问卷调查法对显微神经外科训练效果的调查分析  

A questionnaire method to evaluate the effect of micro-neurosurgical training

作　　者：马妍[1] 陆夏[1] 张智萍 孔锋 张鸿祺[1] 凌锋[1] Ma Yan;Lu Xia;Zhang Zhiping;Kong Feng;Zhang Hongqi;Ling Feng(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053 [2]Yaşargil显微外科训练中心,北京100053

出　　处：《中国脑血管病杂志》2020年第7期398-402,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究重点专项(2016YFC1301700)。

摘　　要：目的探讨显微神经外科医师的培训方法和培训内容的侧重点。方法采取问卷调查法对2001年12月至2019年12月在首都医科大学宣武医院Ya爧argil显微外科训练中心接受过系统培训的490名进修医师进行回访,并对数据进行分析。问卷内容:(1)基本信息(参加培训时的年龄、工作年限);(2)培训期间的情况(参加培训的目的和对培训的体会);(3)培训效果(培训后对实际临床工作的帮助和目前的工作状态,主要指从事颅内外动脉旁路移植手术、显微血管吻合、显微神经外科、整形外科或其他);(4)对培训的建议。结果(1)发放问卷调查表414份,回收166份,排除2份无效问卷,共164份有效问卷调查表,问卷调查表的回收率为40.1%,问卷的有效应答率为98.8%。(2)参加培训时,进修医师年龄为25~51岁,平均(35±4)岁;已有工作年限不等,>10年者占50.6%(83/164),>5~10年者占41.5%(68/164),1~5年者占7.9%(13/164);有一定显微操作基础者占74.4%(122/164)。(3)96.3%(158/164)的进修医师认为培训内容有很大帮助。(4)经过培训后,76.2%(125/164)的医师开展了至少1项新手术,开展最多的是脑血管病的显微手术治疗,仅有39名尚未开展新手术,与至少开展了1项新手术的医师相比,前者年龄小于后者,二者年龄的差异具有统计学意义[(34±3)岁比(36±4)岁,t=-2.60,P=0.01]。(5)2001—2010年与2011—2019年进修医师工作年限、后期培训效果的差异均无统计学意义(均P>0.05);2011—2019年,参加培训的进修医师零基础比例低于2001—2010年,二者差异有统计学意义[20.2%(22/109)比36.4%(20/55),χ^2=5.020,P=0.025]。结论显微外科培训有助于中青年神经外科医师的技术提高,但培训完成后开展新手术需以既往的工作经验和年限作为补充。Objective To identify the future training method and emphasis on micro-neurosurgery training.Methods A questionnaire method was conducted to make return surveys for doctors systematically trained from December 2001 to December 2019 at Yasargil Microsurgical Training Center of Xuanwu Hospital.The questionnaire consisted of three parts:(1)basic information including age and work experience before training;(2)the aim and feeling of microsurgical training;(3)the effect of training mainly focusing on the assistance for current clinical work including extracranial-intracranial bypass grafting,microvascular anastomosis,micro-neurosurgery,plastic surgery;(4)the suggestion of training.Results A total of164 doctors were included in this questionnaire.The mean age of doctors was 35±4 years old when attended training,and the percentage of doctors with ten years work experience was 50.6%(83/164),while the percentage of doctors with five to ten years work experience was 41.5%(68/164).The percentage of doctors with the base of microsurgery was 74.4%(122/164).The majority of doctors(76.2%[125/164])implemented at least a new surgery after the training course in their local hospitals.There were 39 doctors unable to carry out a new surgery,and the mean age of these doctors was significantly younger than that of doctors implemented a new surgery([34±3]vs.[36±4],t=-2.60,P=0.01).The proportion of microsurgeons without the base of microsurgery was significantly reduced from 36.4%(20/55)to 20.2%(22/109)after the year of 2010,the difference was statistically significant(χ^2=5.020,P=0.025).Conclusions Microsurgical training was conducive to improve surgical skills for young and middle-aged neurosurgeons.However,the previous work experience and seniority were also necessary for carrying out a new surgery after training.

关 键 词：问卷调查 显微神经外科训练 医院 教学 

分 类 号：C975[经济管理—劳动经济] R-4[医药卫生]