住院医师临床伦理学认知现状与培训需求调查  

Current situation of clinical ethics cognition and training needs of resident doctors

作　　者：李宗师 白琼[2] LI Zongshi;BAI Qiong(Department of Cardiology,Peking University Third Hospital,Beijing100191,China;Department of Nephrology,Peking University Third Hospital,Beijing100191,China)

机构地区：[1]北京大学第三医院心血管内科,北京100191 [2]北京大学第三医院肾内科,北京100191

出　　处：《中国医药导报》2025年第5期87-90,共4页China Medical Herald

基　　金：北京大学第三医院教学研究专项课题(2020 bysyzxkt02)。

摘　　要：目的调查住院医师对临床伦理学的认知及培训需求,探索针对住院医师的临床伦理学的培训模式。方法选取2020年1月至2021年12月在北京大学第三医院内科轮转的112名住院医师进行调查,调查内容包括住院医师的一般信息、既往接受伦理学培训情况、对医学伦理学的了解程度、对临床伦理学的重视程度、临床工作中面临的伦理学冲突频率、临床伦理学培训的意愿和需求;同时,通过1例存在伦理学冲突的病例,评估住院医师解决临床工作中伦理学问题的能力。结果所有调查对象既往均曾参加医学伦理学培训,住院医师对医学伦理学了解程度评分为(3.70±0.54)分。在面对患者偏好与治疗方案冲突时,住院医师对患者偏好的重视程度评分为(2.86±0.92)分。随着住院医师年级的增加,对医学伦理学的重视程度、工作中面临的伦理学冲突频率增加。超过80%的住院医师表示愿意参加临床伦理学培训,培训内容中知情同意、患者偏好和临床适应证是住院医师感兴趣的主题。培训形式采用网络平台梳理理论知识,以小组为单位的案例讨论,受到住院医师的普遍欢迎。结论住院医师对临床工作中伦理学问题的认识不足,在临床工作中应用临床伦理学解决临床困境的能力存在不足。在住院医师规范化培训阶段开展临床伦理学培训,帮助住院医师提高分析和解决临床困境的能力,形成以患者为中心的诊疗模式,积极应对患者多方面的需求,是临床教学的重点。Objective To investigate the awareness and training needs of resident doctors in clinical ethics,and to explore the training model of clinical ethics for resident doctors.Methods A total of 112 resident doctors rotating in the Department of internal medicine of Peking University Third Hospital from January 2020 to December 2021 were selected for investigation.The contents of the survey include the general information of resident doctors,the past receiving ethics training,the understanding of medical ethics,the importance of clinical ethics,the frequency of ethical conflicts in clinical work,and the willingness and demand for clinical ethics training;at the same time,through a case of ethical conflict,the ability of resident doctors to solve ethical problems in clinical work was evaluated.Results All the resident doctors had participated in medical ethics training in the past,and the score of understanding of resident doctors medical ethics was(3.70±0.54)points.In the face of the conflict between patient preference and treatment plan,the score of importance of resident doctors clinical ethics was(2.86±0.92)points.With the increase of the grade of resident doctors,the importance of clinical ethics,the frequency of ethical conflicts in clinical work increase.More than 80%of resident doctors expressed willingness to participate in clinical ethics training,with informed consent,patient preferences,and medical indications among the subjects of interest to resident doctors.Network platform to sort out theoretical knowledge,combined with group-based case discussions to carry out clinical ethics training was generally welcomed.Conclusion Resident doctors have insufficient ability to identify and deal with clinical ethical conflicts in clinical practice and their ability to apply clinical ethics in clinical work to solve clinical dilemmas is insufficient.It is the focus of clinical teaching to carry out clinical ethics training in the standardized training stage of resident doctors,help resident doctors improve their abi

关 键 词：住院医师 伦理学培训 培训需求 

分 类 号：G64[文化科学—高等教育学]