中华医学教育杂志 ›› 2026, Vol. 46 ›› Issue (6): 464-470.DOI: 10.3760/cma.j.cn115259-20250728-00839

• 住院医师规范化培训 • 上一篇    下一篇

基于住培学员视角的儿科住院医师儿童青少年精神病学培训现状与需求研究

李冬凉1, 董璐2, 李萍萍2   

  1. 1转化医学国家科学中心(上海),上海 200240;
    2上海交通大学医学院附属上海儿童医学中心儿科临床医学院,上海 200127
  • 收稿日期:2025-07-28 出版日期:2026-06-01 发布日期:2026-05-28
  • 通讯作者: 李萍萍, Email: lpp1213@126.com
  • 基金资助:
    上海市教育科学研究一般项目(C2025213);中央高校基本科研业务费上海交通大学科技发展研究基金资助项目(24X010300923);上海交通大学文科科研创新培育项目(WKCX2019)

Current status and demand of pediatric and adolescent psychiatry training for pediatric residents from the perspective of trainees

Li Dongliang1, Dong Lu2, Li Pingping2   

  1. 1National Center for Translational Medicine (Shanghai), Shanghai 200240, China;
    2Pediatric Clinical College, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2025-07-28 Online:2026-06-01 Published:2026-05-28
  • Contact: Li Pingping, Email: lpp1213@126.com
  • Supported by:
    Shanghai Education Science Research General Project (C2025213); The Fundamental Research Funds for the Central Universities, and the Science and Technology Development Research Fund of Shanghai Jiao Tong University (24X010300923); Humanities and Social Sciences Research Innovation Incubation Program of Shanghai Jiao Tong University (WKCX2019)

摘要: 目的 基于住院医师规范化培训(简称住培)学员视角,初步评估儿科住培学员的儿童青少年精神病学培训现状,分析临床需求与培训缺口,为完善住院医师规范化培训体系提供参考。方法 采用问卷调查方法。2025年5月,采用方便抽样方法选取上海交通大学医学院3家住培基地的儿科、儿外科共154名住培学员为调查对象。问卷在参考国内外相关文献和住培大纲的基础上,经儿科、精神科和医学教育学专家咨询修订形成。问卷内容包括住培学员一般资料、儿童青少年精神病相关培训现状及其需求。采用卡方检验、t检验分析相关数据。结果 154名住培学员中,70.8%(109/154)的住培学员在轮转中遇到过儿童青少年精神心理障碍患者,第二年和第三年住培学员的接触比例更高。仅有21.4%(33/154)的住培学员接受过相关培训,且以理论授课为主[78.8%(26/33)]。58.4%(90/154)的住培学员接诊时感到压力,本科及以下学历住培学员的压力感受比例高于研究生学历的住培学员[67.2%(45/67)比51.7%(45/87)];女性住培学员的压力程度高于男性住培学员[(3.45±0.76)分比(2.92±0.86)分],其差异均具有统计学意义(均P<0.05)。88.3%(136/154)的住培学员认为需要增加儿童青少年精神心理障碍知识的培训,第二年和第三年住培学员的培训需求高于第一年住培学员,差异具有统计学意义(P=0.025)。在各种培训形式中,住培学员最认可的培训形式为“门诊/病房跟诊”[(3.73±0.96)分]。不同专业住培学员对培训形式需求存在差异:儿科专业住培学员更倾向于新增轮转[36.0%(40/111)]或“轮转+课程”[38.7%(43/111)],而儿外科专业住培学员则更倾向于在现有教学中增加相关内容[46.5%(20/43)],其差异具有统计学意义(P=0.035)。结论 儿科住培体系在儿童青少年精神病学领域存在明显不足:系统培训覆盖率较低,但住培学员在临床接触儿童青少年精神心理障碍患者的比例较高;大多数住培学员在接诊时感到信心不足与压力,对儿童青少年精神病学的住培需求较高。因此,建议在培训体系中系统融入儿童青少年常见精神障碍的识别、初步处理与转诊等核心知识与实践技能相关教学内容,并基于住培学员的年资与专业差异,建立分层递进的培训路径,同时强化临床实践与多学科协作,以期系统性提升儿科住培学员对常见儿童青少年精神心理障碍的识别、初步处理与规范转诊能力。

关键词: 儿科学, 住院医师规范化培训, 儿童青少年精神病学, 培训需求

Abstract: Objective From the perspective of standardized residency training (SRT) trainees, this study preliminarily aims to assess the current status of standardized child and adolescent psychiatry training for pediatric residents, analyze clinical needs and training gaps, so as to inform the improvement of the SRT system. Methods A questionnaire survey was conducted in May 2025 among pediatric and pediatric surgery residents from three SRT bases affiliated with Shanghai Jiao Tong University School of Medicine, selected by convenience sampling. The questionnaire was developed based on a review of domestic and international literature and SRT syllabi, and revised after consultation with experts in pediatrics, psychiatry, and medical education. It covered residents' general information, current training status, and needs regarding child and adolescent psychiatry. Data were analyzed using the chi-square test and t-test. Results A total of 154 residents participated in the study. A majority of 70.8% (109/154) residents had encountered children or adolescents with mental disorders during rotations, with higher exposure rates among second- and third-year trainees. Nevertheless, only 21.4% (33/154) had received relevant training, primarily through lectures (78.8%, 26/33), and 58.4% (90/154) felt stressed when managing such patients. The proportion reporting stress was higher among residents with a bachelor's degree or below (67.2%, 45/67) compared to those with postgraduate degrees (51.7%, 45/87), and stress levels were higher among female residents (3.45±0.76) than male residents (2.92±0.86), all P<0.05. In addition, 88.3% (136/154) believed that training in child and adolescent mental health knowledge should be increased, with second- and third-year trainees expressing stronger demand than first-year trainees (P=0.025). Among various training formats, ″outpatient/ward follow-up″ received the highest recognition score (3.73±0.96). Training needs differed by specialty: pediatric residents more frequently preferred adding new rotations [36.0%(40/111)] or ″rotations plus courses″ [38.7%(43/111)], while pediatric surgery residents were more inclined to enhance content within the existing curriculum [46.5%(20/43)], P=0.035. Conclusions This survey reveals significant deficiencies in child and adolescent psychiatry within the current pediatric SRT system: the coverage rate of systematic training is low, but the proportion of clinical contact with children and adolescents with mental and psychological disorders is high. Most resident physicians feel a lack of confidence and pressure when consulting such patients, and there is a high demand for residential training in child and adolescent psychiatry. Therefore, it is recommended to systematically integrate core knowledge and practical skills-such as the identification, initial management, and referral of common child and adolescent mental disorders—into the training curriculum. A tiered and progressive training pathway should be established based on trainees' seniority and specialty differences, coupled with strengthened clinical practice and multidisciplinary collaboration, to systematically enhance pediatric residents' competencies in recognizing, initially managing, and appropriately referring common child and adolescent mental health disorders.

Key words: Pediatrics, Standardized residency training, Child and adolescent psychiatry, Training needs

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