基于工作任务分析的《全科专业住院医师规范化培训内容与标准(2019年修订版)》修订必要性研究  

Task-based Analysis of the Necessity of the Revision of the Contents and Standards of Standardized General Practice Residency Training Program(2019 Revised Edition)

作　　者：严春泽[1] 王军霞 王权 李肖肖[1] 季燕[1] 杜雪平[1] YAN Chunze;WANG Junxia;WANG Quan;LI Xiaoxiao;JI Yan;DU Xueping(Yuetan Community Health Center of Fuxing Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属复兴医院月坛社区卫生服务中心,北京市100045

出　　处：《中国全科医学》2020年第28期3508-3515,共8页Chinese General Practice

基　　金：国家卫生健康委员会人才交流服务中心委托项目(201905-222)。

摘　　要：背景新型冠状病毒肺炎疫情发生以来,防治结合的基层卫生服务体系筑起了防疫的第一道防线,但同时也暴露出我国基层全科医生传染病防控知识不足、缺乏实战经验等问题,提示应进一步深化我国全科医生培养机制研究。目的通过对全科住院医师规范化培训结业后全科医生的工作任务分析,为进一步修订《全科专业住院医师规范化培训内容与标准(2019年修订版)》提供依据。方法采用自行设计的调查问卷,通过函调的方式,面向参加全科住院医师规范化培训并取得结业证书不满3年,主要在乡镇卫生院、社区卫生服务中心(站)或综合医院全科医学科工作的全科住院医师展开调查。问卷内容包括基本信息,住院医师工作任务情况,工作任务涉及的症状、疾病及完成工作任务所需的知识、技能。结果参与调查的对象工作单位类型中乡镇卫生院占42.3%(220/520),城市社区卫生服务中心占36.2%(188/520),综合医院占20.4%(106/520),其他占1.1%(6/520)。工作岗位类型中以全科医生岗位为主占63.4%(330/520),全科医生岗位与公共卫生岗位各一半占20.4%(106/520),以公共卫生岗位为主占8.1%(42/520),其他占8.1%(42/520)。工作任务排名中,执行频率排在前3位的工作任务分别为病史采集、体格检查、诊断与鉴别诊断。理论知识点实际应用中,常见慢性非传染性疾病诊治、以服务对象健康问题为导向的临床思维、常见慢性非传染性疾病规范化管理工作任务权重排名前3位。基本技能按工作任务权重排序前10位分别为:临床检验和结果判读、各种伤口换药与拆线、心电图机操作、系统查体、小伤口清创缝合、规范管理高血压、规范管理糖尿病、胸部X线读片、书写心电图诊断报告、健康教育。按部位统计接诊症状、按系统统计接诊疾病的频数及重要性排序为各科常见症状、疾病。结论《全科专业住院医Background In China,the primary healthcare system has played a frontline role in the prevention and treatment of COVID-19 since the outbreak of the pandemic.During the process,a series of problems have been exposed,such as general practitioners’(GPs’)inadequate knowledge and insufficient practice of containing infectious diseases,suggesting that the research on the training mechanism of GPs in China should be further deepened.Objective To analyze the task of GPs after the completion of the national standardized general medicine residency training program,to provide a basis for further revision of the Contents and Standards of Standardized General Practice Residency Training Program(2019 Revised Edition).Methods Participants were general residents who completed the national standardized general medicine residency training program with a certificate less than 3 years ago,and worked at institutions consisted mainly of township health centers,community health centers(stations)and the general practice department of general hospitals.An email-based survey using a self-designed questionnaire was conducted among the participants to collect their demographic data,tasks,symptoms and diseases encountered during practice,and knowledge and skills required to complete the tasks.Results Among the respondents,the percentages of working at township health centers,urban community health centers,general hospitals,and other types of institutions were 42.3%(220/520),36.2%(188/520),20.4%(106/520),and 1.1%(6/520),respectively.The percentages of working as GPs,GPs and public health physicians(whose practice tasks consist of equal parts of general practice and public health issues),public health physicians(whose practice tasks consist of mainly public health issues),and other types of roles were 63.4%(330/520),20.4%(106/520),8.1%(42/520),and 8.1%(42/520),respectively.The top 3 tasks most frequently practiced were medical history collection,physical examination,and diagnosis and differential diagnosis.In terms of the weight for practi

关 键 词：全科医生 住院医师规范化培训 工作任务分析 问卷调查 

分 类 号：R192[医药卫生—卫生事业管理]