利用结构化报告提高放射专科医师规范化培训质量的研究

Application of structured report to qualify the standardized training for radiologists

目的评估结构化报告系统（以冠状动脉CT血管造影为例）在提高放射专科医师规范化培训质量中的作用。方法选择上海交通大学医学院附属仁济医院放射专科基地进行规范化培训的15名医师为研究对象。分别利用结构化报告系统和传统报告模板对其进行冠状动脉CT血管造影报告书写培训，对培训期间及培训结束后1年的影像诊断报告质量进行比较分析，并以问卷的形式对使用该结构化报告系统的医师进行问卷调查。结果结构化报告系统可以有效避免冠状动脉CT血管造影报告中遗漏评估内容，且与医师从事报告书写的时间长短无关（χ2＝0, P＝1.00）。培训结束后，经过1年的工作实践，医师诊断效率明显提高（t＝12.4, P〈0.01）；问卷调查结果表明，该报告系统使用体验良好。结论利用结构化报告系统可以建立起一套针对放射专科医师的规范化、行之有效的培训模式。

Objective To evaluate the role of the structured report system, coronary CT angiography, for example, in improving the training standardization of radiologists.Methods A total of fifteen trainees from radiologist training base in Renji Hospital, School of Medicine, Shanghai Jiao Tong University, were enrolled in the study. All radiologists were trained by structured reporting system and traditional report template separately for writing reports of coronary CT angiography. The quality of these reports during the training and the reports one year after the training were compared and analyzed. A questionnaire survey was adopted to investigate users’ experience.Results The use of structured report system can effectively avoid the missing of evaluation options of coronary CT angiography, and has nothing to do with the length of time involved in writing reports （χ2=0, P=1.00）; Besides, it could improve the efficiency of diagnosis after one-year working when the training was over （t=12.4, P〈0.01）; Questionnaire survey showed that the trainees had good experience of the report system.Conclusions The structured report system could establish a set of standardized and effective training protocol for radiologists.