全科医学规范化培训分层递进培养模式对全科住院医师岗位胜任力提升效果的研究

Application of a tiered progressive training model in standardized residency training of general practice

目的探索分层递进培养模式在方庄社区卫生服务中心全科医学住院医师规范化培训中的创新构建及应用效果。方法通过明确不同阶段全科医学住院医师的教学目标及要求,结合LAP、叙事医学教学方法形成分层递进教学方法,在2022年6月1日至2023年5月31日对26名全科医学住院医师实施分层培养,并通过全科医生岗位胜任力问卷调查评价分层递进培养效果。结果26名住院医师中,初级阶段12人,中级阶段9人,高级阶段5人。培养后,3个阶段住院医师的岗位胜任力总得分均较培养前得分明显提高(t=-3.627,-2.073,-5.277,均P<0.05);全部住院医师基本医疗卫生服务、基本公共卫生服务、信息利用能力与管理能力、医学知识与终身学习、人际沟通与团队合作、职业素养六大岗位胜任力得分均较培养前明显提高。其中初级住院医师在基本医疗卫生服务、基本公共卫生服务、医学知识与终身学习方面得分均较培养前明显提高(t=-3.457,-3.428,-3.063,均P<0.05),中级住院医师在基本公共卫生服务、医学知识与终身学习、人际沟通与团队合作、职业素养方面得分较培养前明显提高(t=-2.328,-2.100,-1.997,均P<0.05),高级住院医师在基本医疗卫生服务、基本公共卫生服务方面、信息利用能力与管理能力、医学知识与终身学习、人际沟通与团队合作、职业素养方面较培养前得分明显提高(t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805,均P<0.05)。结论分层递进培养模式在科医学住院医师规范化培训中的应用有助于提升全科医学住院医师岗位胜任力。

Objective To investigate the effectiveness of a tiered progressive training model in the standardized residency training of general practice in primary care institutions.Methods A tiered progression teaching plan was applied for 26 general practice residents who attended the rotation of general practice residency training in Beijing Fangzhuang Community Hearlth Service Center from June 2022 to May 2023.The plan defined the teaching objectives and requirements for different stages,and the Leicester Assessment Package(LAP)and narrative medicine were included in the teaching methods.The effectiveness of the tiered progression training was evaluated through a questionnaire survey on the post competency of general practice residents.Results There were 12 primary stage residents,9 intermediate stage residents and 5 advanced stage residents.The post-training scores of general practice residents in all three stages of residents were significantly higher than the pre-training scores(t=-3.627,-2.073,-5.277,all P<0.05).The scores of basic medical and health services,basic public health services,information utilization ability and management ability,medical knowledge and lifelong learning,interpersonal communication and teamwork,professional quality after six post competency training were significantly higher than those before training in all three stages of residents.The scores of basic medical and health services,basic public health services,medical knowledge and lifelong learning,in primary residents were significantly improved compared with those before training(t=-3.457,-3.428,-3.063,all P<0.05);the scores of basic public health services,interpersonal communication and teamwork,and professional quality in intermediate residents were significantly higher than those before training(t=-2.328,-2.100,-1.997,all P<0.05);the scores of basic medical and health services,basic public health services,information utilization ability and management ability,medical knowledge and lifelong learning,interpersonal communication and teamwork,and professional quality in senior residents were significantly higher than those before training(t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805,all P<0.05).Conclusion The application of tiered and progressive training model in the standardized residency training is helpful to improve the post competency of general practice residents.