦理的权利，及医生照顾病人健康的伦理责任。 Informed Consent should include:知情同意应该包含： The patient‘s diagnosis, if known; 已知诊断结果； The nature and purpose of a proposed treatment or procedure; 推荐治疗或手术的动机和目的； The risks and benefits of a proposed treatment or procedure; 推荐治疗或手术的风险与好处； Alternatives (regardless of their cost or the extent to which the treatment o