科学发展观视阈特色办学的探索与实践

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1、科学发展观视阈特色办学的探索与实践金秀东 关利新 于景艳 朱晓东（牡丹江医学院，黑龙江 牡丹江157011）摘要从科学发展观的视角，解读地方院校特色办学的内涵，剖析学院确定适合自身特点科学定位，逐步形成“为农村办学、为基层服务”办学特色的理性认识过程；回顾依托区域服务社会、强化特色的实践历程，总结突出“两为”方针独辟蹊径、彰显特色的成果；提出确立科学发展理念，拓展特色办学的视阈，适应医疗卫生事业改革深入发展的新要求，构建“双轨同步”的办学体系，发展特色办学的新思考。关键词科学发展观，特色办学，双轨同步Exploration and Practice of Running a Character

2、istic School on Perspective of Scientific Outlook on Development(Mudanjiang Medical University, Heilongjiang Mudanjiang 157011)Abstract On perspective of Scientific Outlook on Development, unscrambling the connotation of running a characteristic school of Higher Education of the Local Government, an

3、alyzing the orientation of characteristic university that suitable to its own characteristics, gradually formed rational process of cognition of school-running characteristic that “run a school for rural area, serve the basic unit”; Review the practice process that serve the society rely on local, s

4、trengthen characteristic; Summarize and stress achievement of going to extraordinary measures, highlighted characteristic; put forward new thinking that Establish the scientific development concept, develop perspective of school-running features, adapt to new requirements of health care reform devel

5、opment, construct “doubletracks and synchronous ” school-running system of, so to develop running a characteristic school.Keywords Scientific Outlook on Development, running a characteristic school, doubletracks and synchronous 一、科学定位、“两为”方针形成特色随着社会文化和经济的发展，高校办学必须首先解决的问题是科学定位。作为地方院校，必须理智地确定自身的办学理念与定

6、位，构筑适合自身实际和发展需要的办学体系，在特色中找到自己生存和发展的生长点。牡丹江医学院作为一所远离中心城市、历史不长、名气不大的边陲地方医学院校，如何办出特色，这是从上个世纪80年代起就认真思考的问题。经过二十余年的反复探索与实践，逐步形成了一个在科学发展的教育理念指导下，适合自身特点的“特色型大学”定位。学院自1983年开始先后8次对黑龙江省东南部县、市的农村医疗卫生状况及人才需求情况进行了广泛的社会调查，面对大、中专毕业生外流、医师离乡跳农门，“乡土型”医学人才短缺，边远乡、镇和贫困山区缺医少药的现状，通过对调查得到的第一手材料的理性分析，掌握了基层和农村对医疗人才知识结构和能力结构的

7、特殊需求，结合学院自身的办学规模和所处的地理位置，经过深入反思和论证，确立了“为农村办学、为基层服务”的办学方针。决定把办高等医学教育的着眼点、立足点放到农村，放到基层。制定了“面向农村需求，坚持开放型办学和全方位服务”的强化办学特色的总体思路，明确的提出了“让开大路走两厢，打开人才迈往农村的路径”，在实践中制定并不断完善了为农村培养中、高级医疗卫生人才的“一二三四五战略”：1、 坚持一个办学指导思想-为农村和基层服务；2、完成招生重点的两次战略转移、铺设两条服务轨道-实行招生工作重点由城市到农村，由县、镇到乡、村 的两次战略转移。铺设了通向农村的本、专科学历教育和 继续医学教育两条服务轨道；

8、3、坚持三个定向-定向招生、定向培养、定向分配。为农村培养下得去、用得上、留得住的乡土型农村医师；4、建设四多服务网络-多层次、多规格、多形式、多渠道纵向到底、横向到边的服务网络，全方位地为农村培养急需人才；5落实五项人才质量保证举措：（1）调整专业结构、创办农村医学专业，新设农村急需的长、短线专业；（2）深化教育改革，实行基础课、临床专业课和毕业实习课时合理配置，强化实践教学；（3）增加教学投入，加强教学基本建设，提高办学效益；（4）切实加强思想道德教育和医德教育，对在校生进行热爱家乡、扎根家乡、振兴家乡的系列教育；（5）重视教育科研，强化研究机构，努力构建产、学、研一条龙。1982年至20

