中国眼科的住院医师外科手术带教现状调查及分析  

Current situation investigation and analysis of surgical teaching for residents of Chinese ophthalmology

作　　者：陈迪[1] 于伟泓[1] 张潇[1] 高斐[1] 吴婵[1] 陈欢[1] 张美芬[1] CHEN Di;YU Wei-hong;ZHANG Xiao;GAO Fei;WU Chan;CHEN Huan;ZHANG Mei-fen(Department of Ophthalmology, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院眼科,北京100730

出　　处：《基础医学与临床》2021年第7期1076-1080,共5页Basic and Clinical Medicine

基　　金：北京协和医学院小规模特色办学教学改革项目(10023201501003);北京协和医学院研究生教育教学改革项目(10023201900110)。

摘　　要：目的调查目前中国眼科的住院医师手术带教现状。方法对全国部分眼科教学医院、规范化培训基地的眼科主治及以上职称医师进行随机调查问卷,收集手术带教情况及难度分级。结果共有238名眼科医师参与调查问卷,其中194名开展手术带教(占比81.51%),白内障类手术是最常带教的手术类型(占比51.03%);住院医师在整个培训阶段可以观摩的手术台数中位数(4分位数间距)为135(450)台,可部分完成的台数为30(50)台,可全部独立完成的台数为5(19)台。带教老师认为较难的3项工作依次为:建立一个好的Wet Lab项目、避免在手术带教过程中发生并发症和手术带教本身,其占比分别为56.19%,51.55%和50.52%;比例最高的“非常困难”问题是向患者交代手术步骤中有住院医师的参与(占比36.60%);带教最难的步骤是白内障手术中的劈核。结论目前中国眼科的住院医师手术带教已普遍开展,但仍然面临诸多困难,由住院医师独立完成的手术例数较少。Objective To investigate the current situation of surgical teaching for residents of Chinese ophthalmology.Methods Questionnaires were collected from ophthalmology teaching hospitals and standardized training centers across China.Results A total of 238 ophthalmologists were enrolled,of which 194(81.51%)participated in surgical teaching.Cataract surgery was most frequently taught(51.03%).The median number(interquartile range)of surgical operation that residents were scheduled to observe was 135(450),the number of operations that residents performed at some steps was 30(50),and the number of surgical operation that residents may perform independently was 5(19).The three tasks that teachers considered most difficult were to establish a good Wet Lab program(56.19%),the prevention of complications(51.55%)and the overall work of surgical teaching(50.52%).The response with the highest proportion of“very difficult”was to convince patients about the involvement of residents in the treatment(36.60%).The most difficult step in cataract surgery teaching was nucleus fragmentation.Conclusions Although residents'surgical training is widely carried out in China,many difficulties still exist.The number of the operation that can independently be completed by the residents is relatively low.

关 键 词：眼科 手术带教 住院医师规范化培训 问卷调查 

分 类 号：R779.62[医药卫生—眼科]