科研和临床思维训练一体化模式在住院医师规范化培训中的实践与思考——以心血管疾病案例报道撰写为例  

Practice and reflection on the integrated mode of scientific research and clinical thinking training in the standardized training of residents:Taking case report writing of cardiovascular disease as an example

作　　者：李国良[1] 赵长缨 党珮珠 LI Guoliang;ZHAO Changying;DANG Peizhu(The First Affiliated Hospital of Xi’an Jiaotong University Department of Cardiovascular Medicine,Xi’an 710061,China;The First Affiliated Hospital of Xi’an Jiaotong University Department of Cardiovascular Surgery,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院心血管内科,西安710061 [2]西安交通大学第一附属医院心血管外科,西安710061

出　　处：《中国医学教育技术》2025年第2期268-273,共6页China Medical Education Technology

摘　　要：传统的住院医师规范化培训模式多聚焦于临床基础理论与实践技能的训练,而对科研思维在岗位胜任力方面的重要价值关注较少。基于此,本研究探讨了基于病例报道撰写的科研和临床思维训练一体化模式在住院医师规范化培训中的应用价值。本研究为回顾性队列研究,根据规培医师培训期间实际接受的培训模式,将其分为新模式组(n=7)和传统模式组(n=10)。新模式组接受基于病例报道撰写的科研及临床思维一体化训练模式,而传统模式组采用传统培训模式,分析两组医师的规培考核合格率及发表科研论文数量,并通过不记名问卷调查评估两种培训模式的主观体验。结果显示,在规培考核方面,新模式组和传统模式组的规培考核合格率均为100%,新模式组与传统模式组[(450.3±20.5)分vs.(448.7±22.1)分,t=0.153,P=0.882]的成绩差异无统计学意义;新模式组的科研论文产出量优于传统模式组[(3.4±1.8)篇vs.(0.9±0.3)篇,t=3.639,P=0.002];新模式组85%以上的成员认为,新训练模式可提高自身对临床及科研的兴趣,增强自主学习能力,并培养临床思维。基于病例报道撰写的科研和临床思维训练一体化模式显著提高了规培医师对科学研究探索的主观能动性及创新性。The traditional standardized training mode for residents focuses on the training of basic clinical theories and practical skills,and pays less attention to the important value of scientific thinking in terms of job competence.Based on this situation,this study is intended to explore the appli-cation value of an integrated mode of scientific research and clinical thinking training based on case re-port writing in the standardized training of residents.This study employed a retrospective cohort de-sign,dividing resident physicians into the new mode group(n=7)and the control group(n=10)based on the training mode they received during their residency program.The new mode group underwent an integrated training mode combining scientific research and clinical reasoning through case report writ-ing,while the control group followed the traditional training mode.The qualification rates for stan-dardized training and the number of research papers published by the two groups were analyzed.Addi-tionally,an anonymous survey was conducted to evaluate the subjective experience of the new training mode.Results showed that both groups achieved 100%qualification rate in the standardized training.There was no significant statistical difference in scores between the new mode group and the control group(450.3±20.5 vs.448.7±22.1,t=0.153,P=0.882).However,the new mode group produced significantly more research papers compared to the control group(3.4±1.8 vs.0.9±0.3,t=3.639,P=0.002).More than 85%of the students in the new mode group thought that the new training mode could improve their interest in clinical and scientific research,enhance their independent learning abil-ity,and cultivate clinical thinking.Integrated mode of scientific research and clinical thinking training based on case report writing can significantly improve the subjective initiative and innovation of physi-cians in training to explore scientific research.

关 键 词：案例报道 科研训练 临床思维 住院医师规范化培训 

分 类 号：G642.0[文化科学—高等教育学]