Scientific evaluation system of clinical ability is the basis and guarantee of the quality of clinical medical postgraduate training. The following is my clinical medical paper for your reference.

Model essay on clinical medicine 1: Thoughts on quality control of clinical medical examination

Objective: To explore the problems and countermeasures in quality control of clinical medical examination. Methods: This time, 200 physical examination patients admitted to our hospital from May 2065438 to May 2065438 were randomly divided into control group (n = 100 * *) and observation group (n = 65433). Results: The accuracy rate of sample selection in the observation group was 98%, which was significantly higher than that in the control group (85%), with statistical significance * * * P < 0.05***. The satisfaction rate of patients in the observation group was 98%, which was significantly higher than that in the control group (86%), with statistical significance * * * P < 0.05***. Conclusion: In view of the problems existing in laboratory quality management, targeted measures should be made.

Keywords: physical examination; Quality control; Problems; Countermeasures

In modern medicine, clinical examination is an important content, which can provide accurate reference for the diagnosis, treatment, monitoring and prognosis evaluation of diseases. With the outstanding development achievements of medical science and technology, medical examination technology is also developing continuously. The accuracy of examination results is the key to ensure effective diagnosis and control of diseases, which is directly related to medical quality. Therefore, paying attention to the quality control of medical examination is of great significance to improve the therapeutic effect and the relationship between doctors and patients [1]. In this survey, clinical laboratory patients were randomly divided into groups, and the results of strengthening quality control management and routine management were compared. The results are summarized as follows.

1 data and methods

1. 1 general information

From May, 20 13 to May, 20 15, 200 clinical patients were selected, including 65,438 males and 96 females, who were examined by chemistry, microbiology, immunology and hematology respectively. Randomly divided into observation group and control group, each group 100 cases, the overall difference between the two groups was not significant * * * P & gt0.05***, comparable.

1.2 method

The control group applied the conventional management scheme in the inspection process, while the observation group paid attention to the existing problems, formulated targeted solutions and implemented them. The specific operation steps are as follows:

1.2. 1 Quality control problem: * * 1 * * Specimen collection problem: The subjects' diet, exercise and drugs used can all affect the test results, and the geographical location, age, sex and nationality of the patients can also affect the test results. When collecting specimens, patients should be instructed to stop taking drugs and collect specimens in quiet or normal activities. However, if the operation is improper, such as injecting blood directly into a test tube without pulling a needle after venous blood collection, hemolysis will occur. Taking blood from the vein of the infusion arm will dilute the blood sample. ***2*** Inspection equipment problems: improper maintenance and aging of the instrument will affect the sensitivity of detection and cause accuracy problems; The problems in the inspection process are caused by the limited level of inspectors or the failure to master the functions, standard operation and precautions of the instrument; For example, when changing reagents, the reference number of related instruments has not changed, and the consciousness of standardizing and saving samples is not strong, which leads to operational errors and large errors in test results. The reagent used is not set according to the specification requirements, and an error event occurs. ***3*** Man-made problems: Medical science and technology have developed rapidly in recent years, and the inspection instruments are becoming more and more advanced and the degree of automation is higher, but people are still needed to complete all the operations. Therefore, in the detection test, the operator's operation error is one of the main reasons leading to the result error. Personnel operation errors mainly include: too long sample exposure time, irregular operation habits, differences in sample detection peak area integral, insufficient attention to detection results, etc., which can all lead to adverse events. * * * 4 * * Indoor quality evaluation and indoor quality control: indoor quality control is indoor quality control. Paying attention to the development of indoor quality control is an important measure to monitor the stability of instruments, devices, inspection methods, operating environment, processes and reagents, and also a weather vane to ensure the correct inspection results. Inter-laboratory quality evaluation is ventricular interstitial evaluation. Strengthening the evaluation of ventricular interstitial can evaluate the accuracy and reliability of the test results and ensure that the results are consistent or comparable to those of other units. * * * 5 * * Problems after inspection and analysis: In medical inspection, recheck and audit of results are the last line of defense to ensure quality. Inspectors usually rely too much on advanced instruments and equipment, and are prone to error reports, such as abnormal test results in automated hematology analyzer, failure to recheck according to manual rules, and issuance of error reports.

