2024年全國醫學英語水平考試（METS四級）考前沖刺試題及答案四,更多相關資訊請繼續查看易考吧全國醫護英語水平考試
1). Suppose you are now at Stirling University of Scotland with a group of teachers from one of China′s medical universities.All of you intend to visit a local hospital not so far from the university.And as the group leader， you are supposed to write an email to the head nurse， Maria Carol， to make sure your visit schedule.Your teachers are supposed to be divided into three groups.Your email should not be less than 150 words.

正確答案：
2). Why and When to Consider Taking a Family Medicine Board Review Course■As with most medical specialties， there has been controversy over the past decade regarding changes to the maintenance of certification process for board-certified family medicine physicians (MC-FP) and， in particular， changes to the American Board of Family Medicine′s high stakes board exam process.Beginning in 2006， the ABF：■·Computerized and began offering its exam at an increased number of locations and times than in the past； this essentially required a major transition in the underlying testing theory and scoring process as well as an expansion in the exam′s question bank to enable the auto-generation of different exam versions that would be both secure and consistent in terms of knowledge-assessment integrity.■·Undertook a major overhaul of its exam blueprint， expanding from eight topic areas to 14， including population-based care and patient-based systems， plus eight additional modules from which test takers may choose the two they believe most salient to their clinical experience.■These changes were followed by a deep， yet short-lived decline in exam pass rates.And， while the decline was attributed ultimately to a different cause一namely the ABFM′s 2007 extension of board certification tenure from seven to 10 years (with conditions) - other trends have helped to perpetuate the idea that the exam process has become increasingly challenging for family medicine physicians.For example， the evolving structure of care delivery一in particular the dramatic increase in hospitalists as well as strong， steady growth in rates at which primary care physicians refer patients to specialists for clinical diagnosis and treatment - has reduced family medicine physicians′direct exposure to wider varieties of clinical cases， increasing the challenges of staying current with medical knowledge compared with physicians practicing in narrower specialty areas.■Family medicine physicians also practice in a much wider variety of clinical settings.For example， a PCP working for a large group practice in a wealthy suburb that encompasses separate OB， pediatric， and other subspecialties， might have a much narrower breadth of direct clinical experience from which to build new medical knowledge over time.They may also be less consistently exposed to cases more typically seen in poor， more ethnically diverse inner-city settings.Meanwhile， a PCP working for10 years in a rural private practice might see a greater variety of cases， but would be less likely to be in regular communication and sharing with other physicians and specialists.■While the addition of selectable exam modules seems intended to address real-world variability in family medicine practice， FM physicians are still challenged to keep up with ever expanding and changing arrays of medical knowledge across 14 specialty areas，quite a number of which they may never touch in daily practice.So， given these added challenges for family medicine physicians， what is the best way to go about preparing for the high -stakes ABFM recertification exam?■Top Advice for ABFM Exam Prep■Preparation leads to confidence， and confidence leads to success， says Dr.Mark Nadeau， a clinical professor and residency director in the Department of Family and Community Medicine at the University of Texas Health Science Center San Antonio，who has passed the ABFM exam on five separate occasions over the course of his career and now serves also as a senior reviewer with NEJM Knowledge+ Family Medicine Board Review.(For the full story of how Dr.Nadeau has learned to approach successful board- exam preparation， check out ABFM Exam Prep： Make Time and Make a Plan.)■Question banks (both online and print) have also become hugely popular， especially among younger physicians， because the activity of answering questions is often supported by mobile technology and can be worked into small increments of spare time during each day.In choosing question banks， focus on ones that offer plenty of practice answering clinically focused， exam-style questions that require high-level cognitive tasks such as application， analysis， and strategy versus just definition or understanding.Consider also taking advantage of adaptive learning technology (utilized by platforms such as NEJM Knowledge+) to zero in rapidly on weak spots.And be sure to complete practice questions in roughly the same distribution as the exam blueprint， as this will help in pinpointing specific knowledge gaps and directing more focused follow-up study for family physicians with major time constraints.