To evaluate the design and implementation effects of the "Rapid Recognition and Management of Critically Ill Patients" course, and to provide a reference for the improvement of situational simulation teaching in emergency and critical care settings.

Objective To evaluate the interpersonal communication competence of doctors in 10 dimensions of standardized training for specialized doctors and their communication differences with various groups,and to analyze the existing problems and solutions.Methods The 10-item short-form version of the Interpersonal Communication Competence Scale(ICCS-SF)was used to assess the communication abilities of 395 physicians undergoing training at six specialized physician training bases in Shanghai.Descriptive statistics,chi-square tests,non-parametric tests,and multiple linear regression of methods were employed to analyze the communication status and training status of specialist physicians.Results The maximum score for interpersonal communication competence is 50 points,and the average score for the specialist physicians in this study was 38.0(35.0～41.0)points.The impact of the training on the scores is reflected in the total score and the two sub-dimensions of social relaxation and self-affirmation,with statistically significant differences(P＜0.05).Compared to patients and colleagues,specialized training physicians reported the greatest difficulty in communicating with interdisciplinary teams.Physicians who recognized the importance of communication and those whose training included a greater variety of skills achieved higher ICCS-SF scores(P＜0.001).Conclusion It is necessary to further strengthen the coverage and standardization of training,and pay attention to the cultivation of communication competence between interdisciplinary teams on the basis of attaching importance to the communication competence between doctors and patients.

Objective To evaluate the interpersonal communication competence of doctors in 10 dimensions of standardized training for specialized doctors and their communication differences with various groups,and to analyze the existing problems and solutions.Methods The 10-item short-form version of the Interpersonal Communication Competence Scale(ICCS-SF)was used to assess the communication abilities of 395 physicians undergoing training at six specialized physician training bases in Shanghai.Descriptive statistics,chi-square tests,non-parametric tests,and multiple linear regression of methods were employed to analyze the communication status and training status of specialist physicians.Results The maximum score for interpersonal communication competence is 50 points,and the average score for the specialist physicians in this study was 38.0(35.0～41.0)points.The impact of the training on the scores is reflected in the total score and the two sub-dimensions of social relaxation and self-affirmation,with statistically significant differences(P＜0.05).Compared to patients and colleagues,specialized training physicians reported the greatest difficulty in communicating with interdisciplinary teams.Physicians who recognized the importance of communication and those whose training included a greater variety of skills achieved higher ICCS-SF scores(P＜0.001).Conclusion It is necessary to further strengthen the coverage and standardization of training,and pay attention to the cultivation of communication competence between interdisciplinary teams on the basis of attaching importance to the communication competence between doctors and patients.

Objective:To analyze the risk factors that affect the prognosis of patients with hypopharyngeal squamous cell carcinoma（HPSCC） and to compare the efficacy of surgical resection followed by adjuvant radiotherapy（SR） with that of neoadjuvant therapy consisting of platinum-based chemotherapy and fluorouracil combined with either cetuximab or nimotuzumab, followed by SR. The study also aimed to evaluate the overall survival（OS） of patients, their postoperative eating function, tracheostomy decannulation rate, and tumor response to the two neoadjuvant chemotherapies. Methods:A retrospective analysis was performed on the medical records of HPSCC patients who received SR or neoadjuvant therapy followed by SR treatment at the Shanghai General Hospital from 2012 to 2019 and had not undergone any prior treatment. The prognostic factors were analyzed, and the survival analysis of patients who underwent SR treatment with two neoadjuvant chemotherapy regimens was performed. Results:A total of 108 patients were included in the study. The results of the univariate analysis showed that gender（P=0.850） had no significant correlation with the survival rate of HPSCC patients who underwent SR. However, age, smoking history, alcohol consumption history, platelet-to-lymphocyte ratio（PLR）, neutrophil-to-lymphocyte ratio（NLR）, T stage, N stage, neoadjuvant therapy with either cetuximab or nimotuzumab combined with platinum-based chemotherapy and fluorouracil, and histological grade were significantly associated with prognosis（P<0.05）. The multivariate analysis revealed that smoking history, histological grade, and neoadjuvant therapy with either cetuximab or nimotuzumab combined with platinum-based chemotherapy and fluorouracil were independent risk factors affecting the prognosis of HPSCC（P<0.05）. Patients who received neoadjuvant therapy had longer OS than those who underwent SR only（P<0.001）. There was no significant difference in tumor response to the two neoadjuvant therapies and in OS（P>0.05）, and there was no significant difference in the rate of oral feeding and tracheostomy decannulation among the three treatment groups（P>0.05）. Conclusion:Univariate analysis showed that age at tumor onset, smoking history, alcohol consumption history, NLR, PLR, T stage, N stage, whether receiving neoadjuvant chemotherapy, and pathological grade were associated with the prognosis of HPSCC patients receiving SR treatment. Multivariate analysis showed that smoking history, pathological grade, and neoadjuvant chemotherapy were independent risk factors affecting the prognosis. Neoadjuvant chemotherapy with cetuximab or nimotuzumab can prolong the OS of patients, providing a certain basis and reference for the treatment of HPSCC.
Humans ; Neoadjuvant Therapy ; Squamous Cell Carcinoma of Head and Neck ; Cetuximab/therapeutic use* ; Retrospective Studies ; China ; Prognosis ; Fluorouracil ; Head and Neck Neoplasms

