风湿免疫科进修医师临床规范化培训模式初探  

Probe into the clinical standardized training mode for refresher physicians in Rheumatic Immunology Department

作　　者：张上珠 李清扬 李海龙 苏金梅 李梦涛 张文 曾小峰 ZHANG Shangzhu;LI Qingyang;LI Hailong;SU Jinmei;LI Mengtao;ZHANG Wen;ZENG Xiaofeng(Department of Rheumatology and Clinical Immunology,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Ministry of Science&Technology,State Key Laboratory of Complex Severe and Rare Diseases,Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,CAMS&PUMC,Beijing 100730,China;Department of Clinical Nutrition,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、北京协和医院风湿免疫科、国家皮肤与免疫疾病临床医学研究中心(NCRC-DID)疑难重症及罕见病国家重点实验室、风湿免疫病学教育部重点实验室,北京100730 [2]中国医学科学院、北京协和医学院、北京协和医院临床营养科,北京100730

出　　处：《基础医学与临床》2023年第3期519-522,共4页Basic and Clinical Medicine

基　　金：中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-005);北京协和医学院2022年教学质量工程项目(探究病房教学新模式2022zlgc0713)。

摘　　要：目的评估北京协和医院风湿免疫科临床进修医师培训效果,探索风湿免疫科临床进修医师规范化培训模式。方法2021年9月北京协和医院风湿免疫科23名以中级为主的进修医师,参加多场景全面培训体系,包括门诊导师制带教,病房疑难危重症案例式教学,和进修医师专科讲课,多学科讲座。经过6个月的培训,进修医师完成问卷调查。问卷内容包括医疗、科研、教学形式、进修时间4个方面,设为10道选择题和3道填空题。结果进行描述性分析。结果经过6个月多场景全面培训体系的培训,进修医师自我评估,较进修前,医疗水平平均提高55.7%,科研能力平均提高50%。诊疗规范提高的平均值为60.9%,诊疗能力提高的平均值为53.5%。疑难病例诊疗水平提高的平均值为53.0%。少见病诊疗水平提高的平均值为50.4%。65.25%认为学习收获最大的是门诊,其次是病房和进修医师讲课。56.5%进修医师认为最佳进修时间为12个月。结论门诊导师制带教,病房疑难病例案例式教学,和进修医师专科讲课,多学科讲座结合的多场景全面培训体系对于培训风湿免疫科进修医师是有效的。Objective To evaluate the training outcomes of refresher physicians in Department of Rheumatic Immunology,Peking Union Medical College Hospital,and to explore the standardized training mode.Methods In September 2021,twenty three intermediate-level refresher physicians from the Department of Rheumatology and Immunology,Peking Union Medical College Hospital participated in a comprehensive multi-scene training program includingoutpatient tutorials,case-based teaching of difficult and critical cases in wards,specialist lectures and multi-disciplinary lectures.After six months of training,the refresher physicians completed a questionnaire survey covering medical care,scientific research,teaching format,and advanced training duration,with 10 multiple-choice questions and 3 fill-in-the-blank questions.The results were analyzed descriptively.Results After six months of training in a multi-scene comprehensive training program,as shown by the results of the self-assessment by the trainees,the clinical skills and scientific research capacity improved by 55.7%and 50%respectively as compared to the pre-training period.The average improvement of standardized diagnosis and treatment was 60.9%,and the average improvement of diagnosis and treatment skills was 53.5%.The average improvement in the diagnosis and treatment level of difficult cases was 53.0%.The average improvement in the diagnosis and treatment level of rare diseases was 50.4%.There were 65.25%of the refresher physicians believed that the most rewarding learning was in the outpatient clinics,followed by discussion of difficult cases in wards and lectures by the fellowship physicians.56.5%of the refresher physicians felt that the optimal duration of the advanced training was 12 months.Conclusions A comprehensive training system combining outpatient tutorials,case-based training of difficult cases in the ward,specialized lectures and multidisciplinary lectures for advanced refresher physicians is effective for training rheumatologists.

关 键 词：风湿免疫学 医学继续教育 进修医师 规范化培训 教学方法 

分 类 号：R593[医药卫生—内科学]