住院医师规范化培训中专业学位硕士研究生“双轨合一”培养模式分析——以云南省某三甲医院为例

了解云南省临床医学专业学位硕士研究生(下文简称"专硕研究生")在"双轨合一"培养模式下的现状及存在问题,并提出相应的建议及解决办法,为云南省住院医师规范化培训事业的开展提供参考依据。文章对云南省某三甲医院的165名临床医学专硕研究生采用现状调研的方法,分析住院医师规范化培训"双轨合一"模式培养专硕研究生取得的成效及存在的问题。发现云南省住院医师规范化培训现阶段已取得相应的进展,如培训基地的规范、招生规模的扩大等,但在"双轨合一"人才培养模式中存在由传统的"重科研,轻临床"转变为"重临床,轻科研"、医学人文教育滞后等问题。在开展住院医师规范化培训的大环境下,"双轨合一"将逐渐符合云南省对高等医学人才培养新模式的实际需求,将会给云南省整个医疗卫生行业带来巨大的进步。     

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。     

医学硕士专业学位教育与住院医师规范化培训

作为我国毕业后医学教育的另一重要组成部分,住院医师规范化培训与医学专业学位研究生教育在培养目标、对象和内容上均有重合。本文对住院医师规范化培训与医学硕士专业学位教育的培养现况和需求进行分析,在参考和借鉴国外培养模式的基础之上,对更好地加强两种培养工作的衔接提出建议。     

对住院医师规范化培训与专业型硕士培养并轨的探讨

在阐述住院医师规范化培训与专业硕士培养并轨必要性的基础上,分析住院医师规范化培训与专业硕士培养并轨的现状.结合国内外住院医师规范化培训经验,探索完善住院医师规范化培训制度.提出住院医师规范化培训与专业硕士培养并轨尚需解决的问题,提示应进一步完善住院医师规范化培训与专业硕士培养并轨机制.     

临床专业学位研究生培养与住院/专科医师培训的比较研究

通过对临床专业学位研究生培养与住院/专科医师培训模式的比较研究,尝试对两者进行同一化管理,将利于量化临床型研究生临床能力培养情况,提高招生吸引力,利于挑选优秀临床型研究生,与住院医师规范化培训对象招录工作相衔接。     

复旦大学住院医师规范化培训学员基本信息的调查分析

目的:在推进住院医师规范化培训的背景下,切实了解复旦大学住院医师规范化培训学员基本信息的现状及变化情况。方法:对复旦大学2010期、2011期两期住院医师规范化培训学员基本信息进行回顾性调查和分析。结果:与2010期招录学员比较,2011期招录学员中博士研究生、本科生分别增加4.10%和16.74%,而硕士研究生则减少20.84%。本地学校毕业学员减少20.16%,外地学校毕业学员增加20.16%。结论:有关部门应从"建立绩效考核,明确奖惩制度"、"保证培训质量,打造优质品牌"、"加大政策扶持,提升配套服务"等方面进一步重视和完善住院医师规范化培训工作。     

麻醉学专业学位研究生培养与规培有机结合的意义

"规培"研究生是随教育改革而新生的事物,将临床医学硕士专业学位研究生的学位教育与住院医师规范化培训进行有机融合,可以提高人才培养效率与质量,加强了麻醉学临床科研方法与能力以及创新意识的培养。     

临床专业学位研究生与普通专科医师规范化培训模式并轨的探讨

近年来,教育部逐年增加临床专业学位研究生的招生规模,但是对于临床专业学位研究生的培养模式及考核方式等还存在许多问题,这些都直接影响到临床研究生的培养质量.通过临床专业学位研究生与普通专科医师规范化培训模式并轨,建立统一的且适合临床研究生的培养模式,提高培养质量,使得临床研究生毕业时既具备一定的科研能力,又能达到住院医师规范化培训一阶段的临床能力.     

