360度评估在以胜任力为导向的儿科住院医师规范化培训中的应用

Application of 360-degree assessment in the competency-oriented standardized training of pediatric residents

目的探讨360度评估在以胜任力为导向的儿科住院医师规范化培训(下文简称住培)中的应用效果。方法2020年6月至9月,收集2017年至2019年在北京大学第一医院儿科完成住培的48名住院医师的2688份360度评估结果并进行分析。结果①不同评估者对住院医师评分不同:患儿家长评分最高,为(4.9±0.3)分,其次为同级医师(4.7±0.3)分和护士(4.6±0.5)分,上级医师评分最低,为(4.5±0.4)分;②住院医师在不同胜任力方面评分不同:医学专家、交流者、合作者、领导者、健康倡导者、学者及职业人评分分别为(4.4±0.4)分、(4.6±0.5)分、(4.7±0.4)分、(4.5±0.3)分、(4.6±0.4)分、(4.4±0.5)分、(4.8±0.4)分,医学专家和学者角色评分最低,职业人角色评分最高;③护士、同级医师和上级医师对第二年住院医师的评分均高于第一年住院医师,差异均具有统计学意义[(4.8±0.4)分比(4.5±0.6)分、(4.8±0.1)分比(4.6±0.3)分、(4.6±0.3)分比(4.4±0.4)分,均P<0.01];第二年住院医师在医学专家、交流者、领导者、健康倡导者、学者及职业人的胜任力评分均高于第一年,差异均具有统计学意义[(4.5±0.5)分比(4.4±0.5)分、(4.7±0.4)分比(4.5±0.5)分、(4.6±0.4)分比(4.4±0.5)分、(4.7±0.4)分比(4.6±0.5)分、(4.5±0.4)分比(4.3±0.5)分、(4.9±0.3)分比(4.8±0.4)分,均P<0.05]。结论在儿科住院医师规范化培训中,应用360度评估对住院医师进行持续、全面、多维度评价,有助于促进住院医师能力的提升。

Objective To explore the role of 360-degree assessment in the competency-oriented standardized training of pediatric residents.Methods A total of 2688360-degree evaluation results of 48 residents who completed standardized training in the Department of Pediatrics,Peking University First Hospital from 2017 to 2019 were collected and statistically analyzed respectively.Results(1)Different types of evaluators scored residents differently.The score from parents was the highest,(4.9±0.3),followed by(4.7±0.3)from peer residents and(4.6±0.5)from nurses.The score from superior physicians was the lowest,(4.5±0.4).(2)Residents had different scores in different competences.They scored(4.4±0.4),(4.6±0.5),(4.7±0.4),(4.5±0.3),(4.6±0.4),(4.4±0.5),(4.8±0.4)in the role of medical experts,communicators,collaborators,leaders,health advocates,scholars and professionalism,respectively.They had the lowest score in the roles of medical experts and scholars,and the highest score in professionalism.(3)The 360-degree assessment of the second year residents showed higher score from different evaluators and in various competencies than the first-year residents.Conclusions The 360-degree assessment can continuously and comprehensively evaluate the abilities of residents in a multi-dimensional way during the rotation process,and promote the overall improvement of residents.