不同身份类型住院医师规范化培训住培效果分析与优化探索

Effect analysis and exploration on the optimization of standardized residency training for residents with different identity types

目的了解不同身份类型住院医师规范化培训效果,针对性提出优化改进措施,达到培训效果同质化。方法结合文献查阅和专家咨询结果,自行设计调查问卷,针对2019年、2020年结业的324名住院医师进行调查,问卷有效回收率87.65%。通过比较不同身份类型住院医师的首次执医和结业考核通过率、六大核心胜任力培训达标情况,得出其培训效果结论。采用SPSS 21.0进行卡方检验,Fisher确切概率法检验。结果首次执医和结业考核通过率并轨专硕和单位人均高于社会人,最高通过率分别达到100%(10/10)和97.3%(72/74);不同身份类型住院医师两项通过率组间差异无统计学意义。并轨专硕的六大核心胜任力总体达标情况优于社会人和单位人;不同身份类型住院医师在职业素养(P=0.048)、病人管理(P=0.030)、沟通合作(P=0.026)、学习提升(P=0.003)四大能力培训达标方面,组间差异有统计学意义;在专业能力(P=0.131)和教学能力(P=0.061)培训达标方面差异无统计学意义。结论研究者所在医院不同身份类型住院医师考核通过率无差异,一定程度上达到了同质化培训目的。但在六大核心胜任力达标方面,差异比较明显,需要进一步探索优化措施。

Objective To understand the effect of standardized residency training for residents with different identity types,and put forward targeted optimization and improvement measures to achieve the homogenization of training effect.Methods Combined with literature review and expert consultation results,a self-designed questionnaire was conducted for 324 residents who completed their courses in 2019 and 2020.The effective recovery rate of the questionnaire was 87.65%.By comparing the passing rate of first-time medical admission and completion examination of different identity types,and the training standards of six core competencies,the training effect conclusion was drawn.T-test and Fisher exact probability test were also made by SPSS 21.0.Results The passing rates of first-time doctors and completion examinations were higher in professional masters and units than in the general population,with the highest passing rates reaching 100%(10/10)and 97.3%(72/74)respectively.There was no statistical difference between the passing rates of residents with different identity types.The overall standard of the six core competencies of the integrated professional masters was better than that of the society and unit personnel.There were statistical differences between the groups in the training standards of the four abilities of the residents with different identity types in professional literacy(P=0.048),patient management(P=0.030),communication and cooperation(P=0.026)and learning promotion(P=0.003).There was no significant difference in professional ability(P=0.131)and teaching ability(P=0.061).Conclusion There is no difference in the passing rate of residents with different identity types in a military hospital,which achieves the goal of homogenization training to a certain extent.However,there are obvious differences in the standards of the six core competencies,and further optimization measures need to be explored.