教学改革措施在临床实习中的应用及对学生岗位胜任力的影响

Teaching Reform in the Application of Clinical Internship and the Impact on the Competency

目的随着医学教育模式改革的推进,"医学卫生人才岗位胜任力"逐渐成为医学教育发展的重心,为了评价参加实习医学生在改革干预措施后的变化。方法采用自编问卷对参与临床实习的61名医学生,进行教学改革重要性评价,并将其对教学改革的需求应用于其临床实习的一年过程中。对学生进行为期一年的随访,进行实习前后岗位胜任力的比较。结果对教学改革的学生评价中,科学发展能力的教学改革重要性要求最高,基本职业技能次之,而实习医生对于人文医学理念的教育改革项目的重要性评价最低,大部分认为一般重要。参考实习医生对临床教学改革的要求和评价,我们对临床实习进行了为期一年的以胜任力为导向的教学改革。在实习开始前,对各项岗位胜任力方面比较,人文思想理念胜任力的自评胜任力最高,科学发展能力和基本职业技能的胜任力较低。经过一年的临床实习教学方式改革后,科学发展能力及基本职业技能的胜任力均较前明显改善,差异有统计学意义(P<0.05);人文思想理念较前也有改善,差异不具统计学意义(P>0.05)。结论在提高岗位胜任力为目标下,对实习医师培养模式进行了较全面的改革后,能明显改善实习医生的基本职业技能和科学发展能力,为全面提高临床医学实习生的岗位胜任力提供了行之有效的方法。

Objective As the reform of medical education pattern, medical and health personnel post competency has gradually become the focus of medical education development. It is currently the most important and urgent problem in the education teaching reform in the medical colleges and universities that how to strengthen the core competence and professional quality, how to promote the medical teaching quality and how to deliver high quality medical talents for the society. Methods Self-made questionnaire was conducted to 61 medical students participating clinical practice. The subjects evalua- ted the importance of teaching reform, and the results were applied to the year of the clinical practice. We undertook one year of follow-up to compare the post competency before and after the clinical prac- tice. Results On the evaluation of teaching reform, scientific development ability ranked the top de- mands of teaching reform, followed by basic vocational skills, and the medical humanities educationwere attached the lowest importance. On the reference of their evaluation, we carried out one-year post competence oriented teaching reform. Before the start of the internship, humanistic skills were higher than scientific development skills and basic vocational skills among all the self-reported post competence. After one-year post competence oriented teaching reform, scientific development skills and basic vocational skills were significantly improved than before, and the difference was statistically significant（P〈0. 05）; Humanistic skills were improved at the same time, although statistical signifi- cance had not been found（P〈0. 05）. Conclusion With the comprehensive change of intern training pattern, the basic vocational skills and scientific development ability of the interns embrace obvious improvement, which provides a effective method to improve clinical intern post competency.