糖尿病教学查房中全科医学循证方法的应用

The Use of Evidence Based Method in General Practitioner Training Teaching Round of Diabetes Mellitus

全科医师规范化培训过程中的教学查房对了解培训效果、培养学员的实际工作能力发挥重要作用。糖尿病是社区慢性病管理的重点疾病之一,是全科医师在社区组织实施管理的重要窗口。笔者在糖尿病全科教学查房中尝试应用以患者为导向的全科循证方法,训练全科医师循证医学的思维方法和临床解决问题的能力,旨在培养能够胜任社区实际慢性病管理工作的全科医师。总体查房目标为掌握糖尿病的诊断、并发症、治疗等的要点,掌握循证医学和指南,掌握基于患者为中心解决问题的方式,注重个性化和人性化的医疗服务的制定。与既往的教学查房相比较,取得了较好的教学效果,强化了学员全科医疗临床思维和临床技能训练,提高了学员运用循证医学方法解决患者实际问题的能力,增加了学员对全科医学和对今后从事职业的热爱;同时也加强了带教老师的综合教学能力。这种初步的尝试可以推广至社区全科培训基地教学查房。

Teaching rounds played an important role in general practitioner training, especially for understanding the effects of training and improving trainee＇ s competence. Diabetes mellitus（DM） was one of the most important chronic diseases for community health service to be well managed. So problem oriented, evidence based method in general practitioner training teaching round of DM were tried. The general goal of the teaching round was to master the diagnosis and management of DM,keep abreast of new evidence based medicine and guidelines, as well as the solution to the problem oriented method. Compared with conventional method, it strengthened the training of clinical thinking and skills, so as to improve the capability of the trainees to resolve problems with evidence based method ; what ＇ s more, teaching mixed ability of the trainer was also enhanced. This primary attempts might extend to the training in community.