9、05年，学院共录取县、乡、林区、农场的考生12217名，占录取总数的64、5%。针对农村和基层的特点，在课程设置上大胆改革，开展PBL的教学法改革试点和全科医学教育试点，创办了农村医学专业。开办了五年制夜大、农医班、短训班、临床进修班等，培训各类医务人员2000多人。截止2005年，牡丹江医学院有6000多名学历毕业生和数千名受培训的医务人员犹如火种撒落在广袤的农村。二、独辟蹊径、服务社会彰显特色伴随着高等医学教育改革的不断深入，招生与就业形势不断变化，传统的定向招生、定向培养、定向分配格局被打破，在新形势下，学院坚持办学特色不动摇，与时俱进不断丰富其“两为”方针的内涵。2003年学院进行的第

10、7次社会调查走访了94个乡镇卫生院和228个村卫生所，召开77次座谈会，在掌握大量第一手材料的基础上，向有关部门建议，在高级医学人才通向农村的路径还没有完全打通的情况下，应将“解决农民就医难”和“村村大学生”两项任务结合起来实施。在“村村大学生”计划中增加乡村医生的项目，得到了省教育厅的支持和采纳。2005年黑龙江省为切实推进农村卫生事业发展，将乡村医生培养纳入“村村大学生计划”之列。政府出资与高校联合培养乡村医生，我院承担了培养任务。为了培养具备基础医学、临床医学和预防医学基本知识、基本理论、基本技能，“下得去、用得上、留得住”的优秀乡土型人才，我们提出了乡村医生培养计划，探索为农村应用型全

11、科医学人才培养模式的新途径。1、拓展专业教学内容：借鉴多年来学院“两为”办学经验，针对乡村医生是在乡村基层医疗卫生机构中从事医疗、预防、保健和康复等方面工作的“全科医生”的实际需要，学院又一次修订了教学计划，如降低理论课学时，加大实践课时数；加强预防医学力度、增强学生大预防观念；突出中西医结合，为基层卫生机构培养实用型高等中、西医结合型人才。使毕业生胜任在农村基层医疗单位进行常见病、多发病的防治工作和卫生保健工作。2、采用循证医学理念的教学模式：针对学生有一定的临床工作经验，毕业后又要返回原乡村基层医疗卫生岗位独立进行临床工作的实际，为了强化学员的临床思维和临床技能，从教学计划的制定到实施，探

12、索采用了循证医学理念的教学模式。以解决临床问题为出发点，通过在临床实际中发现问题、寻找最佳证据、评价及应用证据，培养学生在实践中发现问题、分析问题、解决问题的能力和创新意识。通过学习以问题为基础的循证医学，培养学生主动学习的意识和能力，不断更新知识，成为一名终身自我教育者 1 。3、优化教学方法：针对乡村医生理论基础较差，学习时间较短，不可能系统详尽的学习和掌握医学理论知识。按照“疾病教学螺旋模式”组织教学，采用“以症状为主线、以问题为中心”的PBL教学法，使教学更贴近临床实际2。4、完善教学管理：根据农村医疗服务季节性较强的特点，采用较为灵活的学分制、弹性学制等“以人为本”的教学管理方式，实

13、行集中与分散相结合的的学习形式，解决学习与工作的矛盾，保证学习效果。“村村大学生计划和乡村医生培养计划”的启动，基于循证医学理念的教学模式的初步探索，为农村应用型全科医学人才的培养开创了新模式。 截止2009年已招生五届，首批学员已完成所有课程圆满毕业并返回原乡村医疗卫生岗位。由于卓有成效的开展了相关的教学改革和教学服务，为农村和基层培养了大批“乡土型”中、高级医疗卫生人才，收到了预期的成效，也得到了有关部门的肯定和表彰。中国教育报、健康报、光明日报、黑龙江日报等多家媒体曾先后多次报道了我院特色办学的动态和做法。卫生部以“一所切实为农村和基层服务的医学院”为题在健康报发表了“牡丹江医学院改革调