■When to Consider Taking a Family Medicine Board Review Course■Materials set forth by board review course providers - including location-based，CD/DVD， and online- only programs一suggest that broad family medicine review courses might be best suited for physicians who：■·Have left exam prep until very late in their recertification cycles■·Are not especially disciplined about studying independently■·Are not typically strong test takers■·Have yet to experience computer-based versions of the exam■·Do not make a regular habit of keeping current with general medical knowledge via journals， conferences， peer networking， question banks， self-assessment tools， and so forth■·Have daily responsibilities such as child or elder care that can make it difficult to carve out.focused time for self directed study■·Practice family medicine in relative isolation (rural， private practice) or among patient populations lacking in ethnic， age， economic， or other forms of diversity■·Show downwardly trending test scores over time (a function of distance from academic settings and regular study)■·Have taken practice tests or utilized question banks and have performed poorly across the board (versus in just a few specific areas)■Choose Carefully■Board prep tools have weak and strong contenders， so careful research is always needed in deciding how to invest one′s time and money on specific board-review offerings.■Many review courses and other resources can be purchased conveniently online， but checking original publication dates for content as well as content revision frequencies is a must to ensure they are up to date with advances in medical knowledge (but not so u-to-date， that it overshoots the exam revision cycle) and up to date with changes in how the ABFM structures its exam to assesses knowledge.■While it is a reasonable assumption that family medicine board review courses have been developed using the ABFM exam blueprint 一meaning they portion course time appropriately across the breadth of subject areas covered in the exam一this is not a given and should always be verified when weighing family medicine board review course options.■A big positive for many family medicine board review courses is that一in addition to medical knowledge一they teach specific test.taking strategies， including how to rapidly deconstruct and decode exam questions.Family medicine review courses may also provide key insights into how questions are developed for the exam， how the exam is structured and scored， why it is important to answer every question (even by guessing)，and specific strategies for making best-possible guesses.■Family medicine board review courses may also train physicians to work more effectively in timed and computer based testing environments.When taking the actual exam， one has approximately 60 seconds to read， digest and answer each question； due to exam scoring methods， it is always best to answer every question.Practicing questions repeatedly within realistic time constraints can go a long way to relieving test-takers′anxiety.■While many family medicine review courses offer money-back guarantees， they are not as fail-safe as exam pass rates suggest.At the end of the day， each family medicine physician must make a clear and honest assessment of his or her own learning styles，capacities for retaining information and testing， and career -path priorities.■Please join our ongoing conversation about best practices for family medicine board exam review by sharing your own experiences with review courses in the comments below.The reform of the exam has led to a significant increase in its passing rate.( )
A.True
B.False
C.Not mentioned

正確答案：B
3). Work-related Factors Influencing Home Care Nurse Intent to Remain Employed■Study results suggest that the original hypothesized model be revised to a more parsimonious depiction of factors influencing home care nurse ITR.We propose a revised model hypothesizing that each of the following nine statistically significant predictors found in this study have a direct effect on home care nurse ITR： nurse- assessed quality of care， client variety， income stability， meaningfulness of work，continuity of care， relationships with supervisors， work-life balance， satisfaction with salary and benefits， and nurse age.■Compared with the original hypothesized model (Tourangeau， Patterson， et al，2014)， the only nurse characteristic found to be associated with ITR was nurse age.The only hypothesized job characteristic found to be associated with ITR was having variety in patient assignment.Two components of conditions of home care nurse employment were found to be associated with ITR： satisfaction with pay and benefits and having income stability.Having continuity of client care was the only work structure variable that was significantly associated with ITR.Surprisingly， none of the work environment characteristics were found to be associated with ITR.Finally， all three hypothesized nurse responses to work including having work-life balance， experiencing meaningfulness of work， and nurse-assessed quality of care were found to be statistically associated with ITR.All these factors， except for nurse age， can be modified through targeted interventions to improve home care nurse ITR.( )■Study results indicate that home care nurses are encouraged to remain employed by their perceptions of the quality of care provided by their home care organization.Previous research (Flynn， 2005； Tourangeau， Patterson， et al.