住院医师对规范化培训制度的认知态度调查

目的 了解上海市住院医师规范化培训制度实施1年来住院医师对培训的认知与态度,为发现培训中的问题、提出改进意见提供信息支持.方法 对上海市2010年招录的住院医师进行抽样问卷调查.结果 住院医师对规范化培训的认知情况较好,仅有0.89％的人认为自己对医院的培训工作完全不了解;对于培训的态度也比较积极,占总数56.37％的人认为参加培训使自己在未来工作中有一定优势;对培训的总体满意度也较高,但其中薪酬满意度仅为2.88％.结论 上海市住院医师规范化培训取得了一定成效,2010年招录的住院医师对培训政策的认识不断加深,态度与看法正面积极,在培训内容、基地设施、带教水平、师资为人和带教积极性方面的满意程度也较高.建议从更加细致化和规范化的角度来完善政策.     

A医院住院医师规范化培训现况及分析

目的调查分析A医院住院医师规范化培训现况。方法采用调查问卷法,调查对象为2015—2016年进入A医院规培基地的住院医师。调查内容包括规培医师的基本信息、规培动机及压力源、专科基地管理三个方面。结果在对培训动机的调查,有40.4%住院医师是因为形势所迫及规培合格证而参加规培。在了解住院医师压力的原因方面,主要体现在生活(经济)压力方面,更多的被调查对象认为是多种原因导致挑战性/阻碍性压力。大多数被调查对象认为日常工作中接受了较高频率的来自上级的指导学习。但还是存在少数带教老师,对住院医师规培带教不够重视。调查对象认为大部分都做到同等施教。在规培效果级临床技能提高维度方面,调查对象均值为满意。结论住院医师规范化培养得到大部分住院医师的肯定,但存在住院医师对规培缺乏积极性、住院医师面临压力较大、师资对规培重视不足、师资质量不均等问题。须在端正住院医师对规培的参培态度、缓解挑战性/阻碍性压力、制定师资管理制度、提高带教积极性、加强师资力量等方面进行提高及改善,以加强A医院的住院医师规范化培训质量的建设。     

上海市住院医师规范化培训十年评估

搜集了上海市住院医师规范化培训的有关文件与资料,并对该项培训的市级管理者进行了访谈,在此基础上对上海市16所二级医院与16所三级医院住院医师和管理人员进行了问卷式调查,对上海市住院医师规范化培训进行了十年评估。上海市十年间住院医师规范化培训重在规范、重在能力培训、重在实效、重在低成本高效果,取得了一定的成效。但上海市住院医师规范化培训还需进一步加强临床能力的培训和考核;进一步研究二级医院二级学科住院医师赴三级医院培训的合理性;政策仍需配套,以全力推进育人工程;并应开展对临床研究生进行临床技能规范化培训的研究。     

教学管三方对住院医师规范化培训的评价及建议调查研究

目的 了解住院医师、带教教师和管理人员对住院医师规范化培训的评价及建议,分析其存在的问题,为住院医师规范化培训及其考核评估模式优化提供参考依据。方法 采用线上、线下调查问卷的方法对上海市住院规范化培训基地的学员、带教老师和相关职能部门管理人员分别进行调查,采用描述性分析方法对结果进行分析。结果 共有386人参与问卷调查,其中学员338人,带教老师13人,管理人员35人。调查结果显示,3组人员在年龄、职称、最高学历、带教几名学生合适、最高学历专业类型、临床工作与理论/技能学习的时间安排等方面差异均有统计学意义（均P<0.01）。目前培养目标以综合型人才为主67.88%（262/386）,89.12%（344/386）的人员赞同双向评价,且认同每季度1次双向评价频率比例最高41.97%（162/386）,77.72%（300/386）的人员认为学员个性化管理很有必要,且导师-学生间、管理人员-学生间联系均较少。学员认为需强化对导师/培训员的考核制度,认可导师学员进行双向评价,并建议考核结果与绩效能挂钩,建立奖励机制,调动积极性;带教老师认为双向评价基础上需进一步优化考核机制;管理人员认为需加强学员、带教老师和管理人员三方人员沟通,建议教学方式和考核多元化。结论 住院医师规范化培训中需合理利用带教老师和学员的双向评价体系,双方合理评价,管理人员参与监督,促进共同成长;教学、沟通方式和考核制度需进一步改进优化,以提升教学质量和保障住院医师规培效果。     

