儿科专业住院医师规范化培训分层出科考核管理体系建设的探索与实践

Hierarchical assessment of pediatric residency during standardized training

目的解决儿科住院医师轮转盲从、无序窘境,达到出科规范化、同质化。方法将出科考核体系分为医院、儿科、14个儿科亚专业三个层面,基地制定亚专业轮转流程,标准化、量化各项学习任务和考核指标,明确轮转目标。出科前,住院医师递交的考核资料由亚专业初审,通过后交由儿科专业基地复审,合格者视为该亚专业轮转达标,准予参加由儿科组织的出科理论考试,否则取消参考资格,视为该亚专业轮转不达标,待全部轮转结束后,自费重新轮转该亚专业,最终经儿科审查合格后,方推荐给院级培训基地参加省级住培结业考核。每次出科理论考试结束后,儿科对住院医师进行综合评价并客观评定奖学金等级,报医院教学管理部门,至此为完整出科考核体系。结果住院医师对儿科管理的满意度调查逐年提高;2019年上半年,参加省级结业技能考核通过率100%,理论考试通过率93.33%,均较前有所提高,且以技能考核提高尤为明显。结论建立、健全统分结合的分层精细化管理和出科考核体系,有利于帮助儿科住培医师提升自我学习能力和综合素质;促进教学活动的顺利开展;提高培训基地的教学质量与效率。

Objective To eliminate blind obedience and disorder associated with standardized training of pediatric residency during the rotation process,and bring standardization and homogenization to resident training.Methods The assessment system was divided into three management levels:the hospital,the pediatric department and fourteen pediatric sub-specialties.The training base formulated the sub-specialty rotation process,standardized and quantified various learning tasks and assessment indicators,and finally clarified the rotation objectives.Towards the end of traing,the trainees submitted their assessment materials to the sub-specialty committee for the first-round review.Those who passed the review would be subjected to the second-round view by the sub-specialty training base.Those who passed were regarded as qualified for theory examination organized by the pediatric department while those who failed in the secondround view had to start their rotation a second time in this sub-specialy at their own expenses after the completion of each rotation before they were recommended to the hospital training base to take the provincial exam for resident training.After the theory examination,the base made comprehensive assessment to the trainees,decided on their amounts of scholarships objectively,and reported them to the department of teaching management.Results The survey showed that the pediatric residents’level of satisfaction with such an assessment system was increasing year by year.In the first half of 2019,the pass rate of the provincial skill test was 100%,compared with 93.33%for the theory test,both of which were significant improvements compared to previous years.Conclusion The hierarchical and refined management system of examination and assessment can help pediatric residents to enhance their ability to teach themselves while improving their overall qualities so that teaching is facilitated and the efficiency and quality of teaching are improved at the training base.