北京市妇产科住院医师规范化培训二阶段结业技能考核分析

Graduation examination results analysis of stageⅡstandardized residency training of obstetrics and gynecology in Beijing

目的通过全面分析2012年—2021年北京市妇产科住院医师规范化培训(简称住培)二阶段结业技能考核成绩,为制订规范化教学培训及考核方案提供科学依据。方法比较2012年—2021年期间北京市不同年份、不同区县、不同级别、不同类型的医疗机构共934名妇产科住院医师二阶段结业技能考核成绩的通过率和分值差异。结果2012年、2018年和2020年的通过率较低,分别为52.5%、55.5%和61.2%,其余年份的通过率均在70%以上。其中,城六区通过率显著高于郊区;三甲医院通过率显著高于非三甲医院;住培培训基地通过率显著高于非培训基地单位;综合医院和专科医院通过率无统计学意义。2020年后加入了技能操作考核,但决定通过率的主要项目仍为病例平均得分。结论良好的政策指引保障了妇产科二阶段住培的质量。郊区医院、非三甲医院、专科医院等非住培培训基地医院需要在病例教学中重点补齐短板,注重师资队伍培养、教学模式创新和教学评价体系建设等。技能操作考核丰富了考核模式。提高住院医师操作技能是住培二阶段的重点。

Objective This study aimed to provide a scientific basis for the formulation of standardized teaching and examination plans by a comprehensive analysis of the graduation examination results in the second stage of standardized residency training of obstetrics and gynecology in Beijing from 2012 to 2021.Methods The passing rate and score differences of 934 candidates from different years,different districts,different levels and different types of medical institutions from 2012 to 2021 were compared.Results The passing rates in 2012,2018 and 2020 were low,52.5%,55.5%and 61.2%,respectively,and the passing rates in other years were more than 70%.The passing rate of urban areas was significantly higher than that in the suburbs,the passing rate of tertiary A-level hospitals was significantly higher than that of other level hospitals,the passing rate of base units was significantly higher than that of non base units,and there was no significant difference between general hospitals and specialized hospitals.After 2020,the skill operation assessment was added,but the main item determining the pass rate was still the average score of clinical cases assessment.Conclusion Good policy guidance ensures the quality in the second stage of standardized training for residents of obstetrics and gynecology.Suburban hospitals,non tertiary A-level hospitals,specialized hospitals and non base hospitals need to focus on strengthening their own weaknesses in case teaching.They should pay attention to the training of teachers,the innovation of teaching mode and the construction of teaching evaluation system.The skill operation assessment enriches the assessment mode.Improving the operation ability of residents is the focus of the stageⅡstandardized residency training.