1.2.2 countermeasure analysis: * * 1 * * quality control before inspection: ① ensure sample quality: before collecting samples, pay attention to the application of humanistic care concept, actively communicate and explain with patients and their families, understand the illness, mood and physiological changes, and inform the purpose, significance, matters needing attention in sampling and retaining samples, and factors affecting the inspection. ② Qualified samples: Strictly carry out three checks and seven pairs of collection to confirm and verify patient information. When collecting samples, there are strict requirements on time, place, * * *, sampling method and quantity. For example, blood samples are usually collected on an empty stomach16 hours, and patients remain calm, quiet and normal before 9 am. When collecting urine samples, patients should eat regularly and avoid sex, exercise and drinking. When women collect after menstruation, they should pay attention to cleaning the urethral orifice, external genitalia and surrounding panels to avoid being polluted by menstrual blood and * * * secretions. Once the sample is collected, it has real effect and needs to be sent for inspection in time. If you don't have the conditions for timely inspection, you need to keep it correctly to prevent deterioration or denaturation, which will affect the inspection results [2]. * * * 2 * * Quality control in inspection: ① Instrument maintenance: The normal implementation of instruments is of great significance in the inspection process. Inspectors need to do maintenance and repair, and regularly evaluate and calibrate the efficiency to ensure the stability and normal implementation of the efficiency. Once there is a problem, they need to inform the supplier in time for replacement or maintenance. At the same time, train medical technicians in the laboratory to prevent human error. (2) To ensure that the inspection reagent is qualified, strictly manage the storage environment and aging of the reagent, and pay attention to the shelf life and production date before use, so as to avoid inducing wrong results due to the failure or deterioration of the reagent. Establish a system for the storage and use of reagents to ensure effectiveness and safety and improve the accuracy of test results. ③ Improve the comprehensive quality of inspectors: Modern instruments are all finely operated, and inspectors need to have theoretical knowledge and operational skills. Therefore, it is necessary to strengthen technical operation training and business study, master instrument operation rules, detection principles, interference factors, graphs and data of detection results, the meaning of alarm and how to maintain and debug, master efficiency evaluation and calibration standards, and prevent operational errors. At the same time, we should have a strong sense of responsibility and love, combine our own technical level, make a reasonable explanation of patients' questions, actively communicate with other departments, understand patients' condition, and evaluate whether the results are accurate in combination with clinical symptoms, so as to improve our detection ability. * * * 4 * * Actively carry out the management of indoor quality control and interstitial evaluation: before sample testing, calibrate the instruments, conduct indoor quality control, test the testing parameters and effectiveness of instruments and equipment, and test the samples under normal conditions. If it is out of control, it is necessary to record it, analyze the reasons, actively correct it, and then carry out testing. Pay attention to the accuracy of quality control. Pay attention to the evaluation of ventricular interstitium to ensure that the test results are consistent with those of other units and comparable.

Statistical analysis of 1.3

The data involved in this paper were analyzed by SPSS 13.0 statistical software, and the counted data were tested by χ2, and the difference was statistically significant (P < 0.05).

Two results

The accuracy of sample selection in the observation group was 98%, which was significantly higher than that in the control group (85%), and the difference was statistically significant * * * P < 0.05***. The patient satisfaction in the observation group was 98%, which was significantly higher than that in the control group, and the difference was statistically significant * * * P < 0.05***.

3 discussion

Medical laboratory plays an important role in modern medicine, which is a comprehensive subject, and its quality management directly affects the overall medical level [3]. There are many problems that cause errors in test results, which need comprehensive analysis and active prevention and control to reduce the unqualified rate of specimen inspection. In this survey, the observation group discussed the problems caused by personnel, instruments, devices, reagents and other factors in the process of specimen collection and inspection before inspection, and formulated targeted prevention and control countermeasures, such as paying attention to communication with patients before specimen collection, strengthening the maintenance and inspection of instruments and devices, paying attention to cultivating the comprehensive quality of inspectors, and actively carrying out indoor quality control and outdoor quality evaluation, which is of great significance to reducing the unqualified rate of inspection and improving patient satisfaction [4]. This result confirmed that the observation group was obviously superior to the control group. To sum up, in view of the problems existing in laboratory quality management, it can improve the inspection quality to formulate targeted countermeasures, including the management of specimen collection, inspection instruments and reagents, inspection personnel and so on.

refer to

[1] Hao Lili. Quality control before clinical medical examination and analysis [J]. Primary Medical Forum, 20 14, 18 * * * 20 * *: 2672-2673.