临床型研究生培养与住院医师培训相结合可行性研究

目的研究临床型研究生培养与住院医师培训相结合的可能性。方法对上海某三级甲等医院临床型研究生和部分临床带教老师进行问卷调查。结果对于临床型研究生培养纳入住院医师培训,对其临床能力培养是否有帮助和对就业是否有帮助,带教老师和学生之间看法具有显著差异(P<0.05);临床型研究生医师资格被带教老师和学生认为是存在的障碍第一位;带教老师认为临床型研究生培养纳入住院医师规范化培训有必要的比例明显高于学生。结论从经济上、技术上、组织管理和社会影响进行分析,临床型研究生培养与住院医师培训相结合有其可行性,两条途径的临床能力培训并轨后,将利于统一的专科医师准入制度的建立。     

脑病科规范化培训住院医师带教体会

住院医师规范化培训是医学生毕业后教育的重要组成部分,作为脑病科的一名带教老师,在带教实践中,重视规培医师的入科思想教育,加强规培医师业务能力的培训,培养规培医师良好的沟通能力,完善规培医师的考核制度。规范化培训阶段是住院医师成长为一名合格医生的重要阶段,进行规范化培训的住院医师是医院临床、教学和科研工作未来的主力军和后备力量。     

住院医师规范化培训存在的问题和对策思考

住院医师规范化培训是毕业后医学教育的重要阶段,在多年开展住院医师规范化培训工作实践中,存在轮转考核流于形式、与人事制度不配套、带教老师责任意识不足等问题,文章就存在的问题进行思考并提出对策.     

广州市住院医师规范化培训存在的问题及对策建议

目的:通过对广州市市属7家住院医师规范化培训(简称“住培”)基地住培医师及带教老师的问卷调查,分析广州市住培制度运行过程中存在的问题,并有针对性地提出具体建议。方法:通过问卷调查方法,获取相关数据,并对数据进行统计分析。结果:住培医师问卷分析:住培医师没有归属感;住培医师外出学习机会少;基地对培训过程不重视;就业指导不足,培训后就业难。带教老师问卷分析:住培医师水平参差不齐;带教老师缺乏学习交流机会;带教任务重,带教薪酬不公平不合理;考核体系不健全,考核缺乏统一标准。结论与建议:增加人文关怀,提升住培医师归属感;严控住培医师招录标准,保证培训质量同质化;增加住培医师和带教老师的外出学习与交流机会;全员重视培训过程,强化培训后的就业管理;建立并完善带教薪酬制度,提高带教老师积极性;健全考核体系,规范管理,统一考核标准。     

住院医师规范化培训考核体系改革的探索

目的:在上海市推行新的住院医师规范化培训制度之际,东方医院对原有的住院医师考核体系进行改革,探索住院医师规范化培训过程中更合理的考核体系。方法:对住院医师考核体系的主旨、内容、流程、方法及与绩效挂钩等方面进行改革。结果:改革后的考核体系有利于提高住院医师培训的积极性,提高对住院医师培训的管理效率。结论:探索建立一套适合于住院医师规范化培训的考核体系,可有效提高住院医师规范化培训质量。     

带教老师对上海市住院医师规范化培训政策的认知与态度调查研究

目的 :了解带教老师对上海市住院医师规范化培训(以下简称"规培")的认知和态度,为以后的规培工作提出改进建议。方法 :对上海市现有带教老师进行抽样问卷调查。结果 :带教老师对规培的认知情况较好,仅有2.82%的人完全不了解各阶段规培的要求;47.92%的被调查者认为带教工作增加了自己的工作负担;带教老师对规培工作的满意度较高,仅有8.08%的被调查者选择不太满意和完全不满意。结论 :大部分带教老师对规培认知程度较高,并且对医院规培工作和规培总体满意度较高。但是带教积极性有待提高。建议提高师资培训的针对性,建立有效的激励机制,提高带教老师积极性。     

