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

梁凌波; 施奕; 卢文婷; 毕明帅; 曾永秋; 苏巧俐

doi:10.16766/j.cnki.issn.1674-4152.003265

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

doi: 10.16766/j.cnki.issn.1674-4152.003265

1.
四川大学华西医院全科医学中心，四川成都 610041
2.
四川省医学科技教育中心，四川成都 610051

基金项目:

四川省区域创新合作项目 2020YFQ0011

四川省卫生健康委员会科研题目 20PJ006

四川大学新世纪高等教育教学改革工程项目第九期，SCU9336

详细信息

通讯作者:
苏巧俐，E-mail：18980601358@163.com

中图分类号: R192.3 R499
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- 文章访问数: 275
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- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-15
- 网络出版日期: 2024-01-13

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

1.
General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China

摘要

摘要: 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。
- 全科医学 /
- 全科医师 /
- 门诊教学 /
- 住院医师规范化培训 /
- 教学竞赛
Abstract: 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.
- General practice /
- General practitioners /
- Outpatient teaching /
- Standardized training for residents /
- Teaching competition

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表 1 首届全科教学门诊指导医师技能竞赛四川省选拔赛参赛队伍基本信息

Table 1. Basic characteristics of participators in the the first national ambulatory teaching competition of general practice in Sichuan Province

基本情况	人数(%)
全科住培基地建立时间	34(100.00)
≤5年	7(20.59)
> 5年且 < 10年	25(73.53)
≥10年	2(5.88)
教学门诊指导医师职称	34(100.00)
中级	20(58.82)
高级	14(41.18)
教学门诊患者选择	34(100.00)
初诊患者	15(44.12)
复诊患者	19(55.88)
患者病程≥3个月	25(73.53)
患者病程 < 3个月	9(26.47)
以慢病管理为教学目的的疾病选择	20(58.82)
高血压	7(20.59)
糖尿病	5(14.71)
慢性阻塞性肺疾病	2(5.88)
支气管哮喘	2(5.88)
冠心病	2(5.88)
胃食管反流病	1(2.94)
胆囊结石	1(2.94)
以症状学为教学目的的症状选择	14(41.18)
咳嗽	4(11.76)
眩晕	3(8.82)
腹痛	2(5.88)
胸痛	1(2.94)
头痛	1(2.94)
腰痛	1(2.94)
下肢水肿	1(2.94)
单关节疼痛	1(2.94)

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表 2 参赛全科专业基地教学门诊扣分排名前10的条目

Table 2. The top 10 deduction items of the ambulatory teaching of the participating training bases

评委评分排名前10的扣分条目	条目(%)	自评评分排名前10的扣分条目	条目(%)
未对住院医师全科临床思维能力加强培训	24(70.59)	缺乏对疾病新进展、新技术的讲授	20(58.82)
院感防控意识淡薄	23(67.65)	未指导住院医师书写或审核修改病历	18(52.94)
缺乏对疾病新进展、新技术的讲授	21(61.76)	未对住院医师全科临床思维能力加强培训	16(47.06)
未指导住院医师书写或审核修改病历	20(58.82)	院感防控意识淡薄	15(44.12)
缺乏对医患沟通技巧的培训	19(55.88)	指导医师示范性查体存在不足或未纠正住院医师查体错误	15(44.12)
未体现分层教学	16(47.06)	师生之间互动不足	10(29.41)
未给予患者充分的健康教育和制定随访计划	16(47.06)	未知情告知患者或未签署教学门诊知情同意书	10(29.41)
师生之间互动不足	16(47.06)	缺乏对医患沟通技巧的培训	9(26.47)
指导医师示范性查体存在不足或未纠正住院医师查体错误	15(44.12)	未给予患者充分的健康教育和制定随访计划	8(23.53)
未知情告知患者或未签署教学门诊知情同意书	10(29.41)	未体现分层教学	4(11.76)

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