全科住院医师规范化培训考核体系的应用与评价研究

Application and Evaluation of Standardized General Medicine Residency Training Assessment System

背景近年来我国全科住院医师规范化培训的开展初见成效,黑龙江省全科住院医师规范化培训历经4年时间,逐步建立了较为系统的考核评价体系,通过分析问题、总结经验,使其更加适应黑龙江省全科医生的人才培养需求具有重要意义。目的对2014年以来全科住院医师规范化培训考核评价体系工作进行回顾性分析,发现问题并制定措施,逐步完善全科住院医师规范化培训考核评价标准和办法,使其更加适应规范化培训的需要。方法选取2014年9月-2019年5月,参加哈尔滨医科大学附属第二医院全科住院医师规范化培训的100例住院医师为调查对象。对3年来学员参加的各项考核成绩进行统计,并采用"全科住院医师规范化培训考核评价管理办法满意度调查问卷"对现行考核评价体系进行评价。结果共95例参与全科住院医师规范化培训的学员被纳入调查,其中2015级41例,2016级30例,2017级24例。2015、2016级学员在连续3年的年度考核中第1次不通过者,参加2次补考,最终通过率均为100.0%。2015级学员结业考试通过率为88.6%(31/35),2016级学员结业考试通过率为100.0%(30/30)。调查问卷13个条目平均得分2.5~4.0分。满意度最高的2个条目为"有助于对临床基本技能与实践操作的考查"(4.0分)和"对促进全科医学临床思维有帮助"(4.0分),满意度最低的2个条目为"有助于对科研能力的考查"(2.5分)和"能够客观地评估住院医师的综合能力"(2.9分)。结论现行的考核体系可行性好、学员接受度高。未来还需重视科研能力和住院医师的综合能力评价,进一步完善考核评价标准体系。

Background In recent years,the implementation of standardized general medicine residency training in China has achieved initial results.Heilongjiang Province has developed a standardized general medicine residency training assessment system(SGMRTAS),and constantly revised it based on analyzing the problems and summarizing the lessons during 4-year implementation of such trainings,which makes the system increasingly satisfy the training needs of general practitioners in this province.Objective To gradually improve the standardized general medicine residency training assessment criteria and methods by analyzing the problems during the implementation of the SGMRTAS since 2014 and giving countermeasures,to make the system increasingly satisfy the needs of such trainings.Methods We recruited 100 residents who had an experience of participating in the standardized general medicine residency training conducted by the 2nd Affiliated Hospital of Harbin Medical University from September 2014 to May 2019.We counted the annual assessment results of the trainees in the past three consecutive years,and used the Questionnaire on Satisfaction with Standardized General Medicine Residency Training Assessment Methods to measure the trainees'satisfaction with the current SGMRTAS.Results Of the 95 trainees included,41 attended the training in 2015,30 in 2016,and 24 in 2017.The annual assessment pass rates in the past three consecutive years for 2015 and 2016 grade trainees were all 100.0%,including those who failed the first assessment,but passed the makeup assessment.The pass rates for the final test of the training for 2015 and 2016 grade trainees were 88.6%(31/35),and 100.0%(30/30),respectively.The mean scores of 13 items in the questionnaire ranged 2.5-4.0 points.The top two items with the highest scores were"The training helps residents to complete basic clinical skills and practical performance assessment""The training promotes the culture of residents'clinical thinking",while the two bottom ones with the lowest scores were"The training helps residents to complete scientific research performance assessment""The training can objectively evaluate the comprehensive capabilities of residents".Conclusion The current assessment system has good feasibility and high acceptance of trainees.To further improve the SGMRTAS,more attention should be paid to the evaluation of residents'scientific research performance and comprehensive capabilities.