上海市创伤救治医师规范培训现状调查

A survey on standardized training of trauma surgeons in Shanghai

目的调查上海市各医疗机构创伤救治医师规范培训情况。方法通过问卷调研、焦点讨论、专家论证等多种方法,调查25所医疗机构的236名创伤救治医师的专业背景、创伤救治知识规范化培训状况、培训需求和建议。结果仅有59.3%(140/236)的医师接受过创伤救治知识规范化培训。参加国际、国内和本医疗机构培训的人数分别占接受过培训总人数的26.4%(37/140)、47.1%(66/140)和84.3%(118/140)。仅83人(70.3%)参加的培训是定期开展的,培训频率每年开展1~2次最多,合计66.3%(55/83);3年内参加本医疗机构内创伤救治知识规范化培训总学时≥48(1学时为45 min)的仅有15人,占12.7%(15/118)。医疗机构培训课程和形式仍以理论知识讲座和单项技能操作培训为主,模拟情景演练形式占比不足,仅有48.3%(57/118)。接受过创伤救治规范化培训的医师更倾向于运用培训知识对创伤患者采取分级评分,与未参加规范化培训的医师人数相比差异有统计学意义(P<0.05)。结论上海市创伤规范培训覆盖率不足、培训时间不足、培训频率较低。建议加强各医疗机构院内创伤救治医师规范化培训,并从管理层面对培训情况进行监督和管理;尽快制定一套适合我国国情的规范的创伤救治知识培训教材和考核标准;在上海市建立严重创伤规范化救治培训基地和规范化的创伤专科医生培训基地;推动建立创伤学科,尽快制定并完善创伤专科医师培训制度。

Objective To investigate the current state of standardized training in trauma surgeons in medical institutions in Shanghai.Methods Questionnaire surveys,focus discussions and expert conferences were conducted to investigate the professional background,status of standardized training on trauma care knowledge,training needs and suggestions in 236 trauma surgeons in 25 Shanghai medical institutions.Results The investigation revealed that only 59.3%(140/236)of the trauma surgeons had received a standardized training on trauma care knowledge.Of them,those who participated in the training by an international,domestic and local medical institution accounted for 26.4%(37/140),47.1%(66/140)and 84.3%(118/140),respectively.Only 83 surgeons(70.3%)received regular training and most of them 66.3%(55/83)did in a low frequency of 1-2 times a year.Only 12.7%(15/118)of the surgeons received a training course of≥48 classes(45 min per class)in the past 3 years.The training courses by medical institutions were mostly lectures on theoretical knowledge and training of a single skill while the simulated scenario drills accounted for less than 48.3%(57/118).The surgeons who had received a standardized training on trauma care were more likely to use their training knowledge to grade and score the patients with trauma,significantly more than those who had not(P<0.05).Conclusions The coverage,time or frequency of standardized training on trauma care was not enough in Shanghai.The standardized training of trauma care surgeons should be strengthened in all medical institutions and be supervised by the management administration.A set of standardized materials and assessment standards for trauma care training should be formulated as soon as possible which fits the domestic conditions in China.Training bases should be established in Shanghai for standardized care of severe trauma and trauma specialists.A training system for trauma specialists should be established to promote traumatology in shanghai.