[2] Mao. Quality management and control before medical laboratory analysis [J]. Experimental and Laboratory Medicine, 2012,30 * * *1* *: 50-51.

[3] Dong Daguang. On quality control before medical examination and analysis [J]. China General Medicine, 20 12,10 * * 7 * *:1143-1448.

[4] Xue Jianli. Talking about how to control the errors in medical examination in the process of examination operation [J]. * * and rehabilitation medicine: next issue, 201,2 * * *11* *: 221.

Second, strategies to improve the employment quality of primary clinical medical graduates

The employment of college students is a topic that needs the common concern of the whole society. Grass-roots employment is an important employment way for medical students, and its employment quality is related to personal career development and the long-term development of medical and health undertakings. Therefore, improving the employment quality of primary medical students has become the focus of employment work in medical colleges. In recent years, the grassroots employment situation of medical college graduates is not optimistic, and grassroots employment is the mainstream choice for medical college graduates. This paper puts forward the ways to improve the employment quality of clinical medical graduates in higher vocational colleges from three aspects.

Keywords: grass-roots employment; Employment quality; Major in clinical medicine; graduate

1 Current situation of medical students' initial employment

According to statistics of Huayu Education Network, there are more than 40 public medical colleges and universities in Chinese mainland, which train nearly100000 medical professionals for the society every year. Although medical colleges and universities have a certain scale in China, and their graduates have made great contributions to the health of our people, today, with the popularization of higher education, the trend of higher education marketization is becoming increasingly obvious, and the competition between education market and educational talents is becoming increasingly fierce, which makes medical colleges and universities face great challenges [1]. The orientation of talent training in medical colleges is to train medical and health talents for grassroots and rural areas. However, with the rapid development of higher medical education in China, the number of medical graduates has also increased year by year. Due to the influence of academic level and professional nature, the employment situation of college graduates is more severe than that of undergraduate and graduate students [2]. In recent years, with the development of China's medical and health undertakings, the implementation of "Several Opinions of the Central Committee of the State Council on Deepening the Reform of the Medical and Health System" No.6 and the further development of the new rural cooperative medical system, the medical and health conditions in primary hospitals have been improved, and most hospitals are overloaded, which has increased the demand for medical and health personnel and guided and encouraged college students to find jobs at the grassroots level. Although it has attracted the attention of * * * at all levels, a series of policies and measures to promote the employment of college graduates at the grass-roots level have been introduced, which have achieved certain results and alleviated the employment pressure of college students to some extent, but compared with the policy objectives, the effect is not ideal [3]. Wang Yunpeng pointed out in "Construction of Long-term Mechanism for Medical College Graduates to Go to Grassroots Employment" that at present, 80.0% of medical and health resources in China are concentrated in cities and large hospitals, and about 90.0% of medical college graduates are employed in large and medium-sized cities and coastal economically developed provinces and cities every year. Primary health care is characterized by lack of resources, poor conditions, less equipment and low level. Pan Riming and others [4] conducted a survey of students' employment intentions at the grassroots level and found that only 4.0% of students expressed their willingness to work at the grassroots level. Zhou Jing found that only 7.6% of college students chose to take an active part in the grassroots employment. In recent years, China has increased its support for college students' employment at the grass-roots level year by year in terms of policy support, financial support and jobs, and has also taken corresponding preferential and encouraging measures in postgraduate entrance examination, recruitment of civil servants and recruitment of personnel in institutions. However, many survey data show that medical students lack a correct understanding and rational choice of grassroots employment. It can be seen that there is a deviation between the choice of employment direction of medical students and the demand of medical and health market, and the employment tendency is seriously misplaced.

Grassroots employment is the mainstream choice for medical college graduates.

