统筹式轮转与按学科轮转在眼科住院医师规范化培训中的效果初探

The outcome of integrated rotation and discipline rotation in the standardized training of ophthalmology residents

目的研究统筹式轮转与按学科轮转在眼科住院医师规范化培训中的效果差别，为进一步完善我国眼科住院医师规范化培训提供参考。方法选择北京大学第三医院规范化培训人员纳入本研究。记录住院医师的轮转方式、专业组数量、管理病种数量和手术例数。从住院医师、带教教师和患者感受三方面来进行比较。结果统筹式轮转中，住院医师轮转的专业组数量、管理病种数量均高于按学科轮转，差异具有统计学意义（均P〈0．05），而手术例数差异无统计学意义（P〉0．05）。住院医师自评问卷结果显示，在轮转总效果、学习兴趣、临床能力、临床思维、医患沟通能力方面，两种轮转方式的差异均具有统计学意义（均P〈0．05）。统筹式轮转医师的教师反馈和患者体验优于按学科轮转医师。结论统筹式轮转中，住院医师学习的病种更多，更有利于学习兴趣、临床能力、临床思维和医患沟通能力的培养；教师反馈学习效果更好，患者体验较好。统筹式轮转使受培训的住院医师可以由浅人深地学习专科知识，有助于青年医师的快速成长。

Objective To compare the outcome of integrated rotation and discipline rotation in the standardized training of ophthalmology resident. And to provide support for improving the standardized training of ophthalmology residents in China in the future. Methods The ophthalmology residents in the Peking University Third Hospital standardized training item were included in this study. The rotation style, the number of professional groups, the number of management diseases and the number of surgeries were recorded. The feedback of the residents, supervisor and patients were compared. Results In the integrated rotation, the number of professional groups and management diseases of residents was higher than that of disciplinary rotation with statistically significant differences （all P 〈 0. 05 ）, but there was no statistical difference in the number of surgeries （P〉0. 05）. The results of the resident self-assessment questionnaire showed that there were statistically significant differences in the overall rotation effect, learning interest, clinical ability, clinical reasoning, and doctor-patient communication skills （all P 〈 0. 05 ）. The teacher feedback and patient experience in integrated rotation is better than in discipline rotation. Conclusions In an integrated rotation, residents contact more cases than in discipline rotation, which is more conducive to learning interest, clinical ability, clinical reasoning, and doctor-patient communication skills. The feedback from teachers and patients are better. The integrated rotation allows the trained residents to learn professional knowledge step by step, which is helpful for the rapid growth of young doctors.