全科医学住院医师规范化培训理论课程的改革与思考

Reform and thinking of standardized residency training theoretical course for general practitioners

目的 :对上海交通大学医学院全科医学住院医师规范化培训理论课程班学员进行课程改革的满意度调查,结合课程班开设情况,为进一步探索医学院校统一开展毕业后全科医学理论课程授课模式、完善培训工作提供实践依据。方法 :整群抽取参加2015年课程班学员265名为研究对象,采用自行设计的调查问卷和访谈方式调查学员对理论课程学习(7项指标)和社区实践教学(3项指标)的满意度。评估采用5分李克特量表。结果 :学员对理论教学满意度的中位数为4.00(3.57,4.57)分,社区实践教学满意度中位数为4.67(4.00,5.00)分,两者差异有统计学意义(Z=-8.65,P=0.00)。学员对社区实践教学的3项满意度指标评分较高,而对理论课程中的考核方式指标的满意度评分较低。结论 :应建立大学、临床培训基地、社区教学基地协同教学管理机制;将理论课程教学安排与住院医师规范培训过程相结合;提倡理论授课与社区实践教学相结合;进一步完善理论课程建设和优化培训考核模式。

Objective： To investigate the satisfaction of the curriculum reform in the students in the residency standardized training theoretical course for general practitioners in Shanghai Jiao Tong University, School of Medicine, to provide the practical basis for further exploring the medical college to carry out the unified general medicine theoretical teaching mode after graduation and improving the training work combining with the course set up. Methods： By a random cluster sampling 265 students who participated in 2015 course were selected as the research objects and the self-designed questionnaire and interview were used to investigate the students＇ learning of the theoretical course （7 items） and satisfaction with community practice teaching （3 indicators）. The 5 point Likert scale was used for assessment. Results： The satisfaction degree of the students to the theoretical teaching was 4 （3.57 and 4.57）. The median of satisfaction degree of community practice teaching was 4.67 （4 and 5）. The difference between the two groups was statistically significant （Z=-8.65, P=0.00）. The scores of the 3 satisfaction indicators of community practice teaching of the students were high. The score of the satisfaction of assessment indicators in the theoretical course was lower. Conclusion： The teaching management mechanism should be set up in the university, clinical training base and community teaching base to combine the theory of curriculum teaching arrangement with hospital standardized training procedure, to promote the combination of theoretical teaching and community practice teaching and to further improve the construction of theoretical course and optimize the training evaluation mode.