住院医师外院规范化培训效果评估

Evaluation of Effect of Standardized Residency Training in Hospitals

目的评估联合培养住院医师的培训效果,为改进住院医师规范化培训提供借鉴。方法对正在外院进行内科学培训的31名肿瘤内科住院医师、其所在培训医院的带教教师、护士长及科室主任各18名进行问卷调查。采用柯氏评估模型,从反应层、学习层、行为层、成果层四个层面收集资料,评估培训效果。结果反应层:住院医师对于规培的整体满意度较高,但对薪水待遇满意度较低。学习层:规培医师参加出科考核等过程考核,一次通过率达100%。行为层:住院医师规范化培训前后行为能力变化有差异,培训后评估分数明显高于培训前(p<0.05)。成果层:住院医师患者投诉率和事故率为0。执业医师资格考试通过率为100%,规培期间课题研究参与率为32%,以第一作者身份发表论文率为23%。结论正在外院联合培养的肿瘤内科住院医师对培训的总体满意度较高,但对培训期间的薪水待遇、工作和生活环境满意度欠佳。培训前后对比,住院医师临床能力与行为评估均有提高,规范化培训取得了较好成效。

Objective To evaluate the effect of combined training for residents,so as to provide references for improving the standardized residency training.Methods Questionnaires investigation were conducted on 31 oncology resident doctors who were undergoing internal medicine training in other hospitals,and 18 clinical teachers,18 head nurses and 18 department directors in their training hospitals.Kirkpatrick Model was used to analyze the questionnaires in four levels including reaction,learning,behavior and achievement.Results Reaction level:residents had good overall satisfaction with standardized training,but had less satisfaction with salary.Learning level:All the resident doctors who participated combined training passed the process assessments including departmental rotation examinations.Behaviors level:The scores of behavioral abilities after the training were significantly higher than those before training(p<0.05).Achievement level:Both the patient complaint rate and the accident rate were zero,and all the resident doctors passed the National Medical Licensing Examination.There were 32%of them participating in researches and 23%publishing professional papers as the first author during the training.Conclusion The resident doctors undergoing the combined training had good overall satisfaction with standardized residency training,but had less satisfaction with salary,work and living environment.Their clinical ability and behavioral assessment improved after standardized training.