不同生源医学生医德认知调查分析与教育对策

Current medical ethics cognition analysis of students from downtown and country and its education strategy

目的了解汕头大学医学院不同生源医学生医德认知现状，寻找适宜的医德教育对策。方法对汕头大学医学院不同年级医学生进行横断面调查，调查内容包括医学生的基本情况及其对医德的认知情况。结果28.2%的城镇来源学生认为医患关系和谐或比较和谐，高于18．2%的农村来源学生（P=0.001或0.019）；40．0%的农村来源学生认为医患关系很紧张，明显高于28．4%的城镇来源学生（P=0.001）；33．0%的城镇来源学生认为目前医务人员救死扶伤履行的“较好”，明显高于25．5%的农村来源学生（P=0.019）；而13.1%的农村来源学生认为目前医务人员救死扶伤履行的“不好”，明显高于8.1%的城镇来源学生（P=0.026）；12.7%的农村来源学生认为目前医务人员的工作热情和责任心“有待提高”，高于7.5%的城镇来源学生（P=0.019）；12.2%的农村来源学生认为产生医疗纠纷的主要原因为“医护人员态度恶劣”，高于7.3%的城镇来源学生（P=0.028）。在“医疗实践的选择倾向”上，城镇来源学生比农村来源学生更符合医德规范要求。结论医学院校应当关注城乡生源医学生教育本身存在的差异，加强医德教育及对农村生源医学生的素质教育，引导医学生形成正确的学医动机。

Objective In order to understand better about the medical ethics cognition of the students from downtown and country, and to find an adequate strategy for educating medical ethics. Methods A cross sectional study of medical students was made on campus from different grades on the basic information about the students, their general cognition of medical ethics. Results The result are as followings：28. 2% of the downtown students think that the relationships between the medical personnel and the patients are very harmonious or just a little bit harmonious, which is higher than 18. 2% of the country students （P=0. 001 or 0. 019）;40. 0% of the country students say that the relationships between the medical personnel and the patients are very intense, which is very higher than 28. 4% of the downtown students（P=0. 001）;33. 0% of the downtown students think that at present the medical personnel are basically eligible to cure the patients, which is higher than 25. 5% of the country students（P=0. 019）;13. 1% of the country students think that at present the medical personnel can not be responsible for their works, which is apparently higher than 8. 1% of the downtown students （ P=0. 026 ）; 12. 7% of the country students say that at present the medical personnel should be required to improve their working enthusiasm and responsibility awareness, which is higher than 7. 5% of the downtown students （ P=0. 019）;12. 2% of the country students think that the causes of medical disputes are due to the worse attitudes of medical personnel, which is higher than 7. 3% of the downtown students（P=0. 028）. There are great differences of choices of medical practices between the students from downtown and country. Con-clusions The medical ethics education of university should pay attention to the distinctions between downtown’ s and country’ s education, and focus on quality education among the medical students from cou-ntryside to make up the gap between downtown’ s and country’ s education. Besides, the university should guide the students form the correct medicine motivation.