首届全科住院医师规范化培训指导医师教学门诊竞赛四川省选拔赛分析

Analysis of the first national outpatient teaching competition for general practitioners in Sichuan Province

目的为评价全科指导医师带教能力,中国医师协会开展了首届全科住院医师规范化培训指导医师教学门诊竞赛。本研究对四川省34所参赛医院的比赛及自评结果进行分析。方法参赛队伍录制教学门诊视频由四川省卫生健康委员会组织专家评分,参赛队伍依据同一评分表自评。通过四川省医学科技教育中心收集各参赛基地的患者选择、病例选择及比赛得分、自评得分和主要扣分点,比较选择不同患者、病例的参赛基地比赛得分的差异,分析参赛基地比赛得分和自评得分的相关性。结果参赛医院比赛平均分为(79.9±9.6)分,自评平均分为(89.9±5.4)分,自评得分的均值高于评委平均值[(89.9±5.4)分vs.(79.9±9.6)分,t=7.517,P<0.001],且自评得分与评委评分之间无相关性(r=0.312,P=0.072)。评委扣分排名前5的条目依次为“未加强全科临床思维能力培训”“院感防控意识淡薄”“缺乏对疾病新进展的讲授”“未指导住院医师书写或审核修改SOAP病历”“缺乏医患沟通技巧培训”。结论研究客观地对四川省参赛医院的全科门诊教学水平进行了分析,显示出目前全科教学门诊的不足之处以及竞赛对全科师资教学能力的评价及促进作用。

Objective To improve the outpatient teaching skills of general practitioners,the Chinese Medical Doctor Association organized the first national outpatient teaching competition to standardize the training of general practitioner residents.This study analyzed the competition and self-assessment results of the 34 participating hospitals in Sichuan Province.Methods Teaching videos were recorded by the participating hospitals and evaluated by experts organized by the Sichuan Provincial Health Commission,self-evaluation was carried out according to the same evaluation standards.Patient and disease selection,competition scores and self-assessment scores were obtained from the Medical Sciences and Technology Education Centre of Sichuan Province.Differences between participating hospitals were analyzed by selecting different patients and diseases.The correlation between competition scores and self-rated scores was analyzed.Results The mean score of the participating hospitals was(79.9±9.6)points.The mean score of the self-evaluation was(89.9±5.4)points.The mean score of the self-evaluation was significantly higher than that of the expert evaluation[(89.9±5.4)points vs.(79.9±9.6)points,t=7.517,P<0.001].No correlation was observed between the self-assessment score and the expert assessment score(r=0.312,P=0.072).The top five items with demerit points were"lack of training in clinical thinking","weak awareness of hospital infection control","lack of introduction of latest disease progress","no guidance or modification of the SOAP records"and"neglect of training in doctor-patient communication".Conclusion The study objectively analyzes the quality of outpatient teaching in the participating hospitals in Sichuan Province,shows the current shortcomings of outpatient teaching of general practice,and the evaluation and promotion effect of the competition on the teaching ability of general practice teachers.