临床技能培训在儿科住院医师规范化培训中的问题探讨

Study on Clinical Skill Training in Pediatric Resident Standardized Training

目的探讨我院临床技能培训中可能存在的问题,旨在优化临床技能培训方案。方法我院于2016年4月—2017年3月采用仿真模型对学员进行临床技能培训及考核,收集64位学员的11项技能考核成绩,依据学员专业、学历及培训项目类别进行分组,对比分析考核成绩是否存在差异。结果 (1)儿内科和儿外科学员各项技能成绩比较显示,不同科室的学院骨髓穿刺术成绩对比,差异具有统计学意义[91.0(86.2,92.8) vs. 87.9(19.6,89.9),(P=0.008)]。(2)硕士和学士学位学员各项技能成绩比较显示,腰椎穿刺术、气管插管术成绩比较,差异具有统计学意义[87.0(81.1,92.8) vs. 84.3(76.9,87.0),(P=0.047);87.4(82.5,90.1) vs. 81.1(76.2,87.0)(,P=0.019)]。(3)不同项目类别成绩比较显示,传染病防护与处理措施成绩最高[96.0(93.3,98.0)],外科项目成绩最低[82.9(76.6,84.7)],且与其他类别成绩比较,差异具有统计学意义(P<0.05)。结论实施高效的儿科住院医师规范化培训,需依据学员专业、学历不同及培训项目差异制定个体化临床技能培养计划。

Objective To explore the possible problems in clinical skills training in our hospital,aims to optimize the training program for clinical skills.Methods From April2016to March2017,the simulation model was used to train and assess the clinical skills of the trainees.Eleven skills test scores of64students were collected and grouped according to their majors,academic qualifications and training items.The differences of test scores were compared and analyzed.Results(1)Comparisons of various skills between pediatric medical students and pediatric surgical students showed that there was a significant difference in the results of bone marrow puncture between different departments[91.0(86.2,92.8)vs.87.9(19.6,89.9),(P=0.008)].(2)Comparisons of skill scores between master's degree and bachelor's degree students showed that there were significant differences in the scores of lumbar puncture and tracheal intubation[87.0(81.1,92.8)vs.84.3(76.9,87.0),(P=0.047);87.4(82.5,90.1)vs.81.1(76.2,87.0),(P=0.019)].(3)Comparing the results of different item categories,the results of infectious disease prevention and treatment measures were the highest[96.0(93.3,98.0)],while the results of surgical items were the lowest[82.9(76.6,84.7)],and there was a significant difference compared with the results of other categories(P<0.05).Conclusion The specialties and various levels of pediatric residents and skills training items should be considered in the clinical skills training,which is helpful for implementing the standardized training of pediatric resident effectively and making individualization of training plan.