目标管理在麻醉专业住培教学中的应用

Application of target management in resident training teaching in anesthesiology

目的 运用目标管理的方法,探索一个立足于我国现阶段医疗卫生现状,能更好、更全面地培养满足临床工作需要的麻醉专业住院医师的临床教学方法。方法 选择进行临床麻醉专业规范化培训住院医师20名,随机分为对照组、实验组,各10名。培训时间均为33个月,带教老师为具备丰富临床教学经验的主治3年及以上职称医生。对照组采用传统教学法,实验组采用目标管理教学法。评估方法:⑴出科考核,规培结束后,对规培住院医师进行出科考试,考试分为书面理论考核和临床操作技能考核;⑵规培期间综合评分,由指导老师填写;⑶指导老师带教评估,由规培住院医师填写;以上均以百分制表示。结果 施行目标管理教学方法的临床麻醉专业规培住院医师,与传统教学方法的临床麻醉专业规培住院医师相比,出勤率、专业课参与率、医德医风情况较好,但差异无统计学意义。实验组出科理论考核成绩(84.6±2.8)分、操作考核成绩(92.9±2.7)分、规培综合评分(93.9±1.6)分、对麻醉科临床带教评估(96.6±1.7)分,对照组分别为(79.0±3.8)分、(84.6±2.5)分、(89.0±1.5)分、(88.6±2.8)分,两组各指标比较,差异均有统计学意义(均P<0.05)。结论 目标管理在临床麻醉专业规培住院医师教学中的应用能提高专业教学质量。

Objective To explore a better and more comprehensive clinical teaching method for anesthesia residents who meet the needs of clinical work using the target management method and basing on the current medical and health situation in China.Methods Twenty residents who were trained in clinical anesthesia were randomly divided into a control group and an experimental group,10 for each group.The training period was 33 months.The instructor was a doctor who had rich clinical teaching experience and had been a physician for three years or more.The control group adopted the traditional teaching method,while the experimental group the target management teaching method.The assessment methods were as follow.⑴Discharge assessment:after the training,the residents discharged from the hospital would be tested through theoretical assessment and clinical operation assessment;⑵Comprehensive score during training:which would be filled out by the instructor;⑶Instruction assessment:which would be filled out by the residents;the above were expressed in percentage system.Results Compared with the traditional teaching method,the resident trained with the target management teaching method had better attendance rate,professional course participation rate,and medical ethics,but with no statistical differences.The scores of theoretical assessment[(84.6±2.8)vs.(79.0±3.8)],clinical operation assessment[(92.9±2.7)vs.(84.6±2.5)],comprehensive score during training[(93.9±1.6)vs.(89.0±1.5)],and the instruction assessment[(96.6±1.7)vs.(88.6±2.8)]were better in the experimental group than in the control group(all P<0.05).Conclusions The application of target management in resident training in clinical anesthesia can improve the quality of specialty education.