以岗位胜任力导向的分层递进式培训在内科住培中的应用

The Application of Hierarchical and Progressive Training Guided by Job Competence in Standardized Training of Internal Medicine Resident Physicians

目的探讨分层递进式培训在蚌埠医学院第二附属医院内科基地培养住院医师岗位胜任力方面的实施效果。方法以2019年9月—2023年2月蚌埠医学院第二附属医院内科基地的2019级、2020级住培医师共41名为研究对象,2020级27名住培医师设为观察组,2019级14名住培医师设为对照组。对照组采取平行式轮转培训,观察组采取分层递进式培训。以日常考核中的360度评价作为评估培训效果的主要观察指标,比较观察组与对照组阶段性360度评价平均分的差异,分析观察组在呼吸、心血管、消化科岗位胜任力的两阶段间的差异,调查观察组的住培医师和指导教师对分层递进式培训的认可情况。结果住培第一阶段观察组与对照组的360度评价平均分比较,差异无统计学意义(P>0.05)。住培第二阶段观察组360度评价的平均分均高于对照组,差异有统计学意义(P<0.05)。观察组在呼吸、心血管、消化第二阶段的六大核心胜任力平均分数均高于第一阶段,差异有统计学意义(P<0.05)。问卷调查显示观察组住培医师和指导教师认为分层递进式培训有利于住培生岗位胜任力的培养,非常赞成目前实施的分层递进式培训方式。结论基于自身专业基地的特点,开展分层递进式培训,有利于培养以德树人、具有六大核心胜任力的合格的临床住院医生。

Objective To explore the implementation effect of hierarchical and progressive training in cultivating the competency of residents in the internal medicine base of the Second Affiliated Hospital of Bengbu Medical College.Methods From September 2019 to February 2023,a total of 41 resident trainees from the internal medicine base of the Second Affiliated Hospital of Bengbu Medical College in 2019 and 2020 were selected as the research subjects.27 resident trainees from 2020 were designated as the observation group,and 14 resident trainees from 2019 were designated as the control group.The control group received parallel rotation training,while the observation group received hierarchical and progressive training.The 360 degree evaluation in daily assessment was used as the main observation indicator to evaluate the effectiveness of training.The difference in the average score of phased 360 degree evaluation between the observation group and the control group was compared,and the difference in the competency of the observation group in respiratory,cardiovascular,and digestive positions between the two stages was compared.The recognition of hierarchical and progressive training by resident physicians and guidance teachers in the observation group was investigated.Results There was no statistically significant difference(P>0.05)in the average 360 degree evaluation scores between the observation group and the control group in the first stage of residential training.The average score of 360 degree evaluation in the observation group during the second stage of residential training was higher than that in the control group,and the difference was statistically significant(P<0.05).The average scores of the six core competencies in the second stage of respiration,cardiovascular system,and digestion in the observation group were all higher than those in the first stage,with statistically significant differences(P<0.05).The questionnaire survey showed that the observation group's resident training physicians and guidance teachers believed that hierarchical and progressive training was beneficial for the cultivation of resident trainees'job competence,and they strongly supported the current implementation of hierarchical and progressive training methods.Conclusion Based on the characteristics of its own professional base,carrying out hierarchical and progressive training is conducive to cultivating qualified clinical residents with six core competencies.