全科医生转岗培训统一结业考试实践性研究

目的 了解全科医生转岗培训效果及存在的问题,为改进培训方法、提高培训质量提供参考依据。 方法 对完成了全科医生转岗培训的学员进行统一结业考试,考试的信度和区分度采用重庆医科大学试卷定量分析系统测定,考试的效度由重庆医科大学全科医学教研室具有丰富教学经验的教师、培训中心的管理老师以及社区带教师资组成的专家组共同评价;将考试结果进行统计学分析,采用非参数秩和检验,双侧α=0.05作为检验水准。 结果 2012-2015年理论考试 基本技能 体格检查 心肺复苏四项的中位成绩在60.0~82.5分之间,各项考试成绩的四分位间距分别为55.2~66.764.3~77.261.5~82.569.0~87.0分;全科接诊的中位成绩为65.0~76.0分之间,四分位间距为60.0~80.0分;次年比前一年的考试成绩有提高差异有统计学意义(P<0.05)。 结论 考试结果显示,培训后的全科学员在全科医学基本理论、基本技能方面基本合格,但在全科接诊综合能力方面总体水平偏低,沟通交流技巧欠缺,对基层常见疾病的诊断处理与预防保健等方面的能力与理想状态有差距;全科学员能力的个体差异也较大。建议将来在全科医生转岗培训中强化全科接诊能力的实战训练,并尝试SP模拟教学及分层个体化的新型培养模式。 

Practical study of uniform final examination for general practitioner's in-service training

Objective To investigate the effectiveness and existing problems with in-service training for general practitioner,and provide the basis for the improvement of training method and quality. Methods The uniform final examination was performed in all general practitioners who finished the in-service training.The reliability,distinction and validity of the tests were evaluated by a team of experts.The results of the final examination were analyzed statistically with Kruskal Wallis Test (α=0.05). Results Between 2012 and 2015,the median score for theory test,basic skills,physical examination and cardiopulmonary resuscitation was 60.0 to 82.5,and the interquartile range was 55.2-66.7,64.3-77.2,61.5-82.5 and 69.0-87.0,respectively.The median score for reception was 65.0 to 76.0,and the interquartile range was 60.0-80.0.All the test results were improved as compared with the year before,the difference was statistically significant (P<0.05). Conclusion The uniform final examination showed that the levels of basic theory and basic skills of general practitioner can reach the general qualifications after the training,but the reception ability is still low,and there is still gap from the ideal in the ability to deal with the common diseases in grass-roots hospitals and health care.The individual differences are significant among the trainees.The reception ability of general practitioner should be pay more attentions in the future training to strength the practice activity,and try SP simulation teaching and layered individualized training mode.