探讨有效培养住院医师临床胜任力的教学方法

Introductions on effective competency-based residency training methods

住院医师规范化培训不仅需要一定的培训强度,而且还需要辅以一定的教学技巧和方法。围绕医师6大核心能力的培养,我们在中美全科医师规范化培训试点项目中引入了一些在美国住院医师培训中常见并行之有效的教学方式。本文就其中的鉴别诊断分析会做重点介绍和讨论。通过对住院医师进行问卷调查,了解住院医师对这种教学方法的认可程度,并对鉴别诊断分析会对他们的主动自学意识、独立思考能力、系统归纳能力、全科思维、推理思辨、鉴别诊断和教学能力的帮助作用收集意见。调查的结果显示:这种学习方法认可度高且非常有效。这种教学方式具有3个明显的特点:以学习者为中心(Learner-Centered Teaching)进行教学;强调互动式学习;按系统分析症状,培养全科思维。本文也介绍了其他几种教学方式,例如午间核心课程讲座(Core Didactic Curriculum Noon Conference)、大讲座(Grand Round)、最新文献汇报(Journal Club)等,希望针对住院医师临床胜任力相关的一些核心软能力提供相应的强化培训方法。

It requires not only considerable training intensity,but also certain teaching techniques and methods for standardized residency training.Focusing on the cultivation of the six core competencies,we have introduced several effective residency teaching methods,which are well-established in the United State,into our Sino - US Pilot General Practice Standardized Residency Training Project in WuHan.This article mainly focused on one of these methods,called Resident Case Report.Through the questionnaires, we surveyed the acceptance of resident case report and collected resident's opinions to see if this new teaching method worked on cultivating their autonomous learning awareness,promoting abilities of independent thinking,teaching,making differential diagnosis and general medical thinking,and if it helped in establishing critical thinking skills and enhancing systematic inductive abilities.The survey results indicated that Resident Case Report is well accepted by residents as an effective training method for the following three distinct characteristics: learner-centered teaching;interactive discussion and cultivating general medical thinking by systematic classifications of differential diagnosis.We introduced several other teaching methods in the meanwhile,such as Core Didactic Curriculum Noon Conference,Grand Round and Journal Club,in the hope of providing specific corresponding residency teaching ways for different soft clinical skills and core competencies.