住院医师规范化培训轮转科室质量监管的关键环节及改进实践  

Key links and improvement practices in the quality supervision of rotation departments in standardized training for resident physicians

作　　者：刘春燕 黎尚荣[2] 常江沂 杜玉梅 姚瑶[2] Liu Chunyan;Li Shangrong;Chang Jiangyi;Du Yumei;Yao Yao(Research and Teaching Department,Shenzhen People's Hospital(the Second Clinical Medical College Jinan University,the First Affiliated Hospital,Southern University of Scienceand Technology),Shenzhen 518020,Guangdong,China;Continuing Education Section,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,Guangdong,China)

机构地区：[1]深圳市人民医院(暨南大学第二临床医学院,南方科技大学第一附属医院)科研教学部,广东深圳518020 [2]中山大学附属第三医院教学部,广东广州510630

出　　处：《中国毕业后医学教育》2025年第3期165-169,共5页Chinese Journal of Graduate Medical Education

摘　　要：目的住院医师规范化培训(简称住培)轮转科室的管理是影响住培质量和专业基地评估结果的重要环节,但现阶段存在培养要求和数量相差大、管理效果参差不齐等问题,需进一步明确其监管环节和监管要点。方法基于住培全面质量管理理念,找出入科环节、临床实践环节和出科环节等3个影响轮转科室监管质量的关键环节,明确各关键环节的监管要点,并从制度保障、实施流程、质量控制、结果应用4个维度落实质量控制,比较控制措施实施前后的质量提升效果。结果经过质量监管,入科教育率达到100.00%;住院医师的医院信息系统个人账号日常使用率从65.06%提升至85.97%(χ^(2)=80.33,P<0.01),独立值班率从55.09%提升至66.18%(χ^(2)=6.52,P<0.05);出科当月平均应考率从33.85%提高至96.14%(χ^(2)=283.55,P<0.001)。结论明确轮转科室住培质量监管的关键环节和监管要点,采取针对性的改进措施,能够提高轮转科室住培管理内涵质量。Objective The management of rotation departments in residency training is a crucial component that impacts the quality of resident training and the assessment results of professional bases.However,at the current stage,there are some issues such as a large discrepancy between training requirements and numbers,and uneven management effectiveness.This study was aimed to further clarify its regulatory links and key points.Methods This study was based on the concept of total quality management,identifying three key links affecting the quality of supervision:the entry phase,the clinical practice phase,and the exit phase,with clear supervisory points defined for each link.It elaborated on how to implement quality control for each key link from four dimensions:institutional guarantee,implementation process,quality control,and application of results.The quality improvement effects before and after the implementation of control measures were compared.Results Through regulatory practice,the rate of department entry education reached 100%.The daily usage rate of individual accounts in the Hospital Information System for resident physicians increased from 65.06%to 85.97%(χ^(2)=80.33,P<0.01),and the independent on-call rate increased from 55.09%to 66.18%(χ^(2)=6.52,P<0.05).The average attendance rate in the month of department exit exam improved from 33.85%to 96.14%(χ^(2)=283.55,P<0.01).Conclusion Clarifying the key links and regulatory points for the quality supervision of residential training in rotating departments and taking targeted improvement measures can improve the quality of residential training management in rotating departments.

关 键 词：住院医师规范化培训 轮转科室 质量监管 

分 类 号：G40-034[文化科学—教育学原理] R4[文化科学—教育学]