基层医师儿科诊疗三阶段标准化培养模式的探索

在全面推行分级诊疗的背景下，基层医院儿科资源不足和诊疗能力落后的问题成为制约儿童疾病分级诊疗制度落实的关键。为解决这一难点，浙江省探索并构建了集培训提升、继续教育、实践输出为一体的基层医师儿科诊疗三阶段标准化培养模式。在培训提升阶段，包括基层医师培训、理论考核和浙江省儿科联盟认证。在继续教育阶段，包括移动端教学资源库和线上定期答疑。在实践输出阶段，包括儿童疾病分级诊疗和公益科普讲座。自2018年至2021年，共开展7期培训班，培训学员1 418人，通过考核327人，最终53人完成浙江省儿科联盟认证并被纳入浙江省儿童疾病分级诊疗体系。联盟新成员将分级诊疗覆盖范围从24个区县32个机构扩充至38个区县73个医疗机构。联盟成员完成科普讲座40场，观众累计13 233人次。基层医师儿科诊疗三阶段标准化培养模式通过多形式、标准化、延续性的方式持续同质化，提升了基层医师的综合能力，也为各地基层医师培养和分级诊疗建设提供了参考。

Practice of a three-stage standardized pattern for pediatric diagnosis and treatment ability training for primary doctors

The shortage of pediatric resources and inadequate diagnosis and treatment capacity in primary hospitals are key problems for implementing hierarchic care system of children''s diseases. To solve this difficulty, Zhejiang province has constructed a three-stage standardized pattern for pediatric diagnosis and treatment ability training for primary doctors, which integrates training promotion, continuing education and practice output. Training promotion includes the training courses, theoretical examination, and the certification of Zhejiang Pediatric Alliance. Continuing education includes mobile teaching resource library and online regular Q&A. Practical output includes graded diagnosis and treatment of children''s diseases and public lectures. From 2018 to 2021, a total of 1 418 trainees participated in 7 training sessions, 327 of whom passed the examination. Finally, 53 participants completed the certification of Zhejiang Pediatric Alliance and were included in the hierarchical diagnosis and treatment system for children in Zhejiang Province, expanding the coverage of hierarchical diagnosis and treatment from 32 institutions in 24 districts to 73 medical institutions in 38 districts. Members of the alliance completed 40 public lectures, with a total audience of 13 233. The three-stage standardized pattern continuously improves the comprehensive ability of primary doctors by means of multi-forms, standardization and continuity. We hope our experience can provide a reference for the training of primary doctors and the construction of hierarchical diagnosis and treatment system in various regions.