天津市以需求为导向的全科医师技能集中培训的实践与探索

目的 探讨以需求为导向的一年资全科医师规范化培训学员集中技能培训及考核方法。 方法 以天津市医师规范化培训医学实践技能培训中心99名一年资全科医师规范化培训基地学员为研究对象，根据全科医师规范化培养标准细则要求，结合全科医师职业特点，通过调查问卷分析，确定全科医师临床基本技能模拟训练与知识强化教育的需求，制定标准的培训课程，培训全科师资队伍，使用标准考核及评价方法测评培训效果，对所有学员培训前后的理论、技能掌握程度进行对比分析，评价课堂效果。 结果 学员认为培训的目的最主要是为了更好的胜任本职工作(68.69%)、完成规范化学习(58.59%)、提升临床技能(58.59%)；最需要的知识与技能为临床技能操作(95.96%)和临床诊疗能力(88.89%)；最喜欢的培训方式是视频、讲授与操作相结合(68.69%)；最喜欢的人文课程是医患沟通(51.51%)。培训前后操作技能掌握程度及综合成绩对比差异均有统计学意义(P＜0.001)，培训后学员成绩均有提高。 结论 以全科医师培训的需求为依据确定标准培训课程，进行规范化培训，应用科学的评价体系可显著提高临床基本技能及相关理论集中培训的效果。 

Practice and exploration of the centralized skills training for general practitioners based on the demand oriented in Tianjin city

Objective To explore the centralized skills training and assessment methods for the first year standardized training of general practitioners based on the need of the trainers. Methods Total 99 first year clinical medical staffs who received standardized training in a Tianjin physician training medical practice skills training center were enrolled into this study.According to the general practitioners standardized training detailed requirements,combined with professional characteristics of general practitioners,through the questionnaire survey analysis,we determined the clinical skills of general practitioners simulation training and intensive knowledge demands,and assessed the training effect.All trainees were examined by the theory and clinical skills before and after the training so that to evaluate of the teaching effect. Results Among 99 subjects,the main purpose of them were to better qualify for the job(68/99),finish the standardized learning(58/99) and improve clinical skills(58/99);The main needed knowledge and skills were clinical operation skill(95/99) and clinical diagnosis ability (88/99);They enjoyed the training model combined the video,lecture and operation(68/99);The favorite course of the humanities was the doctor-patient communication accounting(51/99).After the training,their clinical operation skills and comprehensive evaluation were improved significantly(P<0.001). Conclusion The standardized training that based on the demand oriented standard training courses combined with scientific evaluation system can significantly improve the efficiency of basic clinical skills and relevant theory of training for general practitioners.