外科住院医师手术技能培训的探索与实践  

Exploration and practice of improving the training effect of surgical residents'surgical skills based on teaching bed and teaching outpatient surgery

作　　者：刘婧[1] 曾庆奇 高杰[1] 朱凤雪[2] 王思源[3] 郭鹏[4] 高鹏骥[5] 赵彦[6] 李清[7] 王建六[8] Liu Jing;Zeng Qingqi;Gao Jie;Zhu Fengxue;Wang Siyuan;Guo Peng;Gao Pengji;Zhao Yan;Li Qing;Wang Jianliu(Department of Continuing Medical Education,Peking University People's Hospital,Beijing 100044,China;Surgical Residency Training Program,Peking University People's Hospital,Beijing 100044,China;Department of Breast Surgery,Peking University People's Hospital,Beijing 100044,China;Department of Gastrointestinal Surgery,Peking University People's Hospital,Beijing 100044,China;Department of Hepatobiliary Surgery,Peking University People's Hospital,Beijing 100044,China;Obstetrics and Gynecology Department,Peking University People's Hospital,Beijing 100044,China;Department of Urology Surgery,Peking University People's Hospital,Beijing 100044,China;Peking University People's Hospital)

机构地区：[1]北京大学人民医院继续教育处,100044 [2]北京大学人民医院住院医师规范化培训外科基地,100044 [3]北京大学人民医院乳腺外科,100044 [4]北京大学人民医院胃肠外科,100044 [5]北京大学人民医院肝胆外科,100044 [6]北京大学人民医院妇产科,100044 [7]北京大学人民医院泌尿外科,100044 [8]北京大学人民医院

出　　处：《中华医学教育杂志》2020年第6期463-466,共4页Chinese Journal of Medical Education

基　　金：018年北京市住院医师规范化培训质量提高课题项目(住培2018011);2018年中华医学会医学教育分会和中国高等教育学会医学教育专业委员会医学教育研究立项课题(2018B-N02024)。

摘　　要：目的探讨实施教学病床和教学门诊手术对外科接受规范化培训的住院医师手术技能培训效果的影响。方法2018年3月至8月,选取北京大学人民医院住院医师规范化培训外科基地5个试点科室培训的住院医师(每个科室每个月3人~8人不等)作为研究对象,在试点科室中设立教学病床和教学门诊手术,并为保障其实施采取了系列措施。每月统计住院医师作为术者的次数,与2017年12月至2018年2月间的相关数据进行对比,同时,对试点科室的教学干事(同时担任指导教师)和住院医师进行访谈。结果5个试点科室住院医师平均每月作为术者完成手术45.3例,高于2017年12月至2018年2月间的10.7例。访谈结果显示,项目的实施对提高住院医师手术培训机会有促进作用,但存在来自住院医师、所在科室、指导教师和管理方面的多重困难。结论实施教学病床和教学门诊手术对增加住院医师的手术培训机会和参与程度具有一定积极作用,但实施难度大,仍需探索。Objective To explore the effect of implementing teaching bed and teaching outpatient operation on surgical skill training of resident doctors who received standardized training in surgery.Methods From March to August in 2018,the doctors in 5 pilot departments of the department of surgery in Peking University People's Hospital(about 3 to 8 doctors per department in every month)were selected as the research objects.Teaching beds and teaching outpatient operations were established in 5 pilot departments,and a series of measures were taken to ensure their implementation.Monthly statistics of the number of residents as surgeons were compared with the survey data before the implementation from December 2017 to January 2018.The teaching secretary and resident of the pilot department were interviewed after that.Results Residents in five pilot departments completed 45.3 operations per month on average,which was significantly higher than the 10.7 operations before the implementation of the pilot.The interviews showed that teaching bed and teaching outpatient surgery could increase the opportunities for residents to participate in the operation,but there were many difficulties in the implementation of the project in terms of residents,departments,teachers and management.Conclusions The reform based on teaching bed and teaching outpatient surgery has a positive effect on improving the surgical training for residents in surgery.However,this model of training need more research to overcome barriers in feasibility.

关 键 词：住院医师规范化培训 外科手术技能 教学病床 门诊手术 

分 类 号：R192.3[医药卫生—卫生事业管理] R0[医药卫生—公共卫生与预防医学]