外科住培医师职业认同感及自主学习能力的分析与思考  

Analysis and Reflection on the Professional Identity and Self-Directed Learning Ability in the Standardized Training of Surgical Residents

作　　者：刘骅[1] 钱昌林[1] 邱伟箐[1] 刘颖斌 田红 赵恩昊[3,4] LIU Hua;QIAN Changlin;QIU Weiqing;LIU Yingbin;TIAN Hong;ZHAO Enhao(Department of Biliary and Pancreatic Surgery,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Secretariat,Shanghai Medical Doctor Association,Shanghai 200040,China;Department of Gastroenterology,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Surgery,Renji Clinical Medical College Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院胆胰外科,上海200127 [2]上海市医师协会秘书处,上海200040 [3]上海交通大学医学院附属仁济医院胃肠外科,上海200127 [4]上海交通大学医学院仁济临床医学院外科教研室,上海200127

出　　处：《中国继续医学教育》2024年第22期151-156,共6页China Continuing Medical Education

摘　　要：目的调查外科住培医师职业认同感及自主学习能力,分析存在问题和影响因素,为完善外科住院医师住培制度、增强培训效果提供参考。方法通过自制职业认同感和自主学习能力调查量表,结合抽样访谈,选取2020年7月—2022年12月在上海交通大学医学院附属仁济医院参加外科住院医师规范化培训的医师共计52名进行问卷调查,调查外科住培医师基本情况(性别、年龄、住培实践、学历学位、薪酬收入等)、职业认同感(职业认同、工作压力、社会支持、医患关系)、自主学习能力(学习环境、实践操作、科研培训)。结果住培医师对职业认同感总体评分为(2.85±0.37)分,体现了对职业的基本认同,且能得到较好的社会支持,同时医患关系紧张和高强度、高风险的工作性质对职业信心有一定影响。尤其第3年住培医师总体评分偏低,工作压力更大。住培医师普遍认为培养自主学习能力很重要,总体评分为(3.62±0.38)分,但在与指导教师良好互动、带教老师实践操作培养放手方面仍有提升空间。第3年住培医师认为实践操作机会更多;相较招录住院医师,研究生在科研培训上评分更高,差异均有统计学意义,P<0.05。结论外科住培医师是培养合格临床外科医师的必经阶段,教学管理部门要完善顶层结构设计,轮转科室、带教老师合理编排培训课程,关注培训对象日常工作、学习及心理状况,可以帮助外科住培医师增强职业认同感、提高自主学习能力,为进入后续专科化培训及未来职业发展奠定扎实基础。Objective To investigate the professional identity and self-learning ability of surgical residents,and to analyze the existing problems and influencing factors in order to provide reference for improving the standardized training system of surgical residents.Methods From July 2020 to December 2022,a total of 52 surgical residents who participated in the standardized training in Renji Hospital were selected.Through self-made professional identity and self-learning ability questionnaire,a survey was conducted.The survey focused on the following 3 aspects including fundamental state of surgical residents(sex,age,training practice,educational background and academic degree,compensation income etc.),professional identity(professional confidence,work pressure,social support and doctor-patient relationships)and the analysis of selflearning ability(learning environment,practical operations and scientific research training).Results The overall score of the professional identity was(2.85±0.37)points,which reflected the basic identity of the profession and better social support.At the same time,tense doctor-patient relationship and high-intensity and high-risk work had a certain impact on professional confidence.The overall score of the surgical residents in the third year was lower with greater work pressure.They generally believed that it was important to cultivate the self-learning ability and the overall score was(3.62±0.38)points.However,there was still room for improvement in terms of good interaction with the tutors.The surgical residents in the third year believed that they had more opportunities for practice while graduate students scored higher in scientific research training compared with the residents and the differences were statistically significant.Conclusion Standardized surgical residency training is a necessary stage for training qualified clinical surgeons.The educational management department must improve the toplevel structure design while clinical departments and tutors should reasonably arrange trai

关 键 词：住院医师规范化培训 外科住院医师 毕业后教育 职业认同感 自主学习能力 影响因素 管理策略 

分 类 号：G642[文化科学—高等教育学]