眼科住院医师委托培养效果的评估研究

Study of the effectiveness of entrusted standardized training for ophthalmic residents

目的:住院医师委托培养是我国医学教育标准化和国际化的重要举措。本研究采用客观考核和主观问卷两种方法评估我国眼科住院医师委托培养效果。方法:本研究对象为广东省深圳市政府于2012年8月至2015年7月期间委托中山大学中山眼科中心进行眼科住院医师规范化培训的9名学员。本研究对所有学员的基本信息、临床培训情况、以及考核成绩等客观指标进行统计分析,同时设计了一份包含13个问题的调查问卷,对每位学员的培训情况进行主观评估。结果:本研究纳入9名研究对象,包括2名男性和7名女性,平均年龄为(26±3)岁,学历水平情况为学士7名和硕士2名,其中有7名毕业于国家重点医学院校。3年内人均轮转眼科亚专科超过10科,平均主管病人数及参加手术例数分别为736和1 219例,门诊工作总量人均6 274人次,所有学员均按规定至少完成综述1篇。8名(88.89%)学员认为可以独立诊断并治疗大部分常见眼科疾病,而且能独立完成大部分眼科基本临床操作,5名(55.56%)学员可以单独完成翼状胬肉切除术、霰粒肿刮除术、前房穿刺术等。6名(66.67%)学员认为培训时间安排合理。8名(88.89%)学员对这次委托培养总体比较满意。所有9名培训学员中,最终有7名(77.8%)顺利通过中山大学第一阶段住院医师规范化培训考核。结论:培训学员对现行的眼科住院医师规范化培训方案的接受程度较高,基本达到预期的培训效果,对常见眼病能独立进行诊治。委托培养学员的学历和学习能力的差异在一定程度上影响了最终的培训考核通过率。

Objective： The entrusted standardized training for in China to the international conventions. In this residents is an important measure to gear the medical education study, the effectiveness of standardized training for entrusted ophthalmic residents in China was evaluated both objectively and subjectively. Methods： Nine ophthalmic residents, commissioned by Shenzhen government of Guangdong Province, studied at Zhongshan Ophthalmic Center, Sun Yat-sen University during August 2012 to July 201S were included in this study. The objective indicators of all participants were analyzed, including the basic information, clinical training, the score of examination, etc. The subjective self-assessment was also implemented thought a questionnaire including 13 designed questions. Results： All 9 participants included 2 males and 7 females, 2 medical masters and 7 bachelors, and the mean age was 26＋3 years. Seven of them graduated from the national key medical universities. The mean number of rotated sub-clinical departments was 10.3, the mean number of managed inpatients and the participated operations were 736 and 1 219, respectively. The total number of managed outpatients was 6 274 in average. M1 participants completed at least one review article. Eight （88.89%） participants could independently diagnose and treat the most common ophthalmic diseases, they also could complete the basic clinical ophthalmic operation independently. Five （55.56%） participants could independently manage the pterygium excision, curettage of chalazion, anterior chamber penetration, etc. And 6 （66.67%） of the participants believed that the training length was reasonable. Eight （88.89%） of them were satisfied with the standardized training for residents on the whole. Finally, 7 participants successfully passed the first stage of standardized training program in Sun Yat-sen University. Conclusion： There was a high level acceptance rate of the standardized training programs for entrusted ophthalmic residents. The participants achieved the expected training effects, and could managed the diagnosis and treatment of common ophthalmic diseases independently. But the training effects and passing rate of examination were partly affected by the learning ability of the training students.