多学科联合诊疗对全科规培学员病例分析能力的影响

The Influence of Multidisciplinary Joint Diagnosis and Treatment on the Case Analysis Ability of General Training Students

目的 探讨三级综合医院多学科联合诊疗对基层实践基地全科规培学员病例分析能力的影响.方法 抽取2018年10月1日-2018年12月31日新疆自治区某三级综合医院基层实践基地正在培训的41名全科规培学员,进行参加多学科联合诊疗前后基础知识与病例分析成绩比较.结果 参加全科规培学员多学科联合诊疗后基础知识测试环节康复医学、临床心理咨询、营养保健成绩均显著高于参加多学科联合诊疗前,成绩分别是4.06±0.26与4.31±0.35、4.13±0.38与4.31±0.19、3.52±0.31与3.86±0.28,全科医学概论、医患关系与医学伦理学成绩明显提高,成绩分别是3.71±0.22与4.22±0.41、3.85±0.27与4.13±0.17.病例分析能力测试环节补充询问病史、补充询问体检结果 、补充询问辅助检查结果及进一步检查项目成绩均高于参加多学科联合诊疗前,成绩分别是8.14±0.98与8.75±0.86、7.91±1.01与8.46±0.86、7.96±0.51与8.63±0.62.病史特点归纳、鉴别诊断要点、人文关爱及沟通表达能力成绩提高更加明显,成绩分别是7.61±0.48与8.76±0.57、8.03±0.45与9.14±0.74、7.23±0.68与9.08±0.49,差异均有统计学意义.结论 基层实践基地应充分利用三级综合医院优势教学资源,全科规培学员参加综合医院多学科联合诊疗有助于提高理论水平、病例分析能力、人文关爱及沟通表达能力.

Objective To explore the influence of multidisciplinary joint diagnosis and treatment in a Three A and Tertiary General Hospitals on the case analysis ability of students in general practice base.Methods To select a total of being trained 41 general discipline trainees of the grassroots practice base of a tertiary general hospital in Xinjiang,from October 1st to December 31st in 2018.The result of basic knowledge and case analysis were compared,before and after participating in multidisciplinary joint diagnosis and treatment.Result The result of basic knowledge after participating in the multidisciplinary joint medical treatment,such as rehabilitation medicine,clinical psychological counseling,nutrition care were higher than before,the grades were 4.06±0.26 vs 4.31±0.35,4.13±0.38 vs 4.31±0.19,3.52±0.31 vs 3.86±0.28.The result of introduction to general medicine,doctor-patient relationship and medical ethics were abviously higher,the grades were 3.71±0.22 vs 4.22±0.41,3.85±0.27 vs 4.13±0.1.The result of case analysis ability,such as supplementary medical history,supplementary inquiry of physical examination results,supplementary inquiry auxiliary examination results and further inspection items were higher after participating in multidisciplinary joint diagnosis and treatment,the grades were 8.14±0.98 vs 8.75±0.86,7.91±1.01 vs 8.46±0.86,7.96±0.51 vs 8.63±0.62.The result of summary of characteristics of medical history,key points of differential diagnosis,humanistic care and communication skills were obviously higher,the grades were 7.61±0.48 vs 8.76±0.57,8.03±0.45 vs 9.14±0.74,7.23±0.68 vs 9.08±0.49,the difference was statistically significant.Conclusions Grassroots practice bases should make full use of the teaching resources of tertiary general hospitals.General discipline trainees participated in multidisciplinary joint diagnosis and treatment in general hospitals helped to improve their theoretical level as well as the ability of case analysis and humanistic care and communication skills.