14、查报告”。并拍摄了电视记录片受农民欢迎的医学院。1989年学院获国家教委优秀教学成果特等奖。学院在探索乡村医生培养模式过程中办学质量持续提升，办学特色日益彰显。三、开拓创新、“双轨同步”发展特色办学特色的形成、维持和创新是学校求生存、谋发展的策略。办学特色的形成需要一个长期的过程，具有相对的稳定性。同时办学特色又具有发展性，不仅是过去的，也是面向现在和未来的。在医疗卫生事业改革深入发展的今天，我们既要坚持“两为”方针不动摇，因为乡村医生是我国农村卫生服务的重要提供者，是农村卫生的三大支柱之一3。又要在新的形势下的重新思考，在主动服务社会的过程中寻找到学校发展新的突破口。要在科学发展理念指导下，

15、拓展特色办学的视阈。抓住机遇，主动调整，构建“双轨同步”的办学体系，更好的坚持和发展特色。1、理论教学和实践教学“双轨同步”（1）压缩适当的理论课程，加大实践教学力度，增加实验课和早期临床实践。早期接触临床，可以改善医学教育理论与实践脱节的情况，实现理论联系实际，让学生在实践中增加感性认识，增强责任感，训练与病人交流的能力，激发学习兴趣，培养学生主动获取临床技能4。可以加深医学认识，修正学医目的，明确医生责任；清晰医生角色，树立医生标准；加强沟通理解，锻炼职业能力；理论联系实际，熟悉医疗环境，了解专业走向，提高学习兴趣。（2）以能力培养为主线,构建新的课程体系。本着重实践、强技能，人才培养模式

16、的改革重在实践应用的指导思想，学院从09年启动的新一轮教育教学改革培养方案。新培养方案以本科医学教育标准临床医学专业（试行）为基本依据，结合学院的实际以及办学目标和定位，以新教学大纲的编制、修订为契机促进教学改革向纵深发展。重新拟订的教学大纲体现了教学过程与培养目标相一致，实现了优化课程结构和教学内容的整合；确立以学生为中心的教学理念，促进学生自主学习；结合专业、课程类型，改进教学方法和教学手段，注重加强学生实践能力的培养；改革学生考试成绩评定方式，重视执业医师资格考试。2、教师的培训“双轨同步”，教学和科研“双轨同步”教师个人素质及教学水平对教学效果起着至关重要的作用，教师应具备良好的职业素

17、质和深厚的文化底蕴，在师资培训中既要强调专业知识培训，还要重视人文精神、心理学、教育学、交流沟通技巧、应变能力等方面的学习。专业课教师要“双证+双能”，同时具有教师、医师的职业素质和能力，既能讲授专业知识，又能指导专业实践；理论课教师要成为“能力之师+素质之师”：既能对学生人格价值引导，又能对学生职业引导。逐步建设一支理论基础宽、教学能力强、临床技能精，综合素质高的 “双师型”教师队伍。要把教学和科研有机的结合起来，努力实现力产、学、研一条龙，在东北药开发、地方病、常见病的研究中发挥专家、教授的积极作用，立足龙江、立足基层，为地方经济建设和社会发展服务。3、LBL教学法和PBL教学法双轨同步长

18、期以来LBL教学法一直是教学的主流形式。它以学科为基础，以教师为中心，以课堂讲授为主要形式。强调学科知识的系统完整，条理清晰，框架明确， 对于传播、学习、掌握知识是非常有益的，深为广大师生所接受。但也存在着忽视能力培养、忽视相关学科的融会贯通、忽视学生的感受体验双向交流启迪过程，从而忽视了知识应用，理论联系实际、创新性思维能力的培养。PBL教学法是一种全新的教学理念与教学实践。它以问题为中心，以教师组织引导下的学生自学、讨论为主要形式。强调知识的融会贯通，学以致用，鼓励和倡导学生独立自主地发现问题、提出问题、分析问题和解决问题。进而使学生处于主动地位，自主学习能力、捕捉、整理各种信息价值的能力

