国产新型临床思维训练与考核系统在上海市住院医师规范化培训中的应用及效果评估

Survey of the evaluation of clinical thinking training and assessment system by residents standardized training in Shanghai

目的:观察国产新型临床思维训练与考核系统在上海市住院医师规范化培训中的应用效果,探讨适合我国国情、体现我国特色的住院医师临床思维训练及考核新思路。方法:采用上海市卫生和计划生育委员会自主开发的基于移动终端的临床思维训练与考核系统对2016年上海市44家住院医师规范化培训基地医院的4 559名在培住院医师进行考核。考核完成后采用问卷调查方法对所有参与考核的住院医师进行调查,评价考核效果及系统应用效果。结果:共发放调查问卷4 559份,回收4 528份,有效问卷回收率99.32%。系统界面操作便捷性:21.1%的受调查住院医师认为界面操作很方便,47.1%认为界面操作较方便,23.9%认为界面操作方便性一般,7.9%认为界面操作不方便。系统操作视频学习培训的必要性:33.2%的受调查住院医师认为系统操作视频学习培训很有必要,42.9%认为有必要,20.6%认为必要性一般,3.2%认为没有必要。系统对临床思维能力的评估价值:17.3%的受调查住院医师认为该系统完全可以评估临床思维能力,75.3%认为部分评估临床思维能力,7.5%认为无法评估临床思维能力。系统对临床思维能力的提升作用:23.8%的受调查住院医师认为该系统对临床思维能力有很大提升作用,52.4%认为有部分提升作用,20.3%认为提升作用一般,3.5%认为没有提升作用。住院医师对系统的接受程度:17.0%的住院医师特别能够接受该系统,52.1%比较能够接受,27.1%接受程度一般,3.8%不接受。考核后需要反馈的内容:受调查的住院医师希望得到的反馈内容依次为思维的缺陷(71.8%)、步骤问题(44.8%)、标准答案(42.9%)、分数(33.0%)。结论:由上海市卫生和计划生育委员会自主研发的国产新型临床思维训练与考核系统能够得到住院医师的广泛认可,有助于提升住院医师的临床思维能力,值得在住院医师规范化培训中进一步推广应用。

Objective:To investigate the feedback of residents after their using of clinical thinking training and assessment system.Methods:4 559 questionnaire results of clinical thinking training and assessment system of 44 residents standardized training hospitals in Shanghai in 2016 were analyzed.Results:Only less than 8%of the respondents admitted that the system interface was not easy to operate,7.5%of the respondents believed that it was ineffective to evaluate the ability of clinical thinking,3.5%of the respondents thought it was unbeneficial to improve the ability of clinical thinking,and 3.8%were unwilling to receive the system.Conclusions:The clinical thinking training and assessment system is a system platform which can be accepted by a large majority of residents,and it is helpful to improve the residents’clinical thinking,it is worthwhile to further promote the application in the standardized training of residents.