One hundred years of the Association of Surgeons in the Netherlands. VI. The training

Over the last 25 years the organisation and content of the residency training program for general surgeons have been adapted to meet the needs of changing surgical practice. Recently more profound changes have been dictated by the Dutch Working Hours Act, which has strictly limited the working hours of resident physicians. With this the emphasis will be on improving theoretical and practical training methods. Because of the limiting working hours resident physicians will have a smaller role in patient care. These changes will require a huge effort from both the teaching surgeons and the resident physicians, as well as substantial financial investments from the government and healthcare providers.     

深圳市住院医师规范化培训学员自评效果与满意度调查分析

目的:评价深圳市住院医师规范化培训工作,为下阶段培训工作的顺利开展提供参考。方法:自行设计问卷,对参加培训学员进行调查。结果:回收问卷870份(有效回收率86.8%)。学员对培训基地条件满意比例超过50%,但总体满意度不高,为33.3%。市内培训基地的培训条件、管理水平与市外基地相比,还有一定的差距,市外学员的自评培训效果优于市内培训基地。结论:市内培训基地建设仍需加强,基地管理、考核、培训内容安排、学员待遇等方面还有待完善。     

Colposcopy practice and training in family practice residency programs.

BACKGROUND: The potential growth of colposcopy as a family medicine procedural skill is directly related to the training currently offered to family practice residents. To define whether these skills are being adequately offered to physicians who want to perform this procedure for their patients, a study was designed to investigate the current status of colposcopy practice and training in family practice residency programs. METHODS: A 16-item survey sent to 356 family practice residency directors in the United States included items concerning colposcopy practice, training, educational programs and strategies, colposcopy coordinator educational background, and colposcopic resource materials and equipment. RESULTS: Surveys were returned from 204 (57 percent) family practice residencies. Colposcopy was performed at 45 percent of the residencies that responded. Ninety-six percent of the respondents who did not perform colposcopy believed colposcopy is a procedure that should be performed by family physicians. Clinical teaching and supervision was the most common method of resident training (74 percent). Colposcopy training coordinators were usually family physicians (72 percent), primarily trained by gynecologists. Assistance with implementing a colposcopy training program was requested by 85 percent of those programs presently not performing colposcopy. CONCLUSIONS: This study indicates that there are opportunities for further development of colposcopy practice and training in family practice residencies.     

Preceptor development in residency training through a faculty facilitator

To address the demand for training preceptors, a community hospital-based residency program is using a part-time preceptor in a consultative capacity as a faculty facilitator to model, assess skills, and generally improve the level of teaching. Direct observation of resident-patient interactions and subsequent preceptor critiques are followed by feedback to the preceptor on the cogency and effectiveness of comments made. Goals, objectives, and teaching style are jointly examined by the preceptor and faculty facilitator. Evaluation of videotaped resident-preceptor interactions before and after six months' experience with the faculty facilitator shows significant increases in preceptor skills. Greatest improvement is in comments related to resident's clinical assessments, the resident-patient relationship, and in the quality of the resident-preceptor interaction. Scores by the faculty facilitator are significantly lower but parallel those of an independent, blind evaluator. Preceptor, resident, and administration reactions to the project are all positive. This ongoing program assures the continued upgrading of preceptor skills and provides for faculty attrition. A faculty facilitator providing direct feedback in the clinical setting is a low-cost and viable alternative to workshops and conferences for training effective teachers of family medicine.     