19、以及创新能力得到全面发展，有利于综合素质的全面提高。但也存在着忽视对基础知识的系统性学习，内容少于传统课程的含量，因而缺乏理论知识的系统性不利于医学生的全面发展。由此可见LBL教学法和PBL教学法各有长短，教学中二者均不可偏废，而应视具体情况灵活应用，互补结合5，双轨同步。4、专业医师与全科医生的培养双轨同步当代高等医学教育培养的毕业生应该具备：良好的职业道德；有效的沟通能力、独立思考和解决问题的能力；运用所学知识判断、处理、治疗及预防疾病；知晓与医疗相关的社会因素；医学伦理判断能力；职业本质认知能力6。然而要实现毕业生与社会需求的“零距离无缝对接”仅仅具备这些还难以满足社会需要，因为随着医疗

20、卫生事业的改革，农村和社区急需大批的全科医生。我国业已明确全科医学教育发展应以毕业后医学教育为核心,但当前我国还不能向发达国家那样,培养大批相当于硕士毕业的全科医生去社区和农村基层工作,短时间要让大部分在职基层医生达到大学毕业后教育的水平也是不现实的.那么,在当前我国急需全科医生的情况下,能否考虑在本科中开设全科医学专业7，我们在做这方面的尝试。总结我院多年来“两为”办学实践，一所普通的地方医学院校，能为农村为基层输送大量的医学人才，办出自己的特色，得益于找准自己的位置，准确定位不错位；得益于始终以科学发展观为统领，确立“两为”方针特色办学的理念，不断拓展特色办学的视阈；得益于坚持不懈的追求，

21、以突出办学特色为抓手，坚持育人为本，立足区域、服务地方、不断提升学院的综合实力和社会声誉。参考文献1王莞，冯克俭，李伟扬.基于基于循证医学理念的教学模式在乡村全科医生培养中的初探J.教育学报,2009(3):55-562朴玉霞,曾奇,刘俊峰.深化“两为”办学理念完善乡村医生培养模式J.中华医学教育杂志,2007(1):28-293张蓓蕾,王书城.新世纪我国乡村医生队伍的生存和发展的战略研究J.中国农村医学杂志,2006(1):54-584赵玲玲,刘振国,李小波.低年级学生尽早体验医生角色的探讨与实践J.中国高等医学教育,2007(12):85-865刘亚伟,戴兵,姚定康.PBL联合LBL双轨教

22、学法在肾内科见习中的应用J.中国高等医学教育,2009(12):34-366颜华.浅谈提高医学高等教育质量的对策J.中国高等医学教育,2009(8):13-187吴胤 ,黄子杰.英、德、美、法四国医学教育的共性与启示J.中国高等医学教育,2009(10):42-43基金项目黑龙江省新世纪教改工程项目作者简介金秀东,男,医学博士,院长,教授,研究方向:高等医学教育.关利新,男,医学博士,副院长,教授, 研究方向:高等医学教育.通讯作者 于景艳,女,教授,研究方向：政治教育通讯地址：黑龙江省牡丹江市爱民区通乡街3号 牡丹江医学院社科部 ：157011联系 ：13836309756 （英文版 ） T

23、wo regulations promulgated for implementation is in the party in power for a long time and the rule of law conditions, the implementation of comprehensive strictly strategic plan, implementation in accordance with the rules and discipline to manage the party, strengthen inner-party supervision of ma

24、jor initiatives. The two regulations supporting each other, the adhere to a positive advocate, focusing on morality is of Party members and Party leading cadres can see, enough to get a high standard; around the party discipline, disciplinary ruler requirements, listed as negative list, focusing on

25、vertical gauge, draw the party organizations and Party members do not touch the bottom line . Here, the main from four square face two party rules of interpretation: the first part introduces two party Revised regulations the necessity and the revision process; the second part is the interpretation

26、of the two fundamental principles of the revision of laws and regulations in the party; the third part introduces two party regulations modified the main changes and needs to grasp several key problems; the fourth part on how to grasp the implementation of the two regulations of the party. and revis

