临床医学专业学位研究生培养与住院医师规范化培训并轨的实践及效果评价

Practice and effect evaluation of the combined education on the professional degree of ＇clinical medicine and standardized training of resident doctors

中南大学湘雅医院从2012年开始，尝试将临床医学专业学位研究生培养与住院医师规范化培训“并轨”。我院借鉴美国先进的培训理念，结合我院实际情况建立了以“职业道德、职业技能、病人安全、医学伦理、团队精神、创新和自我提高”为特色的六大培养目标，以项目主管负责制、360度考核评估、OSCE、Mini—CEX等实践为亮点的“湘雅一耶鲁”住院医师规范化培训模式。通过对比分析接受并轨培养和未接受并轨培养研究生的中期考核成绩，发现接受并轨培养学生的临床技能明显优于未接受并轨培养的学生。此外，问卷调查表明，大多数研究生对实施并轨培养的态度积极，认为有助于提高自身临床技能、医疗实践能力、医患沟通能力、理论知识水平，有利于自身未来职业发展。

＂Combined training＂ is a new training mode which combines the education of profes- sional degree of clinical medicine graduate and the resident standardization training. Xiangya hospital of Central South University has tried this kind of training mode since 2012. We draw lessons from the advanced training concept in America in combination with the practical situation of our hospital and have established the ＂Xiangya-Yale＂ model of resident standardization training featuring with the Six Xiangya goals which are ＂professional ethics, professional skills, patient safety, medical ethics, teamwork spirit, innovation and self- improvement＂, highlighting the project manager responsibility system, 360 degree examination and assess- ment, assessment of the OSCE, Mini-CEX evaluation. Through comparing and analyzing the midterm exami- nation scores between the ＂combined training＂ group and ＂non-combined training＂ group, we have found that the ＂combined training＂ group is significantly superior to ＂non-combined training＂ group on clinical skills. In addition, the questionnaire survey results show that most graduate students have positive attitude to ＂combined training＂. They believe it will be helpful for them to improve the ability of clinical skills, med- ical practice, doctor-patient communication skills and theoretical knowledge, and contributes to the future career development. ＂Combined training＂ is one major initiative deepening the reform of medical health system and medical education which greatly promotes the development of our country health enterprise, although there still exist some flaws including training teachers, content, implementation, management and evaluation.