With the rapid development of higher education, while the quality of talents is improving, the number of talents sent by colleges and universities to the society is also increasing, which makes the society's requirements for graduates, including academic level and comprehensive ability, also improve in an all-round way. In recent years, the expansion of medical colleges and universities has basically saturated the medical talent market in big cities, and the increasingly fierce employment competition has tilted the medical student employment market to small and medium-sized cities and primary medical units with relatively less competition and more job demand. In fact, the shortage of grassroots talents has existed for a long time, especially with the acceleration of rural medical and health development, grassroots employment has become the mainstream choice for medical students, especially medical college graduates, and it is also the embodiment of medical students' correct values. This general trend is conducive to solving the problem of "difficulty in seeing a doctor" at the grassroots level, improving the health level of grassroots people, broadening the employment channels of medical college graduates and promoting the growth of medical college graduates. In the long run, it conforms to China's national conditions and has far-reaching strategic significance [5]. It is emphasized that contemporary college students should aim high, be down-to-earth, change their concept of choosing a job, persist in proceeding from reality, be brave in going to the grassroots and hard places, take the road of life step by step, and be good at creating extraordinary achievements in ordinary posts. Medical students' employment at the grass-roots level is the need of China's health reform and development in the new period, and it is also an opportunity to achieve self-employment and success. Medical graduates should clearly understand the social employment situation and career development trend, do a good job in personal career planning, make persistent efforts, look at the vast space and development stage in rural areas and grass-roots units, straighten the employment orientation, realize the best combination of people and society, and realize rational and scientific employment [6].

3 to improve the quality of initial employment of clinical graduates countermeasures

The quality of college students' employment can not be measured only by the employment rate, but should be judged from the following aspects: first, wages and benefits, which are often concerned by people, are related to employees' evaluation of their own labor value; The second is the working environment and location, which is people's consideration of the environment and working comfort; Third, the profession and development prospects; The fourth is the employer's satisfaction with graduates [7]. High-quality employment is the need to promote employment, to promote economic development, to ensure and improve people's livelihood, and to measure the quality of running a university. With the development of economy and the increasingly fierce competition in the industry, the talents needed by all walks of life are becoming more and more specialized. Only high-quality employment can meet the demand for talents in today's social and economic development [8]. The improvement of grassroots employment quality of clinical graduates in higher vocational colleges can be realized from the following three aspects. The first is the drive of social coordination. * * * Continue to increase support for grassroots medical and health units, improve their economic and social environment, and improve their medical conditions; Improve the employment treatment of primary medical students, give special care in wages, implement various insurance, housing provident fund, old-age insurance, medical insurance and other * * * systems, and give appropriate subsidies according to the economic conditions in the region; Encourage large hospitals to "pair up" with primary medical units, establish cooperative relations, increase mutual exchanges and counterpart support, provide learning opportunities for medical graduates, conduct regular on-the-job training, and improve their professional level; Promotion of professional titles will give priority to those with grassroots work experience. We can consider formulating relevant systems for grass-roots work. For example, graduates can enjoy corresponding preferential policies according to their years of service at the grassroots level. After three to five years of service at the grass-roots level, 80% of the tuition fee can be reduced, and after five years, 100% of the tuition fee can be reduced. According to the needs of work, the hospital at the next higher level is not restricted. Second, schools help to promote the role. Widely publicize national and local policies and measures to serve college students' grassroots employment, establish an excellent image of medical students' grassroots employment, publicize advanced models of medical students' grassroots growth and success, make medical students more aware of the implementation of preferential policies for grassroots employment, the protection of personal interests in grassroots employment, the advantages of grassroots employment for personal development, create a cultural atmosphere for grassroots employment, help medical students correctly understand the current employment situation, adjust their employment orientation, and enable graduates to fight for it voluntarily, actively and actively. Make the school development plan based on market demand, determine the direction of talent training, offer courses suitable for grass-roots jobs, offer clinical medicine classes in anesthesia, midwifery, rehabilitation and other professional directions according to the talent demand of grass-roots medical units, and cultivate "marketable" talents; And primary medical units jointly set up a "grass-roots employment orientation class". Tuition and subsidized living expenses are provided by * * and medical units, which not only helps poor medical students solve the problem of learning difficulties, but also opens up new channels for poor medical students to find jobs and attract talents in primary medical units. Organize social practice activities, arrange clinical medical students to practice in the governing unit, build a communication platform between the two sides, let medical students feel the working environment at the grassroots level, strengthen their understanding of grassroots work, and shorten the adaptation period after grassroots employment; Strengthen grass-roots employment guidance, attach importance to career planning guidance, help medical students correctly understand the needs of the labor market, grasp their own conditions, do not pretend to be high-level professionals, and reduce the blindness of job hunting and career positioning; Establish a long-term follow-up mechanism for grass-roots employment graduates, and provide help that is conducive to career stability according to their needs, such as providing free pre-job training, and carrying out qualification examination training for licensed doctors and assistants. The third is family support and personal strength improvement.