27、ed the necessity and revised history of the CPC Central Committee the amendment to the Chinese Communist Party members and leading cadres honest politics several guidelines and column 1 by 2015 to strengthen party laws and regulations focus. Two party regulations revision work lasted a Years, poolin

28、g the wisdom of the whole party, ideological consensus, draw historical experience, respect for the wisdom of our predecessors, which reflects the unity of inheritance and innovation; follow the correct direction, grasp the limited goals, adhere to the partys leadership, to solve the masses of the p

29、eople reflect a focus on the problem. The new revision of the and , reflects the partys 18 and the eighth session of the third, the spirit of the fourth plenary session, reflecting the experience of studying and implementing the General Secretary Xi Jinping series of important speech, reflects the p

30、artys eighteen years comprehensive strictly practice. (a) revised two regulations of the party need of in based on revised, the promulgation and implementation of January 2010, to strengthen the construction of the contingent of leading cadres play an important role. But with the party to manage the

31、 party strictly administering the deepening, has not been able to fully meet the actual needs. Content is too complicated, eight prohibition, 52 are not allowed to hard to remember, and also difficult to put into practice; the second is concisely positive advocated by the lack of prohibited provisio

32、ns excessive, no autonomy requirements; the third is banned terms and discipline law, both with the party discipline, disciplinary regulations repeat and Criminal law and other laws and regulations repeat; the fourth is to clean the theme is not prominent, not for the existing problems, and is narro

33、w, only needle of county-level leading cadres above. is in 1997 based on revision, in December 2003 the promulgation and implementation, to strengthen the construction of the party play very important role. Along with the development of the situation, which many provisions have been unable to fully

34、meet the comprehensive strictly administering the practice needs. One is Ji law, more than half of the provisions and criminal law and other countries laws and regulations Repetition; two is the political discipline regulations is not prominent, not specific, for violation of the party constitution,

35、 damage the authority of Party Constitution of misconduct lack necessary and serious responsibility to pursue; third is the main discipline for the leading cadres, does not cover all Party members. Based on the above situation, need to and the two is likely to be more relevant regulations first amen

36、dment. By revising, really put the authority of Party discipline, the seriousness in the party tree and call up the majority of Party members and cadres of the party constitution of party compasses party consciousness. (II) two party regulations revision process the Central Committee of the Communis

37、t Party of China attaches great importance to two regulations revision . Xi Jinping, general books recorded in the Fifth Plenary Session of the eighth session of the Central Commission for Discipline Inspection, on the revised regulations made clear instructions. According to the central deployment,

38、 the Central Commission for Discipline Inspection from 2014 under six months begin study two regulations revision. The Standing Committee of the Central Commission for Discipline Inspection 4 review revised. Comrade Wang Qishan 14 times held a special meeting to study two regulations revision, amend

39、ment clarifies the direction, major issues of principle, path and target, respectively held a forum will listen to part of the province (area) secretary of the Party committee, Secretary of the Discipline Inspection Commission, part of the central ministries and state organs Department The first par

40、ty committee is mainly responsible for people, views of experts and scholars and grassroots party organizations and Party members. Approved by the Central Committee of the Communist Party of China, on 7 September 2015, the general office of the Central Committee of the Party issued a notice to solic

41、it the provinces (autonomous regions, municipalities) Party, the central ministries and commissions, state ministries and commissions of the Party (party), the General Political Department of the military, every 3 people organization of Party of two regulations revision opinion. Central Commission f

42、or Discipline Inspection of extensive solicitation of opinions, careful study, attracting, formed a revised sent reviewers. In October 8 and October 12, Central Committee Political Bureau Standing Committee and the Political Bureau of the Central Committee After consideration of the two regulations

43、revised draft. On October 18, the Central Committee of the Communist Party of China formally issued two regulations. Can say, two laws amendment concentrated the wisdom of the whole party, embodies the party. Second, and revision of the basic principles of two party regulations revision work and imp

44、lement the partys eighteen, ten eight plenary, the spirit of the Fourth Plenary Session of the Eleventh Central Committee and General Secretary Xi Jinping important instructions on the revised and , highlighting the ruling party characteristics, serious discipline, the discipline quite in front of t

