住院医师规范化培训的核心教学形式——晨间报告和教学大查房

Two essential components of standarized residency training:morning report and grand round

要想达到住院医师培训规范化,首先要将教学方式规范化。晨间报告与大查房是住院医师培训期间2个主要的教学方式。两者都是通过讨论实际病例而达到教学的目的。特别需要注意的是,这2种形式追求的教学重点都是临床实用性,必须和科研讲座或疑难病例讨论明确区分。晨报每天都要进行,偏于小组讨论形式,旨在练习从原始资料中筛选有用的数据,从而形成诊断思路,判断病情严重程度。大查房一般每周1次,是科一级的正式大型会议,通过1个诊断明确的完整病例演示病例处理的全过程,两者是培训必不可少的组成部分。做好晨报与大查房是培训项目的责任,而聘用专职的项目主任是保障成功的基本要素。

The standardization of residency training begins with standardization of teaching formats.Morning report and grand round are two principal formats of teaching during residency training.Both morning report and grand round are case-based teaching,with a special emphasis on the practicality and thus a clear differentiation from research seminar or discussion of difficult cases in consulting nature.Morning report is a small group discussion,with the goal to practice data gathering and analysis,and thereby to establish a list of differential diagnosis and a judgment of acuity.Grand round is usually a weekly formal meeting at department level in which a case with an established diagnosis,a plan,and often an outcome,is presented to demonstrate the entire process of clinical approach to a complex case.Both morning report and grand round are essential components of residency training and their success is the responsibility of the training program through a dedicated program director.