参与式培训在珠宝加工企业健康教育中应用效果分析

目的 探讨适合珠宝加工企业的健康教育方式。 方法 实验组采用多媒体授课、小组讨论、个人防护用品使用练习等参与式培训方式对100名工人进行培训;传统组采用传统的授课方式对另100名工人进行相同内容的培训。在培训前后对两组进行测验,对得分进行汇总、分析。 结果 两组员工培训后绝大部分得分有所提高。实验组工人培训前得分总分为(41.29 ±8.59)分,培训后得分总分为(81.06 ±11.78)分,两者比较,差异有统计学意义(t=10.11,P < 0.05)。传统组培训前得分为(53.68 ±10.58)分,培训后得分为(61.37 ±15.39)分,两者比较,差异无统计学意义(t=1.39,P > 0.05)。实验组不同学历、工龄、技术职称的员工得分在培训前后比较,差异均有统计学意义(P < 0.05)。传统组小学及以下人员、工龄小于15个月人员和初级工在培训后得分有提高,但与培训前相比,差异无统计学意义(P > 0.05)。 结论 参与式培训在珠宝加工企业健康教育中效果明显,可以很好地提高工人的职业健康安全知识水平。     

Graded exercise stress test training in family practice and internal medicine residencies

A mail survey of upper Midwest family practice and internal medicine residency program directors was performed to determine the prevalence and characteristics of exercise stress test training. Two mailings provided a 68% response rate for the 184 programs surveyed. Internal medicine programs were significantly more likely to offer exercise stress test training than family practice programs (57% vs 34%). Overall, an estimated 31% of family practice and internal medicine residency graduates are performing exercise stress tests in their practice. Programs provided an average of 7.3 hours of didactic instruction and 32.7 stress tests per resident. A minority (43%) had an established minimum number of exercise stress tests recommended for competency. Programs with and without exercise stress test training did not differ significantly with respect to age, size of program, or size of community. There were some interstate differences in the extent of exercise stress test training provided by family practice residency programs. Internal medicine programs were more likely to require a minimum number of treadmill tests. Otherwise there were few differences between family practice and internal medicine program instruction in exercise stress test training. Family practice program directors were more likely to believe that their residents should be taught this procedure and to include family physicians in their panel of instructors. Specific guidelines should be created to assure adequate stress test training for interested residents.     

地方现场流行病学培训项目实施效果定性调查

目的了解中国省、市、县开展现场流行病学培训项目（Field Epidemiology Training Programs ,FETP）的实施效果及存在的问题。方法采用定性研究的方法，设计定性研究提纲，对地方FETP项目负责人进行个人深入访谈。对每个项目随机选择10名毕业学员，使用培训效果个人评估表对其进行调查。结果35个FETP项目负责人均认为开展FETP培训非常有必要。28个认为成功，6个认为不成功，1个因项目刚成立未能评估。成功表现在学员能力提高，项目获得社会、业内和政府的认可，项目有长期财政和政策支持。不成功之处主要体现在缺乏经费支持，领导不重视；缺乏优秀的指导教师；学员受常规工作影响未能完全投入到现场实践培训。学员认为培训后个人从不同侧面能力得到提升的比例为83％～97％。结论地方现场流行病学培训项目经过多年发展已在中国初具一定规模，一些项目开展较为成功，但各地培训项目的效果和质量参差不齐。建议对地方FETP指导教师开展定期培训，切实保证FETP培训成为学员在训期间的优先工作，以提高地方FETP的培训质量和效果。     

住院医师感染病学临床技能培训探讨

四川大学华西医院感染性疾病中心是卫生部感染病学专科住院医师培训基地,2003—2007年对94名内科住院医师进行了感染病学临床技能轮转培训,就住院医师感染病学临床技能培训情况、存在的问题及对策进行了探讨。     

医疗仪器维修技术专业教学实训设备的研究

目的：为满足职业教育中医疗仪器维修技术专业的培训需要,完成本专业的技能训练,研究开发专业核心课程教学实训设备。方法：实训设备以临床常用仪器为原型机,改进外部结构,设置仪器基本测试点及典型故障。结果：先后研发出18项264台（套）实训设备,初步建立了电工电子技术、医用电子仪器、医学检验、超声及医学影像设备实训室的医疗仪器维修技术专业实训中心。结论：通过教学实践和社会培训的开展,实训设备在专业核心课程教学中体现出较高的实用价值。