摘要
目的 探讨优化轮转方案在住院医师规范化培训(简称"住培")中的应用效果及对培训质量的影响.方法 选择 2018 年 9 月—2020 年 6 月徐州市第一人民医院的 154 名住培学员,采用信封法分为对照组和试验组,各 77 名.对照组给予传统方法轮转培训,试验组将优化轮转方案应用于住培.2 组均完成 36 个月培训,比较 2 组的培训质量、专业技能考核成绩及培训满意度.结果 试验组培训 36 个月后的培训方法[(91.49±6.51)分]、培训内容[(90.73±6.35)分]、培训课时[(93.24±5.69)分]、培训效果[(92.13±5.46)分]及培训目的[(89.78±5.61)分]评分高于对照组[(75.78±5.62)分、(72.34±4.38)分、(73.62±5.68)分、(74.56±4.23)分、(75.19±4.25)分],差异有统计学意义(P＜0.001);试验组培训 36 个月后的病史采集[(91.24±6.79)分]、体格检查[(90.36±6.56)分]、基本技能操作[(92.41±6.82)分]、病历书写[(92.19±6.86)分]、病例分析[(93.26±6.89)分]、临床思维[(91.56±6.78)分]、医患沟通[(90.79±6.58)分]、专科技能操作[(92.63±6.88)分]等专业技能评分高于对照组[(84.34±6.31)分、(82.67±6.14)分、(83.49±6.45)分、(83.73±6.48)分、(82.31±6.23)分、(84.36±6.51)分、(79.83±6.19)分、(80.49±6.21)分],差异有统计学意义(P＜0.001);培训 36 个月后,试验组的教学模式[(8.56±0.81)分]、临床诊疗水平[(8.81±0.94)分]、操作技能[(8.90±1.10)分]、满足学习要求[(9.41±0.59)分]、自学能力[(9.22±0.56)分]、课程安排合理性[(9.18±0.53)分]、培训模式适应度[(9.15±0.51)分]满意度高于对照组[(6.13±0.58)分、(6.32±0.62)分、(6.26±0.60)分、(6.15±0.53)分、(7.03±0.51)分、(7.46±0.50)分、(7.42±0.46)分],差异有统计学意义(P＜0.001).结论 将优化轮转方案应用于住培中,有助于提高住培质量,提升住院医师的专业技能水平、岗位胜任力,可获得较高的培训满意度.
Abstract
Objective To explore the application effect of optimizing rotation scheme in standardized training of resident physicians(referred to as"residential training")and its influence on training quality.Methods A total of 154 residential training students from Xuzhou No 1 People's Hospital from September 2018 to June 2020 were selected and divided into the control group and the experimental group according to envelope method,with 77 students in each group.The control group received traditional method rotation training,while the experimental group applied optimizing rotation scheme to residential training.Both groups completed 36 months of training,and the training quality,professional skill assessment scores,and training satisfaction of the two groups were compared.Results The scores of training method[(91.49±6.51)points],training content[(90.73±6.35)points],training hours[(93.24±5.69)points],training effectiveness[(92.13±5.46)points],and training objectives[(89.78±5.61)points]of the experimental group after 36 months of training were higher than those of the control group[(75.78±5.62)points,(72.34±4.38)points,(73.62±5.68)points,(74.56±4.23)points,(75.19±4.25)points],and the differences were statistically significant(P<0.001).After 36 months of training,the scores of professional skills such as medical history collection[(91.24±6.79)points],physical examination[(90.36±6.56)points],basic skill operation[(92.41±6.82)points],medical record writing[(92.19±6.86)points],case analysis[(93.26±6.89)points],clinical thinking[(91.56±6.78)points],doctor-patient communication[(90.79±6.58)points],specialized skill operation[(92.63±6.88)points]of the experimental group were higher than those of the control group[(84.34±6.31)points,(82.67±6.14)points,(83.49±6.45)points,(83.73±6.48)points)points,(82.31±6.23)points,(84.36±6.51)points,(79.83±6.19)points,(80.49±6.21)points],the differences were statistically significant(P<0.001).After 36 months of training,the satisfaction degree of teaching mode[(8.56±0.81)points],clinical treatment level[(8.81±0.94)points],operational skills[(8.90±1.10)points],meeting learning requirements[(9.41±0.59)points],self-learning ability[(9.22±0.56)points],rationality of course arrangement[(9.18±0.53)points],training mode fitness[(9.15±0.51)points]of the experimental group were higher than those of the control group[(6.13±0.58)points,(6.32±0.62)points,(6.26±0.60)points,(6.15±0.53)points,(7.03±0.51)points,(7.46±0.50)points,(7.42±0.46)points],the differences were statistically significant(P<0.001).Conclusion The application of the optimizing rotation scheme in the residential training of resident physicians is helpful to improve the quality of residential training,enhance the professional skill level and post competency of residents,and obtain higher training satisfaction.
基金项目
徐州市卫生健康委科技项目(XWKYHT20220078)
维普
万方数据