多学科诊疗模式对规培医师临床能力的影响  

The Influence of Multidisciplinary Team on the Clinical Ability of the Physicians

作　　者：胡明[1] 陈劲松[1] 黄炯强[1] 詹高房 叶志伟[1] HU Ming;CHEN Jinsong;HUANG Jiongqiang;ZHAN Gaofang;YE Zhiwei(Department of Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510120,China)

机构地区：[1]广州医科大学附属第一医院外科

出　　处：《中国继续医学教育》2019年第31期80-82,共3页China Continuing Medical Education

摘　　要：目的评价多学科诊疗(MDT)模式对培养规培医师临床能力的影响。方法选择进入广州医科大学附属第一医院外科接受规范化培训的住院医师92名,在胃肠外科轮转培训期间随机分为实验组和对照组,实验组将作为MDT病例主管医师,参加胃肠外科每周一次的肿瘤MDT讨论,讨论前需要将自己分管的胃肠肿瘤患者的病历资料制作成PPT,查阅相关资料,了解该疾病的最新进展和循症医学证据,讨论后整理各专家的意见,做好记录并在上级医师指导下落实诊疗方案;对照组作为普通成员参与讨论。培训结束后通过调查问卷和出科考核综合评价,计量资料用t检验,计数资料用χ^2检验。结果实验组和对照组医师对MDT模式教学的满意度分别为86.9%和69.6%,差异有统计学意义(P <0.05);实验组和对照组出科平均考试成绩分别为(81.3±9.2)分和(75.2±11.3)分,差异有统计学意义(P <0.05);实验组和对照组的考试成绩及格率分别为97.8%和85.8%,差异有统计学意义(P <0.05);实验组和对照组的考试成绩优秀率分别为26.1%和15.2%,差异有统计学意义(P <0.05);实验组绝大多数学员认为MDT模式在提高学习主动性和积极性、提高分析和解决问题能力、对胃肠肿瘤治疗新进展知识的掌握等方面具有明显优势。结论 MDT模式有利于培养规培医师的临床能力,以主管医师身份参加MDT诊疗活动,可提高从不同视角分析问题的能力,有助于提高临床思维能力和处理复杂问题的能力,培养多学科交叉协助的工作能力。Objective To evaluate the effect of multidisciplinary team(MDT) on training the clinical ability of physicians. Methods 92 resident doctors admitted to the First Affiliated Hospital of Guangzhou Medical University were randomly divided into the experimental group and the control group during the rotation training of gastrointestinal surgery. The experimental group was acted as the chief physician in charge of MDT cases, to participate in weekly discussions on tumor MDT in gastrointestinal surgery, where medical records of patients with gastrointestinal cancer who were under their control need to be made into PPT, to consult relevant information, to learn about the latest progress of the disease and medical evidence of symptomatic diseases. After discussion, collect the opinions of the experts and make a record. Under the guidance of the superior physician, implement the diagnosis and treatment program, the control group was conducted as ordinary members to participate in the discussion. At the end of the training, the comprehensive evaluation of questionnaire and examination was carried out, the measurement materials were tested by t test, and the count data were used by χ^2 test. Results The satisfaction of the doctors in the experimental group and the control group were 86.9% and 69.6% respectively, the difference was statistically significant(P < 0.05), and the average test scores of the experimental group and the control group were(81.3±9.2) points and(75.2±11.3) points respectively, the difference was statistically significant(P < 0.05). The passing rates of test scores in the experimental group and the control group were 97.8% and 85.8% respectively, the difference was statistically significant(P < 0.05). The excellent rate of test scores in the control group was 26.1% and 15.2% respectively, the difference was statistically significant(P < 0.05). Most of the students in the experimental group thought that the MDT model had obvious advantages in improving the learning initiative and enthusiasm, improving

关 键 词：多学科诊疗 规培医师 临床能力 外科 毕业后教育 培养模式 

分 类 号：G642[文化科学—高等教育学]