美国住院医师规范化培训胜任力体系的借鉴与思考

Reference and reflection on the American standardized residency training competency system

通过总结美国住院医师规范化培训(住培)胜任力发展情况,结合我国目前住培发展形势,借鉴国外先进办学理念以及管理办法,提出住培胜任力培养体系发展建议。运用知网、PubMed中英文数据库,以“住院医师规范化培训”“胜任力”“培养体系”等为关键词,检索2018-01-2022-02以及美国住培相关经典文献以了解中美两国住培胜任力发展情况。纳入标准:(1)中美住培现状;(2)医学教育体制;(3)住培胜任力。剔除标准:(1)案例分析;(2)研究范围较小或质量较差。最终31篇文献纳入分析。我国在住培实施之初便提出胜任力概念并不断更新理解,统一的测量工具仍待完善;我国医学教育侧重满足人民群众卫生服务需求,胜任力培养存在一定差异;胜任力考核体系也在构建完善中,保障体制机制还需逐个落实。我国住培应结合目前医学教育发展现状,联动教育部门在各个阶段落实胜任力的培养;系统化建设胜任力培养体系,注重反馈机制的搭建;放眼世界范围内先进住培培养理念与方法,不断更新完善住培胜任力概念,推动胜任力培养体系的构建。

To summarize the development of residency training competency in the United States and put forward policy suggestions for residency training development by combining with the current development situation in China and drawing lessons from foreign advanced ideas and management methods.The relevant literature published between January 2018 and February 2022 in China National Knowledge Infrastructure(CNKI),PubMed and classic literature on residency training in the United States were collected,using the terms"standardized residency training""competency"and"training system".Inclusion criteria contained(1)current situation of residency training in China and the United States;(2)medical education system;(3)research on competency.Exclusion criteria included(1)case analysis;(2)those with limited research scope and poor quality.Finally,a total of 31 articles were included.At the beginning of the implementation of residency training,China put forward the concept of competency and constantly updated it,and the unified measurement tool still needs to be improved.Medical education in China focuses on meeting people’s health service needs,which also leads to certain differences in competency training;The competency assessment system is also under construction and improvement,and the guarantee system and mechanism need to be implemented one by one.Residency training of China should be combined with the current development status of medical education and linked with the education department to implement the training of competency at all stages.Relevant departments should systematically build a competency training system and pay attention to the construction of feedback mechanism,take a broad view of the world’s advanced residency training concepts and methods,constantly update and improve the concept of residency training competency,and promote the construction of competency training system.