中华医学教育杂志

中华医学教育杂志 ›› 2025, Vol. 45 ›› Issue (2): 146-151.DOI: 10.3760/cma.j.cn115259-20240110-00038

• 住院医师规范化培训 • 上一篇    下一篇

广东省住院医师规范化培训基地临床实践保障现状调查与分析

姚瑶1, 陈璐1, 屈琪2, 余京飞1, 吴少林3, 黎尚荣1   

  1. 1中山大学附属第三医院教学部,广州 510630;
    2中山大学附属第三医院医务部,广州 510630;
    3 广东省医师协会,广州 510630
  • 收稿日期:2024-01-10 发布日期:2025-01-25
  • 通讯作者: 黎尚荣, Email: lishangr@mail.sysu.edu.cn
  • 基金资助:
    2022年度教育部产学合作协同育人项目(220901449091156);2023年度广东省临床教学基地教学改革研究项目(2023-32);2022年广东省住院医师规范化培训指令性课题(2022-22)

Investigation and analysis of clinical practice guarantee mechanisms in standardized training base for residents in Guangdong Province

Yao Yao1 , Chen Lu1, Qu Qi2, Yu Jingfei1, Wu Shaolin3, Li Shangrong1   

  1. 1Department of Education, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China;
    2Department of Medical Management, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China;
    3Guangdong Medical Association, Guangzhou 510630, China
  • Received:2024-01-10 Published:2025-01-25
  • Contact: Li Shangrong, Email: lishangr@mail.sysu.edu.cn
  • Supported by:
    2022 Ministry of Education Industry-University Cooperation Collaborative Education Project (220901449091156); 2023 Guangdong Province Clinical Teaching Base Teaching Reform Research Project (2023-32); A Mandatory Subject for the Standardized Training of Resident Doctors in Guangdong Province in 2022 (2022-22)

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摘要： 目的 了解广东省住院医师规范化培训基地的临床实践保障机制建立和落实情况,为各级有关部门和培训基地进一步调整住培管理制度和教学方法提供依据。 方法 2023年4至7月选取广东省60家西医培训基地为研究对象,通过问卷调查其临床实践保障制度建设情况、医师资格考试通过情况、执业注册情况、处方权获取情况、临床一线值班情况、医疗系统权限授权情况等,采用非参数检验统计分析不同批次、不同规模、是否高校附属医院等对临床实践保障机制建立和落实的影响。 结果 10家(16.7%)培训基地制定了针对住院医师的临床实践保障制度,60家培训基地全部实现了相应权限的“一人一账号”的医疗系统账号管理。全省通过医师资格考试住院医师占总在培住院医师比例的均值为62.31%,其中第一批次(64.60%)和第二批次(68.80%)培训基地高于第三批次(48.42%),且11~20个专业基地的培训基地该比例(69.15%)、21个及以上的培训基地该比例(63.67%)均高于1~10个专业基地的培训基地(53.82%),其差异均具有统计学意义(均P<0.05)。全省住院医师及时执业注册率为81.02%。附属医院具有处方权住院医师占通过医师资格考试住院医师人数比例(40.70%)低于非附属医院(64.67%),其差异具有统计学意义(P<0.05)。 结论 住院医师规范化培训制度的培训效果已初步显现,但各培训基地临床实践保障机制建设有待进一步加强,特别是及时执业注册、处方权审批和临床一线值班的管理,培训基地临床实践保障的落实仍需法律层面的法规规范、省行政主管部门的制度推进和培训基地针对性的管理改进。

关键词: 问卷调查, 住院医师规范化培训, 培训基地, 临床实践保障, 机制, 落实

Abstract: Objective To understand the establishment and implementation of the clinical practice guarantee mechanisms of the standardized training bases for residents in Guangdong Province, and to provide a basis for the relevant departments and training bases to further adjust the management system and teaching methods of residency training. Methods From April to July 2023, 60 residency training bases in Guangdong Province were enrolled, and the creation of their clinical practice guarantee mechanisms, the passing of physician qualification examination, the registration of practice, the acquisition of prescription right, the clinical frontline duty, and the authorization of healthcare system authority were investigated through questionnaires, and the impact of different batches, different sizes, and whether or not they are affiliated with university hospitals on the establishment and implementation of the clinical practice guarantee mechanisms were statistically analyzed by using non-parametric tests. Results Ten training bases have formulated a clinical practice guarantee system for residents, and all 60 training bases have realized the ″one person, one account″ medical system account management with corresponding authority. Across the province, the percentage of residents who have passed the medical qualification examination out of the total residents in training is 62.31%, with the first batch at 64.60% and the second batch at 68.80%, significantly higher than the third batch at 48.42%, all P<0.05. Furthermore, training bases with 11-20 specialties have a pass rate of 69.15%, and those with 21 or more specialties have a rate of 63.67%, both higher than bases with 1-10 specialties, which have a rate of 53.82%, all P<0.05. Affiliated hospitals have a significantly lower percentage of residents with prescription rights who have passed the medical qualification examination (40.70%) compared to non-affiliated hospitals (64.67%), P<0.05. Conclusions The training effect of the standardized residency training system has initially become evident, but the construction of clinical practice assurance mechanisms at various training bases needs further strengthening. This includes timely professional registration, prescription rights approval, and management of front-line clinical duty. The implementation of clinical practice guarantees at training bases still requires regulatory standardization at the legal level, systemic advancement by provincial administrative authorities, and targeted management improvements at the training bases.

Key words: Questionnaires, Standardized residency training, Training base, Clinical practice guarantee, Mechanism, Implementation

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