住院医师与实习医学生的查房观

Ward rounds view of residents versus externs

目的:评估查房对培训住院医师与实习医学生的影响因素。方法:设计的调查问卷包含14个与查房相关的内容。备选答案分成1～5个等级。发放给134人(住院医师66人,临床医学实习生68人)。结果:现实查房中,病人治疗指导做的最好(3.71±0.72)。临床技能(2.48±1.02)和临床诊断的指导(2.49±1.12)分值最低,住院医师分值显著低于实习生(P<0.001)。期望的查房也是病人治疗指导(4.64±0.55)列首位,临床诊断(4.60±0.61)与临床技能(4.50±0.68)的指导。实习生更期望临床诊断及治疗病人指导。绝大多数(87%)更喜欢临床查房,而不是病例讨论室查房。即使查房时间较充足,绝大多数(62%)仍认为缺乏个人亲和力。结论:需要改进查房,满足实习生的要求。

Objective：To investigate the various feedbacks of the residents and externs regarding ward rounds and to assess the effect of ward rounds on their training.Methods：The questionnaire included 14 items about ward rounds,and the rank of answer was 1-5.Then,they were delivered to the respondents（n=134） of residents（n=66） and externs（n=68）.Results：All respondents deemed that the best aspect of the current ward rounds was treatment of patients（3.71±0.72）.Teaching of clinical skills（2.48±1.02） and bedside teaching（2.49±1.12） accepted the lowest gross mean score respectively.The residents were significantly lower than the externs（P0.001）.With regard to their expected ward rounds,treating patients also ranked first（4.64±0.55）,followed by bedside examinations（4.60±0.61） and clinical skills teaching（4.50±0.68）.The residents devoted more attention to communication skills,counseling and medical ethics,but the externs more cared for teaching of bedside examination and treatment.A majority of the respondents（87%） wanted bedside rounds rather than conference room rounds.Although the time length of rounds was enough,a majority of respondents（62%） thought there was still a shortage of individual attention in ward rounds.Conclusions：There is the requirement about ward rounds improvement for maximizing its value to the learners.