住院医师规范化培训的区域实践与建议——以山西省为例

为了解山西省临床医学专业学位研究生“四证合一”规培的实施现状，并分析其影响因素，本研究自行设计调查问卷，对山西省2015 级临床专业学位研究生规培的基本情况、成效、师资、存在问题及建议等方面进行了调查分析。问卷Cronbach’s α 信度系数为0.89，结构性效能分析显示KMO 检验值为0.93，Bartlett 球形检验值P ＜ 0.01，方差累计贡献率为64%。结果显示，70.63% 的研究生选择“出于未来就业考虑”作为参加规培的原因；46.39% 的研究生认为参加规培以来“有较大压力”；34.97% 的人认为有“较多”的临床实践机会。研究表明，当前山西省“四证合一”规培体系已较为完善，但依然存在诸多薄弱环节，如规培轮转安排及培养模式等问题急待改进，希望本文能为完善今后规培制度提供借鉴和参考。

Regional practice and suggestions for the standardized training of residents: based on Shanxi Province

To understand the status and influencing factors of the implementation of the “Unification of Four Certificates” training program for clinical medical postgraduates in Shanxi Province, a self-designed questionnaire was adopted to investigate and analyze the basic information of Grade 2015 clinical postgraduates in Shanxi Province, the basic conditions of training, the effectiveness of clinical rotation, teacher training, existing problems and solutions. The Cronbach’s α reliability coefficient of the questionnaire was 0.89. The structural efficiency analysis showed that the KMO test value was 0.93, the Bartlett spherical test value was P<0.01, and the cumulative variance contribution rate was 64%. Results showed that 70.63% of the respondents chose “out of future employment consideration” as the reason for their participation in the “Unification of Four Certificates.”46.39% of postgraduates thought they had “considerable pressure” since they took part in standardized training. Most of the pressure came from “publication pressure”. 34.97% of people thought they had “more” clinical practice opportunities. At present,the system of the “Unification of Four Certificates” in Shanxi Province has been improved. The awareness and satisfaction of trainees are generally good, but there are many weak links, such as the arrangements of clinical rotation and the training modes.Hopefully, this investigation can provide reference for improving the future residents training system.