重庆市全科医生转岗培训中学员的问诊能力研究

Research on Inquiry Ability of General Practitioners in the Job-transfer Training in Chongqing

目的了解重庆市全科医转岗培训中学员的问诊能力现状及尚存问题,为进一步提高全科医生的问诊能力提供参考。方法以2014—2016年在重庆医科大学附属第一医院全科医学教育中心参加培训的468例全科医生转岗培训学员为研究对象。采用自制的"全科问诊能力考核方案"对学员的问诊能力进行评价,各项能力评分均进行标准化(1分)后进行比较。结果 468例学员全科问诊能力考核的中位得分为21.20(10.65)分。其中,得分排在前3位的考核内容分别为询问患者既往史、个人史、家族史1.00(0.34)分,学员问诊时仪表、举止、态度0.80(0.60)分,询问主要症状0.75(0.20)分;得分排在后3位的考核内容分别为学员的自我介绍0.20(0.40)分,表达共情0.40(0.20)分,询问患者的基本情况0.40(0.60)分。结论全科医生转岗培训中学员问诊时询问既往史、个人史、家族史,问诊时仪表、举止、态度,询问主要症状的能力较好;而学员问诊时的自我介绍,表达共情,询问患者姓名、年龄、职业、住址等基本情况的能力有待提高。

Objective To investigate the current situation and existing problems of general practitioners'inquiry ability in the job-transfer training in Chongqing,and to provide a reference for further improving the inquiry ability of general practitioners.Methods The research subjects were 468 physicians who attended the job-transfer training for general practitioners in General Medical Education Center of the First Affiliated Hospital of Chongqing Medical University from 2014 to 2016.Trainees'inquiry ability were evaluated by a self-made inquiry ability assessment program.The scores of these abilities were standardized(1 point)and then compared.Results The median score of 468 trainees was 21.20(10.65).The assessment contents of the top three scores were whether trainees asked patients'past history,personal history,and family history[1.00(0.34)],trainees'appearance,behavior,and attitude[0.80(0.60)],and whether trainees asked the main disease symptoms[0.75(0.20)].The assessment contents of the last three scores were whether trainees gave the self introduction[0.20(0.40)],whether trainees had a good expression in process of inquiry[0.40(0.20)],whether trainees asked patient's name,age,occupation,address and other general situation[0.40(0.60)].Conclusion The trainees have a better performance on asking patients'past history,personal history,and family history,and main symptoms as well as having a good appearance,behavior and attitude.However,they have a worse performance on giving the self introduction,having a good expression in process of inquiry,and asking patient's name,age,occupation,address and other general situation,which are expected to be improved in future.