摘要
目的:探索后疫情时期神经内科住院医师规范化培训工作的反思与启示。方法:纳入2020—2023年间在北京大学第三医院神经内科进行住院医师规范化培训的学员，按受教育经历分为社会规范化培训组和研究生组。从疫情时期对抗疫的态度和行动、疫情时期和疫情后的心理状态及对未来工作的态度和启示三方面进行问卷调查，并采用Fisher精确概率法比较2组间差异。结果:纳入研究生13人，社会规范化培训学员9人，共22人。研究生组和社会规范化培训学员组曾有意向报名赴湖北支援的分别有9人（69.2%）和8人（88.9%），主要原因是“敬佑生命，救死扶伤”，有9人（69.2%）和7人（77.8%），主要顾虑是“自己医学知识欠缺”，有9人（69.2%）和6人（66.7%）。疫情期间多数学员出现了不同程度的心理反应，在疫情结束后均得到了不同程度的恢复。疫情结束后2组分别有11人（84.6%）和8人（88.9%）仍愿意从事临床工作，其中主要原因是“临床工作是自己的职业”，有8人（61.5%）和6人（66.7%）。研究生组的主要顾虑是“科研压力大”（11人，84.6%），社会规范化培训学员组的主要顾虑是“工作紧张，工作强度大”（6人，66.7%）。2组学员均认为最应加强的培训是“急危重症的处理”，有10人（76.9%）和6人（66.7%）。对2组进行比较，仅参加“社区核酸采集及疫苗接种”抗疫活动差异存在统计学意义［研究生组4人（30.8%）vs 社会规范化培训学员组8人（88.9%），P=0.011］。结论:疫情期间学员的支援意愿和行动积极，尽管出现过心理问题，疫情后均有一定程度恢复。后疫情时期应加强对“急危重症处理”的培训。
Abstract
Objective:To explore the reflection and enlightenment of standardized training of neurology residents in the post-epidemic era.Methods:The trainees who underwent standardized residency training in the Department of Neurology, Peking University Third Hospital, from 2020 to 2023 were included and divided into the social normative training group and the graduate student group according to their educational experience. Questionnaire surveys were conducted from three aspects: "attitudes and actions to fight the epidemic", "psychological state during and after the epidemic", and "attitudes and enlightenment for future work", and the differences between the two groups were compared by Fisher test.Results:Totally 22 trainees were enrolled, including 13 graduate students and 9 social trainees. There were 9 (69.2%) and 8 (88.9%) who were interested in signing up for support to Hubei, mainly because of "respecting life and saving life", 9 (69.2%) and 7 (77.8%), and the main concern was "lack of medical knowledge", 9 (69.2%) and 6 (66.7%). During the epidemic, most trainees had different degrees of psychological reactions, and they all recovered to varying degrees after the epidemic ended. After the epidemic, 11 (84.6%) and 8 (88.9%) were still willing to engage in clinical practice. The main reason was that "clinical practice is one's own profession", with 8 (61.5%) and 6 (66.7%). The main concern of graduate students was "high pressure on scientific research" (11 students, 84.6%), and the main concern of trainees was "intense work and high work intensity" (6 students, 66.7%). The participants identified the most intensive training they need is "management of acute and critical illness", with 10 (76.9%) and 6 (66.7%). Comparing the two groups, there was a statistical difference between only participating in the "community nucleic acid collection and vaccination" anti-epidemic activities [4 graduate students (30.8%) vs 8 trainees (88.9%), P=0.011].Conclusion:During the epidemic, the trainees were willing to support and were active. Despite psychological problems, they have recovered to some extent after the epidemic. In the post-epidemic era, training on "acute and critical care" should be strengthened.
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