安徽省住院医师规范化培训学员对病理科培训需求的调查分析

徐洪海; 王伟; 武世伍; 冯振中; 刘银华; 王继年

doi:10.16766/j.cnki.issn.1674-4152.002652

安徽省住院医师规范化培训学员对病理科培训需求的调查分析

doi: 10.16766/j.cnki.issn.1674-4152.002652

1.
安徽医科大学第一附属医院病理科，安徽合肥 230022
2.
中国科学技术大学附属第一医院病理科，安徽合肥 230036
3.
蚌埠医学院第一附属医院病理科，安徽蚌埠 233003
4.
安徽医科大学第二附属医院病理科，安徽合肥 230601
5.
皖南医学院附属弋矶山医院病理科，安徽芜湖 241001
6.
安徽医科大学第一附属医院教育处

基金项目:

安徽高校人文社会科学研究项目 SK2019A0176

安徽医科大学疫情防控期间专项质量工程项目 2020xj011

安徽医科大学国家一流本科专业建设项目(临床医学)子项目 2021KCSZ003

详细信息

通讯作者:
王伟, E-mail: weiwang@hmfl.ac.cn

中图分类号: R192 R36
计量
- 文章访问数: 164
- HTML全文浏览量: 47
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-24
- 网络出版日期: 2022-11-29

Requirements of standardised residency training in the department of pathology in Anhui Province

1.
Department of Pathology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China

摘要

摘要: 目的调查安徽省住院医师规范化培训学员对病理科培训的掌握现状及需求，以期为病理科住培体系的建设提供参考。方法以安徽省5所综合性教学医院为代表，对2021年在病理科接受住培教育的学员发放病理科培训内容掌握及需求的调查问卷。结果问卷共发放124份，回收122份，回收率为98.39%。其中低于30%的非病理专业住培学员掌握活检小标本(10人)及常规术后标本取材(11人)，而病理专业的掌握程度超过85.00%(分别为74人和76人)。非病理专业住培学员对术后标本和术中冰冻切片的常见病掌握分别为32.43%(12人)和18.92%(7人)，而病理专业分别为82.35%(70人)和54.12%(46人); 对宫颈脱落细胞学的掌握，非病理专业和病理专业住培学员分别为10.81%(4人)和44.71%(38人)，差异有统计学意义(均P＜0.001)。对于培训需求，病理专业学员更希望学习常见病、疑难罕见病的诊断思路，非病理专业则倾向病理报告解读要点分析，此外，超过60.00%(57人)的病理专业学员选择HE染色和特殊染色、免疫组化的具体操作，而超过一半非病理专业倾向病理技术流程的理论介绍。结论病理科住培体系应根据住培学员的专业、学历不同开展分类分层精准培训。
- 住院医师规范化培训 /
- 病理科 /
- 问卷调查 /
- 精准培训
Abstract: Objective To assess the content mastery and investigate the training needs of standardised residency training (SRT) residents in the department of pathology in Anhui Province, and provide suggestions for establishment of the SRT system for the department of pathology. Methods Questionnaires for the content mastery and training needs were distributed to trainees who were recruited in the SRT program in the department of pathology in five comprehensive teaching hospitals in Anhui Province in 2021. Results A total of 124 questionnaires were sent out and 122 were included, with an effective inclusion rate of 98.39%. Results showed that less than 30% of the non-pathology specialty trainees mastered the sampling of small biopsy specimens (10 cases) and routine postoperative specimens (11 cases), in contrast, more than 85.00% of the trainees mastered these two pathology techniques (74 cases, 76 cases). The diagnosis of common diseases of postoperative specimens and intraoperative frozen sections in non-pathology specialty trainees were 32.43% (12 cases) and 18.92% (7 cases), respectively, whereas those in the trainees majoring in pathology were 82.35% (70 cases) and 54.12% (46 cases), respectively. The mastery of cervical exfoliative cytology in the trainees who were not majoring in pathology and the trainees majoring in pathology was 10.81% (4 cases) and 44.71% (38 cases), respectively, and the differences were significant (all P < 0.001). For the training needs, pathology specialty trainees prefer to learn the pathology diagnosis ideas of common diseases and difficult and rare diseases, whereas non-pathology specialty trainees prefer to learn the analysis of the key points of the interpretation of pathological reports. In addition, more than 60.00% (57 cases) of pathology specialty trainees tend to the actual operation of pathology technology process of HE staining operation training and special staining and immunohistochemistry training, whereas more than half of non-pathology specialty trainees tend to the theoretical introduction of pathology technology process. Conclusion Classification and stratification of precise training according to the different specialization and education backgrounds of the trainees are needed in the SRT program in the department of pathology.
- Standardised residency training /
- Pathology /
- Questionnaire /
- Precision training

HTML全文

图 1 不同专业住培学员对于病理诊断的培训需求比较

注：A为术后及活检标本相关培训内容; B为术中冰冻标本相关培训内容; C为细胞学诊断相关培训内容; D为病理诊断培训形式。不同专业住培学员比较，^aP＜0.01。

Figure 1. Comparison of the training needs of residential trainees in different specialties for pathological diagnosis

下载: 全尺寸图片幻灯片

图 2 不同学历住培学员对于病理诊断的培训需求比较

注：A为术后及活检标本相关培训内容; B为术中冰冻标本相关培训内容; C为细胞学诊断相关培训内容; D为病理诊断培训形式。不同学历住培学员比较，^aP＜0.05。

