上海市黄渡社区全科教学门诊开设START培训法的探索分析

Application of START method in general practice teaching clinic of Shanghai Huangdu Community Health Service Center

为探讨能有效提高社区全科医生临床业务能力的培训方法,上海市嘉定区安亭镇黄渡社区卫生服务中心于2017年4月至2019年9月在社区全科教学门诊采用START(standardized reception:标准化接诊,teach:讲课练习,analysis:分析,research:科研项目,training:技能训练)培训法对50名全科医生进行培训,培训3个月后评价其临床业务能力和教学能力在培训前后的差异,并开展满意度调查。培训后全科医生的临床技能、医患交流技能均较前明显提高(均P<0.01)。其中,采集病史、临床思维和健康教育3个方面评分均高于培训前(均P<0.01);培训前后病史书写和控制接诊时间评分差异无统计学意义(均P>0.05);医患关系建立、采集病史和反馈、从患者角度理解问题、信息共享和知情同意4个方面评分均高于培训前(均P<0.01);教案设计、教学方法等教学能力评分较培训前明显提高(均P<0.01);学员对START培训法的满意度为96.0%(48/50)。提示START培训法能明显提高社区全科医生的临床业务能力和教学能力。

From April 2017 to September 2019,the START(standardized reception,teaching,analysis,research,training)method was adopted to train 50 general practitioners at the community general practice teaching clinic of Shanghai Huangdu Community Health Service Center.After 3 months of training,the progress of clinical competence and teaching ability were assessed.After training,the scores of clinical skills and communication skills were significantly higher than those before training(P<0.01).The scores of medical history taking,clinical thinking and health education were higher than before(all P<0.01).But there was no significant difference in record writing and reception time management between those before and after training(all P>0.05).The scores of the ability for building physician-patient relationship,collecting information and providing feedback,understanding complaints from patients′perspective,sharing information and obtaining informed consents were higher than that before training(all P<0.01).The teaching ability of plan design and teaching method were significantly improved compared with that before training(all P<0.01).The satisfaction rate of START method was 96.0%(48/50).The START method applied in community teaching clinic can significantly improve the clinical competency and teaching ability of general practitioners.