45、he law, based on the current, a long-term, advance as a whole, with Bu Xiuding independent and . Main principle is: first, adhere to the party constitution to follow. The constitution about discipline and self-discipline required specific, awaken the party constitution of party compasses party consc

46、iousness, maintaining the authority of the constitution. General Secretary Xi Jinping pointed out that no rules, no side round. Party constitution is the fundamental law, the party must follow the general rules. In early 2015 held the eighth session of the Central Commission for Discipline Inspectio

47、n Fifth Plenary Session of the 16th Central Committee, Xi Jinping again pointed out that constitution is the party must follow the general rules, but also the general rules. the revision of the and is Method in adhere to the regulations established for the purpose of combining rule of virtue is to a

48、dhere to the party constitution as a fundamental to follow, the constitution authority set up, wake up the party constitution and party rules the sense of discipline, the party constitution about discipline and self-discipline specific requirements. 4 second is to adhere to in accordance with the re

49、gulations governing the party and the party. The Party of rule of virtue de, mainly refers to the partys ideals and beliefs, excellent traditional style. The revised the closely linked to the self-discipline, insisting on the positive initiative, for all members, highlight the vital few, emphasized

50、self-discipline, focusing on the morality, and the majority of Party members and the ideological and moral standards. The revised Ji method separately, Ji, Ji Yan to Method, as a negative list, emphasizing the heteronomy, focusing on vertical gauge. Is this one high and one low, a positive reaction,

51、 the strict party discipline and practice results transformation for the integration of the whole party to observe moral and discipline requirements, for the majority of Party members and cadres provides benchmarking and ruler. Third, insist on to. In view of the problems existing in the party at th

52、e present stage, the main problems of Party members and cadres in the aspect of self-discipline and abide by the discipline to make clearly defined, especially the partys eighteen years strict political discipline and political rules, organization and discipline and to implement the central eight pr

53、ovisions of the spirit against the four winds and other requirements into Disciplinary provisions. Not one pace reachs the designated position, focusing on in line with reality, pragmatic and effective. After the revision of major changes, major changes in the and modified and needs to grasp several

54、 key problems (a) adhere to according to regulations governing the party and party with morals in combination, for at the present stage, the leadership of the party members and cadres and Party members in existing main problems of self-discipline, put forward principles, requirements and specificati

55、ons, showing Communists noble moral pursuit, reflected at all times and in all over the world ethics from high from low 5 common requirements. One is closely linked to the self-discipline, removal and no direct relation to the provisions of . the second is adhere to a positive advocate, eight prohib

56、ition 52 are not allowed to about the content of the negative list moved into synchronization amendment . Three is for all the party members, will apply object from the leadership of the party members and cadres to expand to all Party members, fully embodies the comprehensive strictly required. The

57、fourth is prominent key minority, seize the leadership of the party members and cadres is the key, and put forward higher requirements than the ordinary Party members. Five is to simplify, and strive to achieve concise, easy to understand, easy to remember. The revised is the ruling Party since the

58、first insists on a positive advocate forAll Party members and the self-discipline norms, moral declaration issued to all members of the party and the National Peoples solemn commitment. criterion of a clean and honest administration consists of 4 parts, 18, more than 3600 words. After the revision o

59、f the , a total of eight, 281 words, including lead, specification and Party member cadre clean fingered self-discipline norms, etc. Part 3 members low-cost clean and self-discipline, the main contents can be summarized as four must eight code. Lead part, reiterated on ideal and faith, fundamental p

60、urpose, the fine traditions and work style, noble sentiments, such as four must the principle of requirements, strong tone of self-discipline, The higher request for 6 and supervised tenet, the foothold in permanent Bao the partys advanced nature and purity, to reflect the revised standards requirem

61、ents. Members of self-discipline norms around the party members how to correctly treat and deal with the public and private, cheap and rot thrifty and extravagance bitter music, put forward the four norms. Party leader cadre clean fingered self-discipline norms for the leadership of the party members and cadres of the vital few, around the clean politics, from civil servant of the color, the exercise of power, moral integrity, a good family tradition and other aspects of the leadership of the party members and cadres of the four norms