青年医师从事临床教学工作状况的调查与分析

目的 调查青年医师参与临床教学工作的感受及其教学能力培训情况,了解他们所面临的困难及需要的帮助.方法 选择437名在北京大学第一医院工作的主治医师和正在接受住院医师规范化培训（含第二阶段）的住院医师为调查对象,分为主治医师组和住院医师组.采用问卷调查方法,了解他们参加临床教学工作的动机和感受,接受教学培训情况,从事教学工作的困难和需要的帮助.比较住院医师和主治医师两组间存在的差异,采用多因素逻辑回归方法,分析造成被调查者集中反映的内心感受、困难体验及帮助需求等现象的主要影响因素.结果 发放调查问卷440份,收回有效问卷437份,有效问卷回收率99.3％.实际抽样调查比例,主治医师组为66.3％,住院医师组为61.1％.在437名被调查者中,84.7％的人员直接参与了临床教学工作;认为自己属于被动参与临床教学工作的人员占比55.6％;主治医师组直接参与临床教学工作和被动参与临床教学工作的比例均显著高于住院医师组（P＜0.05）.喜欢从事临床教学工作的人员占比67.7％;认为从事教学工作有益于自身学习进步的人占比90.4％;提出接受系统教学能力培训需求的人员占比50.3％;在这些项目的认同比例上,主治医师组与住院医师组之间的差异无统计学意义.主治医师组接受过教学培训的人员比例显著高于住院医师组（P＜0.05）.“认为自身知识、教学能力欠缺,不足以支撑教学工作”的困难体验,在住院医师组中的发生率显著高于主治医师组（P＜0.05）.多因素Logistic Regression分析结果显示,直接参与教学活动（OR：2.733,P=0.001）、以提高自身能力为动机参与教学（OR：5.677,P=0.000）和因为热衷于培养年轻医生而参与教学工作（OR：4.752,P=0.000）是产生“喜欢从事教学工作”心理感受的主要影响因素.工作或受训年限（OR：0.752,P=0.003）、

Survey and analysis about the working state of young physicians engaged in the clinical teaching

Objective To investigate the feelings of young physicians engaged in clinical medical education,and their training backgrounds in teaching ability,to learn their difficulties and the need for helps.Methods 437 attending physicians and residents on training program （including PGY1-5）,in Peking University First Hospital were enrolled in this retrospective study.Questionnaire investigation was used to collect the information about their motivations and feelings to engage in clinical medical education,their training backgrounds in teaching ability,the difficulties they met and the helps they needed in clinical teaching.Main elements were compared between the attending physicians and residents,multivariable logistic regression analyses was used to determine the independent relative factors of their feelings,difficult experience and helps needed,what were focused by most of subjects.Results Effective rate of questionnaire investigation was 99.3% （437/440 questionnaire distributed）.The actual sampling size in attending physicians population was 66.3% （126/190 peoples）,and was 61.1% （311/509 peoples）in residents.In all subjects （n =437）,84.7% （370 people） were actually engaged in clinical education,55.6% （243 people）thought that they were passively involved,and these ratio were significant higher in attending physicians population than in residents （P〈0.05）.Engaging in clinical teaching was estimated as a favorite by 67.7 % （296 people）,90.4% （395 people） considered that clinical teaching is beneficial to the improvement of themselves,and 50.3% （220 people） thought that they need systemic training in education,no significant difference was found between attending physicians and residents in terms of self-identification ratio in above confessions.Trainings in education was significantly more experienced in attending physicians than residents （P〈0.05）,and the difficult experience of ＂insufficient in knowledge and ability to support the clinical teaching＂ was significa