Figure 2. Comparison of the training needs of residential trainees with different educational backgrounds for pathological diagnosis

下载: 全尺寸图片幻灯片

表 1 不同专业住培学员对病理学内容的掌握情况比较[人(%)]

Table 1. Comparison of the mastery of pathology content by resident trainees of different majors [persons (%)]

项目	详细内容	病理专业(n=85)	非病理专业(n=37)	χ²值	P值
病理取材	病理取材记录	85(100.00)	37(100.00)
	活检小标本取材	74(87.06)	10(27.03)	43.319	< 0.001
	常规手术后标本取材	76(89.41)	11(29.73)	44.883	< 0.001
	术中冰冻标本取材	33(38.82)	2(5.41)	14.072	< 0.001
	复杂、疑难标本取材	31(36.47)	1(2.70)	15.191	< 0.001
常规手术、活检标本的病理诊断	完全不会	3(3.53)	10(27.03)		< 0.001^a
	读懂病理报告	82(96.47)	27(72.97)		< 0.001^a
	常见病初诊	70(82.35)	12(32.43)	29.152	< 0.001
	疑难、罕见病初诊	16(18.82)	0		0.003^a
	运用免疫组化、分子病理等辅助初诊	27(31.76)	4(10.81)	5.972	0.015
术中冰冻标本诊断	完全不会	9(10.59)	14(37.84)	12.512	< 0.001
	读懂病理报告	76(89.41)	23(62.16)	12.512	< 0.001
	常见病初诊	46(54.12)	7(18.92)	12.999	< 0.001
	疑难、罕见病初诊	9(10.59)	1(2.70)		0.280^a
细胞学诊断	完全不会	23(27.06)	17(45.95)	4.173	0.041
	读懂病理报告	62(72.94)	20(54.05)	4.173	0.041
	常规宫颈脱落细胞学	38(44.71)	4(10.81)	13.119	< 0.001
	其他细胞学如胸腹水、甲状腺穿刺等	25(29.41)	2(5.41)	8.621	0.003
病理技术	完全不会	3(3.53)	10(27.03)		< 0.001^a
	大致了解病理技术流程	82(96.47)	27(72.97)		< 0.001^a
	熟悉病理技术流程，知晓各环节要点及其对病理制片的影响	56(65.88)	12(32.43)	11.691	0.001
	HE染色切片操作	33(38.82)	7(18.92)	4.635	0.031
	特殊染色及免疫组化	23(27.06)	3(8.11)	7.073	0.008
	分子病理	9(10.59)	3(8.11)		0.999^a
	电镜	7(8.24)	2(5.41)		0.720^a
注：^a为采用Fisher精确检验。

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表 2 不同学历住培学员对病理学内容的掌握情况比较[人(%)]

Table 2. Comparison of the mastery of pathology content among residential trainees with different degrees [persons (%)]

项目	详细内容	研究生^a(n=82)	本科(n=40)	χ²值	P值
病理取材	病理取材记录	82(100.00)	40(100.00)
	活检小标本取材	57(69.51)	25(62.50)	0.600	0.439
	常规手术后标本取材	60(73.17)	27(67.50)	0.423	0.516
	术中冰冻标本取材	25(30.49)	10(25.00)	0.396	0.529
	复杂、疑难标本取材	24(29.27)	8(20.00)	1.194	0.275
常规手术、活检标本的病理诊断	完全不会	6(7.32)	7(17.50)		0.118^b
	读懂病理报告	76(92.68)	33(82.50)		0.118^b
	常见病初诊	57(69.51)	25(62.50)	0.600	0.439
	疑难、罕见病初诊	11(13.41)	5(12.50)	0.020	0.888
	运用免疫组化、分子病理等辅助初诊	25(30.49)	6(15.00)	3.403	0.065
术中冰冻标本诊断	完全不会	9(10.98)	14(35.00)	10.143	< 0.001
	读懂病理报告	73(89.02)	26(65.00)	10.143	< 0.001
	常见病初诊	42(51.22)	11(27.50)	6.156	0.013
	疑难、罕见病初诊	8(9.76)	2(5.00)		0.495^b
细胞学诊断	完全不会	22(26.83)	18(45.00)	4.028	0.045
	读懂病理报告	60(73.17)	22(55.00)	4.028	0.045
	常规宫颈脱落细胞学	28(34.15)	14(35.00)	0.009	0.926
	其他细胞学，如胸腹水、甲状腺穿刺等	22(26.83)	5(12.50)	3.203	0.073
病理技术	完全不会	5(6.10)	8(20.00)		0.028^b
	大致了解病理技术流程	77(93.90)	32(80.00)		0.028^b
	熟悉病理技术流程，知晓各环节要点及其对病理制片的影响	56(68.29)	12(30.00)	15.979	< 0.001
	HE染色切片操作	36(43.90)	4(10.00)	14.022	< 0.001
	特殊染色及免疫组化	23(28.05)	3(7.50)	8.620	0.003
	分子病理	12(14.63)	0		0.008^b
	电镜	8(9.76)	1(2.50)		0.269^b
注：^a研究生包括在读医学专业学位硕士研究生、已取得研究生学历的社会招收住培学员和已取得研究生学历的单位委派住培学员。^b为采用Fisher精确检验。

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