全科医师规范化培训的回顾分析

Retrospective Analysis of Standardized Training for General Practitioners

目的对我院全科医师规范化培训的实践工作进行回顾,分析培训计划的实施效果和学员反馈意见,提出培训中存在的突出问题和可行的改进措施。方法依照《上海市全科专科医师规范化培养细则》标准,制定和实施培训计划,对学员成绩和反馈意见进行分析。结果新华医院9名2006级学员经过3年培训,全部通过国家执业医师资格考试和上海市卫生局统一组织的毕业考核,合格率为100%。28名2006、2007级学员中,认为在临床基地实践中能接触到更多病种26人(92.9%)、获得更多临床操作机会21人(75.0%)、培养良好诊疗思路20人(71.4%);认为在社区实习基地实践中有利于医患沟通能力的培养19人(67.9%)、更贴近全科医师的实际工作17人(60.7%)。认为对社区工作帮助最大的理论学习内容是:社区常见病多发病的诊断与鉴别诊断23人(82.1%)、急诊医学及双向转诊23人(82.1%)、社区合理用药21人(75.0%)。20人(71.4%)认同临床基地带教老师有必要在带教前接受全科师资培训或短期下社区熟悉工作。78.6%的学员愿意向他人推荐全科医师规范化培训。结论制定和实施适合全科医学教育特点的培训计划是行之有效的。随着受训学员的逐年增加,加快师资队伍建设尤为重要,特别是在社区实习基地显得更加迫切。

Objective To retrospectively analyze the implementing results of training plan for general practitioners in our hospital and the feedback of the trainees,so as to find the major problems in practice and put forth some feasible measures of improvement.Methods According to ＂Regulations on standardized training for general practitioners,Shanghai＂ the training plan was set up and conducted,and then the trainees＇ school marks and their opinions were analyzed.Results Through 3-years training in Xinhua hospital,all of the 9 trainees of grade 2006 passed the examination of national medical license and graduation examination of Shanghai Municipality Bureau of Health,with a pass rate of 100%.Among the 28 trainees of grade 2006 and 2007 there 26（92.9%）who held that more kinds of diseases can be encountered in the practice at the clinical base,21（75.0%）who got more chances of clinical operation,20（71.4%）who trained to have good thinking on diagnosis and treatment,19（67.9%）who believed that the ability of communication with the patients could be raised through practice in the community base,17（60.7%）held that the practice was more consistent with real work of general practitioner.There were 23 who held that the most useful theoretical knowledge were diagnosis and differentiating diagnosis of common and frequently-encountered disease（82.1%）,23（82.1%）who believed that the knowledge of emergency medicine and dual transfer were most helpful.20（71.4%）held that the coaching doctors needed to be trained on general practice or working shortly at community health care centers,and 78.6% who were willing to recommend the standardized training to others.Conclusion It is feasible and effective to set up and implement the training plan suitable for general medical education.To speed up the construction of trainers is very important with the increase of trainees year by year,especially at the practice base in community.