Objective It combines medical big data and machine learning techniques to explore clinical outcomes based clinical physician performance evaluation method.Methods The non-negative principal component analysis(NPCA)was used in cases.Based on the non-negative sparse principal component analysis(NSPCA),a comprehen-sive index fitting was performed on 11 clinical performance indicators of 170 clinicians treating cardiovascular diseases.At the same time,confidence intervals were constructed based on root cause assessment techniques to calculate the range of indicators for each clinician.Results The coincidence rate of outpatient discharge diagnosis,the rate of grade A healing of surgical incision,the proportion of surgical patients,the rate of 3-day diagnosis,the proportion of third-grade and fourth-grade surgery,the completion of surgery and the number of operations were significant in dis-tinguishing the work performance of clinicians.However,the average length of hospital stays before surgery,the rate of unplanned readmission within 30 days,the average length of hospital stays of discharged patients,the main diag-nosis and cure/improvement,and the number of patients admitted were not significant in distinguishing the clinical work performance of clinicians.The overall work performance of all clinicians can be ranked through comprehensive index fitting,and the further evaluation of high,middle and low performance of each specific index can reveal the potential reconstruction dimensions of each clinician.Conclusion It utilizes machine learning techniques to achieve a comprehensive evaluation of clinical performance,utilizing medical big data as the foundation.It holds the potential to provide important support for a more scientific and objective assessment of clinical performance.

Objective Focusing on the evaluation system of senior health professional titles in Shanghai,it discusses the rationality of the existing policies from the perspective of clinicians who plan to participate in the promotion,and put forward suggestions for optimizing the content and form of the evaluation.Methods Online questionnaire surveys had been conducted for all clinicians who participated in the application for Shanghai's senior health professional titles in 2020 to collect the personal information and their attitudes towards the professional title review system.R 4.0.2 soft-ware was used to conduct statistical description,cluster analysis,chi-square test,non-parametric test,etc.Results A to-tal of 1,674 people from 32 clinical specialties were surveyed.According to the two factors of growth space and growth speed,the participating subjects are divided into four different categories of groups,which are named according to the sample characteristics:Stars,Mainstay and Veteran.There are no differences among the three groups in the familiarity,and difficulty evaluation of clinical indicators for the senior health professional title evaluation system.The proportion of Veteran considered unreasonable is relatively high.There are differences among the three groups in overall difficulty level,scientific research difficulty and qualification difficulty.Conclusion The incentive attribute of the health technical person-nel senior title evaluation system should be continuously strengthened,and the differentiated characteristics of the de-velopment of health talents should be paid attention to.Big data can be used to highlight the quantification and differen-tiation of clinical competency evaluation indicators,which can effectively improve the scientific level of professional title evaluation.