， 2014) supports this finding.Home care organizations should be encouraged to disseminate indicators of quality in their organizations and engage home care nurses in the development and evaluation of strategies that improve care quality.Previous research supports the finding that having greater variety of patients positively influences home care nurse ITR (Anthony & Milone-Nuzzo， 2005； Tourangeau， Patterson， et al， 2014).Home care organizations should support nurses to care for patients with a variety of needs as this allows nurses to employ a greater breadth of knowledge and skills， positively influencing their retention.( )■Continuity of care provider was also found to influence home care nurse ITR.This study finding is consistent with previous research (Ellenbecker et al.， 2006； Tourangeau，Patterson， et al， 2014).( )Home care organizations should implement nursing care models that promote continuity of care， while ensuring nurses use a variety of knowledge and skills by assigning patients that vary in age， diagnosis， and care needs.■Similar to previous research (Armstrong- Stassen & Cameron， 2005； Tourangeau，Patterson， et al， 2014)， study findings indicate that experiencing meaning in home care nursing work positively influences home care nurse ITR.Home care organizations can further strengthen positive feelings nurses have about the meaning of their work by implementing recognition and reward programs.( ) Study findings highlight the importance of positive relationships between home care nurses and their supervisors.This finding is consistent with previous research， which found that home care nurses valued competent， supportive， and accessible supervisors (Ellenbecker et al， 2006； Flynn& Deatrick， 2003； Tourangeau， Patterson， et al， 2014).Supervisors should receive adequate education and training to provide effective leadership in the unique home care work environment.Ensuring the presence of competent， accessible leadership can promote nurse ITR.■Similar to previous research (Tourangeau， Patterson， et al， 2014)， higher work-life balance was found to be positively associated with ITR.Home care organizations can facilitate improved work-life balance by addressing unmanageable workloads.( )Addressing nurse workload to improve work-life balance can promote home care nurse ITR.Similar to previous research (Armstrong -Stassen & Cameron， 2005； Denton et al， 2007； Tourangeau， Patterson， et al， 2014)， findings indicate that home care nurse ITR is positively influenced by higher satisfaction with salary and benefits and greater income stability.Home care organizations should implement strategies to address income instability such as offering opportunities for guaranteed continuous full time employment that ensures stable income levels.( )■Although the primary purpose of this study was to test and refine a model of home care nurse retention in the Ontario home care context， study results support previous theoretical work examining ITR among home care nurses in the United States (Ellenbecker et al.，2008).( )Although nine factors were found to significantly influence home care nurse ITR， there remains much to discover about home care nurses′ work environments and factors that influence their decisions to remain working for their current employers.■Additional research is needed to better understand work-related factors contributing to ITR.This knowledge will inform the development of strategies to promote home care nurse ITR.■This study provides groundwork for future research examining strategies that promote retention among home care nurses.As health care continues to shift into community settings， the retention of home care nurses will become increasingly important.Home care employers should focus on identifying modifiable factors affecting nurse retention and develop strategies modifying these factors.Ensuring nurses have adequate training and resources to provide quality patient care， improving employment conditions to increase income stability and satisfaction with pay and benefits， ensuring manageable workloads to facilitate improved work- life balance， and providing accessible， competent leaders are strategies home care employers can implement to promote retention among their nurses.( )
A.Such programs ensure nurses′ work is acknowledged， further promoting ITR
B.Consistency in care provider allows for the development of therapeutic nurse & patient relationships that are valued by both patients and nurses
C.However， factors influencing home care nurse retention that can be modified remain largely unexplored
D.Addressing income instability may also promote increased satisfaction with salary and benefits， which may improve home care nurse ITR
E.Although not modifiable， age has also been reported as being positively associated with ITR
F.Strategies to improve home care nurse workload include providing support for nonnursing activities (e.g.， ordering of supplies) or ensuring that travel between clients is kept to a minimum
G.This suggests that there are international similarities in home care sectors and that there may be common challenges， and， potentially， common solutions to promote home care nurse ITR
H.However， encouraging patient variety may not be congruent with trends to “specialize” nursing care， particularly for patients with complex needs

正確答案：A

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