At present, the state has clear guidance and corresponding preferential policies for college students' grassroots employment. Graduates' families and individuals should have a clear understanding of the current employment situation, master and effectively use these policies, look at grassroots employment from the perspective of sustainable development, respect the objective reality of society and consider their own actual situation, take a correct position at this stage when the employment situation is not optimistic, seize employment opportunities, actively participate in grassroots service projects, and actively choose grassroots employment. Especially, the employment of students majoring in clinical medicine is narrow. On the one hand, we should pay more attention to the study and exercise of professional skills and non-professional skills, improve the knowledge structure, improve our comprehensive strength and broaden employment channels; On the other hand, we should strengthen self-psychological adjustment, reasonably position ourselves in the process of choosing jobs and obtaining employment, find out our own coordinates in the employment army, grasp the initiative of employment, stand on the grass-roots level, maintain professional stability, enhance personal ability and improve the quality of employment. At present, college graduates generally pursue high salary and comfort, which leads to the obvious polarization between the surplus and shortage of talents in big hospitals and primary medical and health units in cities, and the competition among graduates is extremely fierce, especially for students in higher vocational medical colleges. If they still choose their jobs and employment with the concept of "elite", they will be divorced from the needs of society and reality. Therefore, medical graduates should adjust their employment outlook and expectations, reasonably reduce the level of employment, closely integrate their personal ideals with the development of the country, the nation and the times, and realize their self-worth in dedication. Practice has proved that the grass-roots level is a fertile ground for medical students to exercise and grow healthily. The more difficult the conditions are, the more talents can be cultivated, exercised and cultivated [9].

References:

[1] Chen Mingxiong, Guo jinxia, Zou zizheng, et al. research on the characteristics and orientation of medical colleges [J]. health vocational education, 2014,32 * * * 3 * *: 5-6.

[2] Li Bohe, Wang, "1+2m" talent training mode plays a guiding role in grassroots employment of clinical medical graduates [J]. China Science and Education Innovation Guide, 2012 * * * 29 * *:118653.

[3] Zhou Jing, Liu Lezhou. Analysis of the current situation of college students' grass-roots employment consciousness and its countermeasures [J]. Introduction to Science and Education, 2015 * *1* *: 20-21.

[4] Pan Riming, Zeng Xiaofeng. Cause analysis and countermeasures of college students' employment difficulties at the grass-roots level [J]. Contemporary Education Forum, 2007 * * * 10 * * *: 78-80.

[5] Yang Qiong. Present situation and countermeasures of medical college graduates serving the grassroots [D]. Changsha: Hunan University, 20 14.

[6] Zhang. Grass-roots employment is promising —— Analysis on the inevitability of grass-roots employment of medical graduates [J]. Journal of Mudanjiang Medical College, 20 1 1, 32 * * * 4 * *: 94-95.

[7] Zheng. On the Methods of Improving the Employment Quality of College Students [J]. Journal of Shanxi Normal University: Social Science Edition, 2014 * * 41* *: 202-203.

[8] Party Zhiping. Research on improving the quality of college graduates' employment at the grass-roots level under the background of high-quality employment [J]. Modern Education Science, 2014 * * * 6 * *:155-158.

[9] Cao Wei. Construction of grass-roots employment system for medical students [J]. Northwest Medical Education, 2009, 17 * * * 4 * * *: 790-792.