外科住院医师规范化培训手术教学和技能培训实践的探讨  

Practice of surgery teaching and skill training in standardized residency training of surgeons

作　　者：耿磊[1] 邓俊芳[1] 胡晨[1] 沈恬[1] 余松峰[1] 蒋国平[1] 张珉[1] 郑树森[1] GENG Lei;DENG Junfang;HU Chen;SHEN Tian;YU Songfeng;JIANG Guoping;ZHANG Min;ZHENG Shusen(The First Affliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属第一医院外科学教研室,浙江杭州310003

出　　处：《中国毕业后医学教育》2018年第4期247-249,263,共4页Chinese Journal of Graduate Medical Education

基　　金：中国工程院咨询研究基金资助项目(2016-ZD-11)

摘　　要：手术教学和技能培训是外科住院医师规范化培训的重要内容,为保证培训效果,浙江大学医学院附属第一医院外科学教研室建立了一套完整的培训体系。首先,借鉴美国Milestones方案,制定了分层、分级培训模式,使住院医师学习目标清晰、方向明确、阶梯式进步,有很好的激励促进作用,并保证了同质化的培训效果。其次,根据职责划分建立了多层次教学团队,有核心教学团队、骨干教学团队和基础师资队伍,设立了项目主管制度,定期组织师资培训,完善教学绩效奖励机制,激发教学积极性。为保障手术和技能培训质量,通过临床实践,开设标准化、模块化手术教学课程,模拟教学训练等多种教学手段使住院医师能够熟练掌握各种操作及手术基本技能。最后,通过对全局观、厚积薄发、科班教学、创新和担当精神等外科理念的培养,提升对外科手术的认识。Surgery teaching and clinical skill training are important aspects for standardized residency training of surgery. With this goal, teaching ＆ research office of surgery department in the First Affiliated Hospital, Zhejiang University Medical School, has established an integrated training system. First, we formulated a stratified and hierarchical training mode with reference of ACGME Milestones project, which provided the clear targets, distinct domains and multistep progressions for residents, and contributed to homogenization of the programs.Then, we built surgical teaching teams of different levels based on different tasks, which included managing trainers teams, executive trainers teams and basic trainers teams. We implemented the program-director system, and organized teaching trainings at regular intervals. Furthermore, the incentives for excellent trainers were necessary for inspiring the teaching enthusiasms. Meanwhile, various teaching methods including clinic practice, standard curriculum and simulation training courses were implemented for obtaining the high quality training outcomes. Finally, by culture of the core surgery ideas like global views, emphasis on accumulation, teaching by tutors, innovation and responsibilities, it will help the residents to gain further understanding of surgery.

关 键 词：住院医师规范化培训 手术教学 技能培训 

分 类 号：G642[文化科学—高等教育学]