对某基层医院住院医师规范化培训的几点建议

Some suggestions on standardized training of resident doctors in a primary hospital

目的探讨基层医院住院医师规范化培训的相关问题，为基层住院医师规范化培训提供依据。方法通过问卷方式，调研甘肃省环县人民医院医师职称、住院医师年龄和学历分布情况，分析对该院住院医师的工作胜任力自我评价以及需要提高的内容，提出基层医院医师需要改进的内容。结果甘肃省环县人民医院共有住院医师52名，46名参加调查，参与率88．5％。甘肃省环县人民医院医师职称以住院医师为主，占43．3％（52／120），年龄主要分布在31-35岁，学历大专占42．3％（22／52），本科占48．1％（25／52），该院76．1％（35／46）的住院医师认为胜任住院医师有一定困难，71．7％（33／46）的住院医师认为需要加强临床思维和临床技能的培训。结论加强住院医师自身学历提升，完善医院教学制度，加强教学管理，针对临床思维和临床技能培训是基层医院目前规范化培养的主要问题。加速住院医师规范化培训完善向中级医师的转化，改善不合理医师结构是基层医院发展的关键所在。

Objective To explore the issues related to the standardized training of resident doctors at the primary hospital and provide basis for the standardization of doctors＇ training. Methods Questionnaires were used to investigate the resident titles, ages, and education background in the Huanxian People＇s Hospital. The self-assessment of the competency of resident doctors and professional contents necessary for their improvement were analyzed to identify the medical topics should be recommended to improve their clinical knowledge and techniques. Results Forty-six of 52 registered residents in the Huanxian People＇s Hospital participated in the survey with a participation rate of 88.5%. In this hospital, mainly the title of physicians was resident, accounting for 43.3% （52/120）, the ages were chiefly in the range of 31 - 35 years, and their education levels were college degree 42.3% （22/52） and bachelor degree 48.1% （25/52）. 76.1% （35/46） of the residents found they had difficulties in working and not competent enough on the present post, and 71.7% （33/46） of residents considered that they were in urgent need to strengthen their trainings of clinical thinking and clinical skills. Conclusions Strengthening the residents＇ self academic qualifications, improving the hospital teaching system, enhancing the teaching management, and focusing on clinical thinking and clinical skills training are the main issues in the current standardized training in primary hospitals. By accelerating the standardized training of residents, they may have the chance to transform to be the middle-level physicians and improve the unreasonable structure of doctor title distribution that will play the key role in the development of primary hospitals.