病房门诊相结合模式在全科专业住培医师儿科轮转中的应用

Application of the Clinical-ward Combination Training Mode of Resident Training in the Rotation of General Practitioners in the Department of Pediatrics

目的 探讨半天病房结合半天门诊培训模式在全科专业住院医师规范化培训医师儿科轮转中的应用。方法 选取对象为2015年9月1日-2019年3月31日期间在某医院儿科住院医师规范化培训基地参加培训的全科住培医师115名,随机分组,实验组58人,对照组57名。实验组上午参加病房工作下午参加门诊工作,对照组全天参加病房工作。培训结束统一参加出科考试和问卷调查。结果 实验组和对照组的A2、A3型题目考核成绩分别为(34.93±4.71)分和(32.43±3.52)分,差异有统计学意义(P<0.05),实验组和对照组A1型题目考试成绩分别为(70.72±7.23)分和(69.90±6.56)分,差异没有统计学意义(P>0.05)。调查问卷中,实验组培训满意程度、临床思维能力提高程度和医患沟通能力提高程度分别为(3.86±0.79)分、(3.53±0.68)分和(3.72±0.65)分,与对照组相比差异有统计学意义(P<0.05),实验组临床技能提高程度、文献检索能力提高程度和团队合作能力提高程度分别为(3.18±0.54)分、(2.90±0.59)分和(2.77±0.57)分,与对照组相比差异没有统计学意义(P>0.05)。结论 全科住培医师在儿科轮转中,上午参加病房工作下午参加门诊工作可以提高临床思维能力和医患沟通能力,全科住培医师的满意度更高。

Objectives This study aims to investigate the application value of the resident training mode of half-day-clinical and half-day-ward combination for general practitioners during their rotation in the department of pediatrics. Methods 115 general residents who participated in the pediatric standardized training in a hospital from September 1, 2015 to March 31, 2019 were randomly divided into two groups, with 58 residents in the experimental group and 57 residents in the control group. The residents in the experimental group participated in ward training in the morning and clinical training in the afternoon, while the residents in control group participated in ward training all day. At the end of training, all residents participated in the graduation examination and questionnaire survey.Results A2 and A3 test scores in the experimental group and the control group were(34.93±4.71) and(32.43 ±3.52) respectively, which showed significant difference(P<0.05). A1 test scores in the experimental group and the control group were(70.72±7.23) and(69.90±6.56) respectively, with no significant difference(P>0.05). According to the questionnaires, the degrees of increment in the satisfaction level towards training, clinical thinking ability and communication ability between doctor and patient in the experimental group were(3.86 ±0.79),(3.53±0.68) and(3.72±0.65) respectively, which were significantly different with those in the control group(P<0.05). The degrees of improvement in clinical skills, literature retrieval ability and teamwork ability were(3.18±0.54),(2.90±0.59) and(2.77±0.57) in the experimental group respectively, which had no significant difference with those in the control group(P>0.05). Conclusions During the pediatric rotation,general practitioners participating in ward training in the morning and clinical training in the afternoon could improve their clinical thinking ability and their communication ability with patients. Their degree of satisfaction was higher.