绩效考核在住院医师规范化培训中的作用

目的：探讨绩效考核在住院医师规范化培训中的作用。方法：以我院在培住院医师规范化培训学员66人为研究对象,比较绩效考核革新前后的学员绩效收入满意度、临床理论知识和技能操作考核评分、住院病历评分等。结果：绩效考核革新后,住培学员对学员收入满意度、临床理论知识和技能操作考核评分、住院病历评分显著高于绩效考核方案革新前,差异均具有统计学意义（p＜0.05）。结论：绩效考核有助于提高住院医师规范化培训学员工作积极性,提高住院医师规范化培训的质量,具有一定的推广价值。     

加强住院医师规范化培训的几点建议

住院医师培训是毕业后医学教育的重要组成部分,本文主要介绍我院住院医师规范化培训现状,为确保住院医师规范化培训工作的顺利开展,促进住院医师职业道德和临床技能的双向提高提出建议,从而完善住院医师规范化培训体系建设。     

Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan

Medical Education 2010: 44 : 289–297 Objectives This study analyses and discusses recent changes in young Japanese doctors’ career paths, in terms of their distribution in different types of facilities and specialties, following changes to the postgraduate clinical training system in 2004. Methods Data from the National Survey of Physicians, Dentists and Pharmacists conducted by Japan’s Ministry of Health, Labour and Welfare were used for this study. Results After the introduction of the new postgraduate training system, 2 years of clinical training became mandatory and a doctor‐to‐facility matching system was introduced. Since then, more young doctors have migrated from academic hospitals to non‐academic hospitals. The number of first‐year doctors at non‐academic hospitals increased, whereas the number at academic hospitals decreased. In terms of the distribution of doctors per specialty, the decreasing tendency of doctors to choose internal medicine and surgery has accelerated. These results illustrate the significant changes that have affected young doctors’ career paths since the new system was introduced. Conclusions Designing and providing desirable postgraduate clinical training and achieving appropriate doctor distribution are important policy issues. Appropriate policy interventions regarding a mechanism to ensure the appropriate distribution of doctors should be established and attention should be paid to expanding doctors’ choices and increasing patient satisfaction and general cost‐effectiveness.     

住院医师／专科医师对规范化培训带教师资和培训管理的满意度调查分析

目的调查参加规范化培训的住院医师／专科医师对带教师资综合职业能力和培训管理的满意度,进一步了解不同医院开展毕业后医学教育所面临的问题和进行毕业后医学教育规范化培训异同。艿珐采用自制问卷对成都市4所三级甲等医院598名住院／专科医师进行问卷调查．对收集的数据进行因子分析和方差分析。结呆受调查的598名住院医师／专科医师对带教师资的综合职业能力的满意度评分在3．83～4．11之间（满分为5分）．而对培训管理的满意度评分在2．91～3．75之间,且不同医院住院医师/专科医师的满意度有差异性P〈0．05。结论无论教学医院还是非教学医院,都应加强带教师资建设和培训管理．才能提高住院医师／专科医师对规范化培训的满意度,以促进住院医师／专科医师规范化培训的顺利开展。     

临床医学专业学位研究生教学培养模式的问题

国家及军队加大研究生教育结构调整,大力发展专业学位研究生教育。本校自1998年开展该类型研究生教育以来,已培养出大批质量较高的临床应用型人才,但仍然存在若干问题。本文拟通过介绍长海医院神经外科的临床带教试点工作,探讨解决临床医学专业学位研究生培养中面临的困难和问题,探索推进“医教协同”的临床医学专业学位研究生培养模式改革。     

军队医院开展住院医师规范化培训初探

本文结合住院医师规范化培训的历史和现状,系统分析军队医院开展规培的矛盾和问题,提出对策和建议,指出要理清人才建设思路,探索医师规培模式,建立军地配套政策,完善相关规章制度,走开住院医师规范化培训军地衔接、融合发展之路。     

以学生为主体的神经内科住院医师规范化培训模式体会

目的研究以学生为主体的神经内科住院医师规范化培训模式及其效果。方法选择2018年1月—2019年4月期间在该院神经内科接受规培的住院医师45名,根据不同培训模式划分组别(对照组22名、研究组23名),给予对照组传统的床旁教学查房模式,给予研究组以学生为主体的规范化培训模式,对比两组培训的效果。结果两组学员腰穿成绩对比差异无统计学意义(P>0.05),但研究组学员阅片情况、神经系统查体、理论知识考核等成绩明显高于对照组学员(P<0.05);研究组学员对教学的总满意度明显高于对照组学员(P<0.05)。结论以学生为主体的神经内科住院医师规范化培训模式,有利于提升规培的效果,并提升学员对教学的满意度。     

