The status quo, problems and countermeasures of standardized training for specialists in Shanghai
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摘要: 目的 了解上海市专科医师规范化培训的现状和存在问题,为完善专科医师规范化培训制度提供决策依据。 方法 通过问卷调查和培训基地现场访谈,自行设计《上海市专科医师规范化培训现状调查表》,结合政策文件学习和培训基地的现场督导访谈,系统梳理存在问题。以2018年参加上海市专培结业综合考核、已完成培训拟结业的881名专培医师为调查对象,调查内容包括被调查者的一般情况,培训过程、培训考核及培训结果的评价,培训满意度评价及意见建议等。采用描述性统计分析有关指标百分比。 结果 经调查,专培医师对带教老师的满意度最高,对薪酬待遇和培训年限满意度较低。专培医师的临床能力明显提升,专培制度建设取得一定成效,但在配套政策、保障机制、专科设置、过程管理、考核体系、师资管理上仍需改进。 结论 建议完善配套制度,形成科学、规范、系统、严密的制度体系;补充专科设置,细化培训方案和标准;加强管理体系的合作与分工,建立协同育人机制;建立基地评估指标体系,加强过程管理和基地建设;以岗位胜任力为导向,完善考核评价体系;加强师资队伍建设,建立临床教学激励机制。Abstract: Objective To understand the status quo, provide policy evidence and improve the standardized training program for specialists in Shanghai. Methods Via questionnaires and training base interviews, 881 specialized training physicians who participated in the comprehensive assessment and were going to complete the training were selected as the respondents. The survey included the general information of the respondents, the evaluation of the training process, assessment and results, satisfaction evaluation and suggestions. Results According to the investigation, the trainees had the highest satisfaction with teachers, and lower satisfaction with salary and training duration. The programs has achieved certain results, but it still needs improvement in supporting policies, guarantee mechanisms, specialist settings, quality control, assessment systems, and teacher management. Conclusions It is recommended to improve the supporting system to form a scientific, standardized, systematic and rigorous institutional system; add the specialist settings, refine the training programs and standards; strengthen the cooperation and division of management system, establish a collaborative education mechanism between medical school and training hospitals; establish a training base evaluation index system, strengthen the construction of training base and quality control; improve the exam system based on specialist's position competency; strengthen the construction of teaching staff and establish a clinical teaching incentive mechanism.
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