实习医师临床操作技能调查

Report on Present Status of Clinical Practice of Interns

目的：了解实习生临床技能水平，为医学人才培养方案的制定提供理论依据。方法通过问卷调查，对203名本科五年制实习生临床技能操作的掌握情况进行调查，并根据实习结束后的临床技能操作考核成绩作为评判标准。结果①6所教学医院实习生技能掌握情况良好率为16．75％，临床教学实践和实习效果不容乐观。②在203名实习生中，模拟人练习组考核优秀率为56．1％，未接受模拟人练习组优秀率为41．3％，差别有统计学意义（χ2＝4．281，P ＜0．05）。理论培训组考核优秀率为61．8％，未接受理论培训组优秀率为41．9％，差别有统计学意义（χ2＝6．387，P ＜0．05）。③在进行操作时会事先与患者进行充分沟通的实习生中57．5％可以得到患者的充分配合。在未沟通组中仅有40．6％的实习生可以得到患者的配合，差别有统计学意义（χ2＝5．199，P ＜0．05）。结论实习生在临床技能操作中操作机会少、教学培训少等问题不同程度存在，严重影响临床教学质量。建议采用技能培训、加大建设力度、制定科学的实习方案等方法提高临床教学质量。

Objective To investigate the clinical skills of interns , and provide a theoretical basis for medi -cal personnel training.Methods Through questionnaires, we investigated 203 interns of five -year undergraduate program for their clinical skills, and used clinical practice examination results at the end of internship as the evalua -tion criteria.Results ①the good rate of practical skills of interns in 6 clinical teaching hospitals was only 16.75%. It showed that the clinical teaching practice condition and the effect of internship practice was not optimistic .②In the 203 interns, the excellent rate of the group that accepted exercise on human model was 56.1%, the excellent rate of the group did not accept the exercise was 41.3%.The difference was statistically significant （χ2 =4.281, P 〈0.05）.The excellent rate of the group that accepted the theory training was 61.8%, the excellent rate of the group did not accept the training was 41.9%.The difference was statistically significant （χ2 =6.387, P 〈0.05）.③57.5% of the interns who communicated with the patients in advance could obtain good cooperation from patients . But only 40.6% of interns who did not communicate in advance could obtain the cooperation .The difference was sta-tistically significant （χ2 =5.199, P 〈0.05）.Conclusion At present, there exists many problems like little operat -ing chance, little practice training in clinical skills operation during the internship .These problems seriously affected the quality of clinical teaching.Approaches like more practice training, more efforts to formulate a scientific internship scheme and construction of scientific internship program are recommended to improve the clinical teaching quality .