带教医生与学生对全科社区见习认知比较研究

Investigation the cognition of teachers and medical students majored in five-year program of several community health service centers

目的旨在对上海市临床五年制医学生见习所在社区卫生服务中心带教医师及见习医学生对于全科医学课程的认知情况进行了解,比较两者间差异,分析其中可能的原因,并提出相应的建议。方法采用文献法对国内外临床医学生全科医学教育现状进行梳理;采取问卷调查法与个案访谈对上海市13家社区教学负责人、带教医师及上海交通大学医学院2008级临床医学专业五年制临床医学生进行调研。结果在前期课程认知方面差异主要体现在:带教医师认为应当分阶段在不同学期开设理论课程,而临床医学生更倾向于在早期开设;多数学生认为各课程以18课时最为合适,而带教医师则认为在此基础上个别课程应适当增加课时。在社区见习课程认知方面差异主要体现在:学生认为各课程设置4课时即可,而带教医师认为设置8课时以上更为合适。在见习时间的差异方面,60.9%的带教老师认为应当延长至4周,而56.6%的同学认为2周正好,24.2%的学生认为应缩短至1周。结论带教医师与临床医学生在对于社区全科见习的认知基本一致,带教医生认为应当延长社区见习时间。结果提示应建立完善课程网络体系,注重实践教学质量;提高医学生全科医学认知,增强社区全科兴趣;制定师资考核考评机制,配套相应激励政策。建立完善课程网络体系,注重实践教学质量;提高医学生全科医学认知,增强社区全科兴趣;制定师资考核考评机制,配套相应激励政策。

Objective To investigate the cognition of teachers and medical students majored in five-year program of several community health service centers（ CHS） in Shanghai which played a role as teaching hospitals and to provide references of community clerkships of general practice,and to compare and analyze the differences,and to table proposals. Methods Understand the current situation of general practice education by lecture review. Questionnaire survey method and case interview were used. Questionnaire survey was conducted in directors of teaching,teachers and students of 13 CHSs. Results Teachers think specialized-base courses should be arranged by stages when students think courses should be arranged earlier. Students believe 8 periods for each specialized-base course and 18 periods for each specialized course while teachers prefers more. Students are agree with teachers on curriculum provision except that 60. 9% teachers tend to extend the time of community trainee when 56. 6% students think two-weeks＇ trainee is enough moreover 24. 2% consider it should be shorter. Conclusion More efforts should be put on establishing a curriculum management system of general practice,raising cognition and interests of general practice,and more perfect supporting policies should be formulated.