全科住院医师规范化培训基地教学门诊开展 现状调查

A survey on the current situation of teaching clinics in standardized training bases of general practice

目的了解和分析《全科专业住院医师规范化培训全科教学门诊规范(试行)》发布后全科教学门诊的开展状况,针对存在的问题提出对策和建议。方法根据《全科专业住院医师规范化培训全科教学门诊规范(试行)》自行设计调查问卷,对全国范围内全科专业住院医师规范化培训(以下简称“全科住培”)带教教师和全科住培医师分别进行问卷调查,了解全科教学门诊开展现状,包括基本信息、教学门诊诊间设置、教学门诊带教教师要求、教学门诊患者遴选、教学门诊实施及其保障措施等方面。结果全科教学门诊带教中指导书写SOAP(subjective-objective-assessment-plan)病历、注重分层带教、注重全科临床思维培养、及时点评和反馈等4个方面的工作做得较好,目前主要存在独立的教学评估室建设不全、全科住培带教教师培训不足、全科教学门诊相关培训偏少、预约患者比例明显偏少、全科教学门诊半天接诊患者数量偏多、对全科教学门诊支持和考核不规范等问题。因此,应当加强全科住培带教教师队伍建设、加强医院层面支持、规范考核机制等,以提高全科教学门诊质量。结论全科住培基地教学门诊开展现状总体良好、较前规范,但仍然存在部分问题尚待解决。因此,应当加强全科师资队伍建设、提高全科住培带教教师待遇,规范全科教学门诊开展。

Objective To understand the development status of general practice teaching clinics in the initial stage after the release of“standardized training for general practice resident physicians in general practice teaching outpatient standard(trial)”,and to put forward countermeasures and suggestions for the current problems.Methods According to the“standardized training for general practice resident physicians in general practice teaching outpatient standard(trial)”,a questionnaire was designed,and a questionnaire survey was conducted on general practice teachers and general practice resident physicians to understand the current development of general practice teaching outpatient clinics,including basic information,setting of clinics for teaching clinics,requirements for outpatient teachers,selection of outpatients,implementation of teaching clinics,and safeguarding measures for the implementation of teaching clinics.Results The general practice teaching clinic has done a good job in four steps,including guiding the writing of subjective-objective-assessment-plan(SOAP)medical records,focusing on layered teaching,focusing on the cultivation of general practice clinical thinking,timely comments and feedback.At present,there are mainly problems,such as incomplete construction of independent teaching evaluation rooms,insufficient teacher training in general practice,less training related to teaching clinics,significantly fewer appointments,more patients admitted to the outpatient clinic for half a day,and irregular support and assessment for general practice teaching clinics.It is suggested to strengthen the construction of general teaching staff,strengthen hospital-level support,and standardize the assessment mechanism to improve the quality of teaching clinics.Conclusions The status quo of teaching clinics in general practice residential training bases is overall good and more standardized than before,but there are still some problems.It is suggested to strengthen the construction of general practic teaching staff and improve the treatment to standardize the development of general practice teaching clinics.