Application of comprehensive ability cultivation in standardized training of ophthalmic resident physicians
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摘要:
目的 在国家标准化住院医师培训课程的基础上进行探索改革，以期培养出具有较高综合实践能力的眼科住院医师，为国家输入高素质眼科人才，并为其他学科教学改革提供理论依据。 方法 本研究以眼科住院医师为研究对象，在国家标准化住院医师培训课程的基础上对培养计划和培养内容等方面进行改革创新，有计划有目的地将3年的培训课程分成3个阶段，每个阶段的培训有不同的侧重点，并建立有效的考核制度；本课题研究中增加了“门诊实践培训”过程，希望通过“师带徒”的方式完善眼科住院医师知识框架、提高临床思维能力；针对不同起点的住院医师，根据他们知识结构特点，采取不同的培养计划和方案，让他们在竞争中学习进步，缩短差距。目前，我国医疗环境还存在很多问题，如医疗资源不均衡分布，医患关系紧张、暴力伤医、过劳死等一系列问题，这些问题的解决可以从住院医师培训层面入手，在标准化住院医师培训课程中加强医学人文素质培养，引导住院医师树立职业责任感及正确价值观，提高与人沟通、团队协作、自我管理、终身学习等能力，长久将会改善整个医疗环境。 结果 在住院医师培训课程的基础上增加“门诊实践培训”过程，能够进一步完善眼科住院医师知识框架、提高临床思维能力；针对不同起点的住院医师，根据他们知识结构特点，制订个性化培养计划和方案，因材施教，显著提高学习效率；鉴于国内医疗大环境复杂，强化住院医师医学人文素质培养能够使医患关系更加和谐。 结论 探索规范化的眼科住院医师培训体系，个性化培养不同起点的住院医师，实现眼科人才培养的可持续发展。 Abstract:Objective To explore the reform on the basis of the national standardized training courses for resident ophthalmologists, in order to train ophthalmologists with higher comprehensive practice ability, to import high-quality ophthalmologists for the country, and provide theoretical basis for the teaching reform of other disciplines. Methods This research took ophthalmic residents as the research object, reformed and innovated the training plan and training content on the basis of the national standardized resident training course, divided the three-year training course into three stages with different emphasis in each stage, each stage of the training had a different focus, and established an effective assessment system. In this study, "outpatient practice training" was added, hoping to improve the knowledge framework of ophthalmology residents and improve their clinical thinking ability through the way of "teaching and apprenticing". According to the characteristics of their knowledge structure, different training plans and programs were adopted for residents with different starting points, so that they could make progress in the competition and shorten the gap. At present, the medical environment still existed many problems, such as uneven distribution of medical resources, the doctor-patient relationship nervous, violence injury medical, karoshi, and a series of problems, these problems could start from the resident training level, in the standardized resident training courses to strengthen the medical humanistic quality training, guide the resident set up professional sense of responsibility and the right values, improve to communicate with people, teamwork, self-management, life-long learning ability, and improve the medical environment for a long time. Results We added the "outpatient practice training" process to the resident training courses, which could further improve the knowledge framework of ophthalmology resident doctors and improve clinical thinking ability. For residents at different starting points, according to their knowledge structure characteristics, we could formulate personalized training plans and programs, teaching students in accordance with their aptitude, significantly improve learning efficiency. In view of the complex domestic medical environment, strengthening the training of medical humanities for residents could make the doctor-patient relationship more harmonious. Conclusion To explore a standardized training system for ophthalmology residents, and to cultivate residents with different starting points in a personalized way, the sustainable development of ophthalmology personnel training can be realized. -
表 1 手术名称及要求
年度 手术名称 完成最低例数 参加最低例数 第2年 前房穿刺术 2 10 羊膜移植术 2 5 翼状箭肉切除术 5 10 脸内外翻矫正术 5 10 角膜穿通伤缝合术 2 5 膜裂伤缝合术 3 6 第3年 泪道手术 2 5 睫状体冷冻或光凝术 2 5 斜视矫正术 2 5 手术虹膜切除术 2 5 激光虹膜切除术 5 10 小梁切除术 2 10 白内障摘除术 5 10 
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表 2 亚专科轮转安排
病种 时间 青光眼 2个月 白内障 2个月 角膜与眼表疾病 2个月 斜视与小儿眼病 2个月 眼外伤 2个月 眼底病 4个月 眼眶癌、眼肿瘤、眼整形、泪器疾病 4个月 选修机动 4个月
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