临床专业学位研究生消化内科轮转培养的实践

Practice of the rotation training model for professional clinical postgraduate students in department of gastroenterology

目的比较临床专业学位研究生培养与住院医师规范化培训相结合的模式(简称"并轨"模式)与"传统"模式培养对临床专业学位研究生在消化科轮转中的意义。方法选取2012年7月至2016年7月在青岛市市立医院消化内科轮转的临床专业学位研究生为研究对象,分别应用"并轨"模式(30人)或"传统"模式(20人)培养,比较研究生的临床知识、技能以及各项核心能力。采用SPSS 13.0进行t检验和卡方检验。结果"并轨"模式较"传统"模式培养的研究生临床考核各项成绩总分明显提高,差异具有统计学意义[(92.60±2.52)vs.(83.80±3.14),t=10.93,P<0.01];两种模式培养的研究生在职业素养、医患沟通能力方面差异无统计学意义;"并轨"模式培养后的研究生在临床专业理论知识及临床思维能力、诊治技能、心理素质方面均明显优于"传统"模式培养的研究生(χ^2=27.00,χ2=10.23,χ^2=12.21,P均<0.01),差异具有统计学意义;但在临床科研能力方面,"传统"模式较"并轨"模式略有提高,差异无统计学意义(χ^2=1.39,P=0.24)。结论"并轨"模式优于"传统"模式,"并轨"模式较"传统"模式更有利于培养其临床实践等综合能力,值得进一步推广。

Objective To investigate the significance of "merge" model versus "traditional" model in rotation training for professional clinical postgraduate students in department of gastroenterology. Methods The professional clinical postgraduate students who underwent rotation training in Qingdao Municipal Hospital from July 2012 to July 2016 were enrolled as subjects and were trained with the "merge" model and the "traditional" model, respectively. The two groups of subjects were compared in terms of clinical knowledge, skills, and core competencies. Results The postgraduates trained by the "merge" model had a significantly higher total score of clinical examinations than those trained by the "traditional" model [(92.60±2.52) vs.(83.80±3.14), t=10.93, P<0.01], while there were no significant differences in professional quality and doctor-patient communication between the two groups. Compared with those trained with the "traditional" model, the postgraduates trained by the "merge" model had significantly better understanding of clinical knowledge and clinical thinking ability, diagnosis and treatment skills, and psychological quality (χ^2=27.00, 10.23, and 12.21, all P<0.01);however, there was no significant difference in clinical research ability between the two groups (χ^2=1.39, P=0.24). Conclusion The model of professional clinical postgraduate training combined with standardized training of residents is superior to the traditional training model, and compared with the "traditional" model, the "merge" model is more beneficial to the training of comprehensive clinical practice abilities and thus holds promise for further application.