基于岗位胜任力全科住院医师对规范化培训与社区执业认知差异分析

Difference of cognition between standardized residency training of general practitioners and community practice from the perspective of clinical competency

目的从岗位胜任力角度探讨全科医生对规范化培训与社区执业间的差异,分析存在的原因及解决方法,为今后住院医师职业成长及其规范化培训提供参考和借鉴。方法2017年11月,采用方便抽样法,选取上海市某高校附属医院16名已结业全科医学科住院医师作为访谈对象,其中男性6名、女性10名,平均年龄(28.38±1.59)岁,均为初级职称、本科学历。结果全科住院医师在结束培训进入社区独立工作之初岗位胜任力面临挑战,主要表现在临床思维、医患沟通及基于临床实践不断学习的能力和科研能力不足。全科住院医师在社区从业和规范化培训期间的差异主要原因在于执业环境和角色变化。结论对于全科住院医师岗位胜任力的培养,需要针对临床思维、医患沟通能力等核心岗位胜任力方面进行。同时,要充分发挥全科住院医师主观能动性,激发其成长的内在动力。

ObjectiveTo explore the differences in cognition between standardized training and community practice from the perspective of clinical competency,and to analyze the causes and solutions so as to provide reference for future development and standardized residency training of general practitioners.MethodsGroup interviews were conducted among graduates of standardized training of general practitioners in a university hospital in Shanghai.In November 2017,16 graduates were interviewed.There were 6 males and 10 females,with an average age of(28.38±1.59).All of them had junior professional titles and bachelor’s degrees.ResultsIt was found that general practitioners under standardized residency training faced challenges upon working in a community after graduation,mainly manifested in the lack of clinical thinking,poor doctor-patient communication skills,and inability to keep studying and researching.The main reason for the difference between community practice and the training period was the change of the working environment and role.ConclusionThere is the need to focus on the training of core clinical competence,such as clinical thinking,doctor-patient communication ability,which is currently insufficient for general practitioners.Meanwhile,we should keep motivating trainees themselves.