西藏委托培养住院医师与社会人身份住院医师培训质量比较  

Comparison of residence training quality between commissioned training residents from Tibet and non-commissioned training residents

作　　者：王星月[1,2] 陈惠铃 于嗣民 张伟 WANG Xingyue;CHEN Huiling;YU Simin;ZHANG Wei(Medical Chinese Teaching and Research Section,West China School of Medicine/West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Graduate Medical Education,West China School of Medicine/West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Party Committee Office,West China School of Medicine/West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西临床医学院/华西医院医学中文教研室,成都610041 [2]四川大学华西临床医学院/华西医院研究生部,成都610041 [3]四川大学华西临床医学院,成都610041 [4]四川大学华西临床医学院/华西医院党委办公室,成都610041

出　　处：《华西医学》2020年第8期974-978,共5页West China Medical Journal

基　　金：四川省科学技术厅科技计划项目(2017FZ0104)。

摘　　要：目的比较四川大学华西医院西藏委托培养住院医师与社会人身份住院医师的培训过程是否实现了均质化。方法采集2016级西藏委托培养住院医师170人与社会人身份住院医师96人在2016年9月—2018年4月共计19个月中的轮转科室培训时长和操作次数数据,并对具有代表性和可比性的11个科室的25项操作数据进行了对比。结果两类人员在19个月内完成了47个不同科室的轮转,其中45个科室为两类学员均轮转的科室。11个比较科室中,委托培养学员在麻醉科的平均受训时间低于同级社会人学员(Z=–4.543,P<0.001);25项操作数据中有7项数据的差异有统计学意义(P<0.05),其中学员在动脉穿刺和呼吸机管理(重症监护病房)、患者处理(急诊科)、动脉穿刺、呼吸机管理和术中监测(麻醉科)这6项数据上,显示西藏委托培养学员的操作次数低于社会人学员(P<0.05);在肺与纵隔检查(放射科)这1项数据上,显示西藏委托培养学员的操作次数高于社会人学员(P<0.05)。结论在两类人员受训过程中,其轮转安排时间基本一致,但进行的临床实践操作存在差异。西藏委托培养学员对放射科的培训要求更高;委托培养学员返回藏区执业时独当一面的岗位胜任力内在要求学员对影像学技能操作主动参与度更高。而对于危急重症、急诊急救、手术技能,委托培养学员因语言、入训时间的原因参与度不如社会人学员,需要在后续的培训中逐步夯实和提高。Objective To compare whether the training process of commissioned training residents from Tibet and non-commissioned training residents have achieved homogenized.Methods The training time and operation frequency data of 170 commissioned training residents from Tibet and 96 non-commissioned training residents of grade2016 during the 19 months from September 2016 to April 2018 were collected.The 25 operational data of 11 departments that are representative and comparable are compared.Results The two types of trainees completed the rotation of 47 different departments within 19 months,of which 45 departments were the departments where both types of students were rotated.Among these 11 departments,the average training time of trainees from Tibet in the Departments of Anesthesiology was lower than that of non-commissioned trainees(Z=–4.543,P<0.001).There were statistically significant differences in 7 of the 25 operating data(P<0.05).The operation number of arterial puncture and ventilator management(Intensive Care Unit);patient treatment(Department of Emergency);arterial puncture,ventilator management and intraoperative monitoring(Department of Anesthesiology)of trainees from Tibet were lower than those of non-commissioned trainees(P<0.05).The operation number of lung and mediastinal examinations(Department of Radiology)of trainees from Tibet was higher than that of non-commissioned trainees(P<0.05).Conclusions During the training of the two types of trainees,the rotation schedule was basically the same,but there were differences in the clinical practice operations.Trainees from Tibet have higher requirements for radiology training.Trainees from Tibet will return to Tibet with independent practice needs,so their requirements of medical imaging skills operation would be higher.Due to language and training time,the critically ill,emergency first aid,and surgical skills of trainees from Tibet are not as good as those of non-commissioned trainees,and they need to gradually strengthen and improve these skills in subsequ

关 键 词：西藏 委托培养 住院医师培训 培训质量 

分 类 号：C975[经济管理—劳动经济] R-4[医药卫生]