双轨合一模式下军医大学临床专业学位研究生培养现状

目的调查在“双轨合一”模式下海军军医大学临床医学专业学位研究生教学现状与效果。方法抽取该校此培养模式下研究生进行问卷调查,内容涉及研究生工作重点、学习需求及对带教工作的建议等。结果发放调查问卷180份,回收180份,回收率100%。其中77.78%的研究生所属第二研究生大队,22.58%的研究生所属第三研究生大队。81.67%的研究生已参加临床科室轮转。在科室轮转中,医疗文书写作、谈话签字等病情告知、参与手术或操作及病房值班均为研究生的临床工作重点。64.44%的研究生认为在轮转实习中,综合临床素质提高很大。53.89%的研究生认为临床带教质量有待加强。52.22%的研究生认为出科考核严格。绝大多数研究生迫切希望获得更深入细化的专业知识、学科进展、并发症处理等方面的知识。81.67%的研究生表示很少有开展相对复杂操作的机会。结论临床专业学位研究生临床培养内容与方式需要进一步优化改进。     

Developing postgraduate medical education for trusts: a secret to long-term success.

The delivery of effective postgraduate education for doctors in trusts is becoming vital to secure the individual services of trusts. Increasingly, training requirements are impacting on the location of clinical services that NHS trusts provide. Failure to understand the benefits and drawbacks of providing postgraduate education could affect the long-term strategic direction of trusts. The paper seeks to identify the case for investment, the need to address key deliverables to secure effective postgraduate education and the need for clinicians and managers to evaluate the effectiveness of such training for their organisations.     

基于延伸教学模式的全科医生转岗培训效果分析

目的：探讨全科医生转岗培训采取延伸教学模式的效果。方法对吉林地区参加2013年全科医生转岗培训的174名社区医生,采用吉林省全科医生培训基地吉林卫生学校提出的延伸教学模式进行培训及干预,并进行跟踪管理。结果实施干预1年后,社区医生的全科理论知识水平和全科临床技能水平与培训干预前相比均有明显提高,差异具有统计学意义(P <0.05)。结论延伸教学模式能有效提高全科医生在转岗培训中的全科理论知识与全科临床技能,具有良好的实用性和有效性。     

Developmental challenges,stressors and coping strategies in medical residents: a qualitative analysis of support groups

Medical Education 2010: 44 : 908–916 Objectives Stress and burnout are endemic in postgraduate medical training, but little research is available to guide supportive interventions. The identification of the longitudinal emotional and developmental coping needs of internal medicine residents could assist in the better design and implementation of supportive interventions. Methods In this retrospective, exploratory study, six internal medicine resident support groups (n = 62; residents in postgraduate years [PGY] 1–3) were followed for a period of 2 years. Qualitative data were extracted from monthly support group process notes to identify common themes, stressors, emotions, coping strategies and developmental challenges faced during training. Quantitative questionnaire data were collected on burnout, group attendance and resident satisfaction. Results Using professional identity development models and classic stress and coping theory as a starting point, a derivation of grounded theory was used to identify common themes and emotions documented in support group process notes. The most common themes included understanding resident roles and responsibilities, developing an identity as a resident and doctor, building professional confidence, cognitive and behavioural responses to stress, and concerns about flaws in local and national health care training and delivery systems. Anxiety and guilt were the most commonly reported emotions, followed by positive emotions and anger. Burnout scores were highest for the second half of PGY1, but improved over subsequent training years. Support group attendance and satisfaction were both high. Residents overwhelmingly pointed to peer relationships as the most critical source of support throughout postgraduate training. Conclusions Developmentally informed programmatic adaptations could better support the emotional growth and personal and professional development of postgraduate medical trainees. Future directions should include a controlled trial of resident support groups, assessments of ‘active ingredients’ (i.e. to establish which supportive interventions are most effective), and evaluations of programmatic adaptations.