目的 研究毕业后医学教育国际认证对以胜任力导向的住院医师规范化培训的影响。方法 于2017年9月和2021年11月,即北京大学第一医院在2019年获得毕业后医学教育国际认证前后2年,分别对我院负责住院医师规范化培训的指导医师进行胜任力问卷调查,研究认证过程对指导医师胜任力认知水平以及对住院医师培养结果的影响。率的比较采用χ²检验。结果 本研究2017年纳入有效问卷348份,2019年纳入有效问卷196份。结果显示,经过认证后,指导医师胜任力指标的领导者、健康倡导者、学者3种角色达标率均有较大提高,其中:选择能够在临床实践中展现领导力由265人(76.1%)到183人(93.4%),能够促进患者、社区和人群健康由283人(81.3%)到188人(95.9%),促进医学知识的发展和传播由306人(87.9%)到190人(96.9%),差异均具有统计学意义(均P<0.05)。在住院医师培训效果评价方面,指导医师对住院医师的医学专家、领导者、健康倡导者3种角色的评价(达标率)均有较大提高,其中,选择合理运用预防和治疗措施由268人(77.0%)到173人(88.3%),能够在临床实践中展现领导力由220人(63.2%)到143人(73.0%),能够促进患者、社区和人群健康由246人(70.7%)到162人(82.7%),差异均具有统计学意义(均P<0.05)。结论 毕业后医学教育国际认证有助于提高指导医师的教学能力和住院医师的胜任力评价,促进了住院医师规范化培训质量的提高。

Objective To study the impact of international certification of medical education after graduation on the competency-based training of residents. Methods In September 2017 and November 2021, that is, two years before and after the Peking University First Hospital obtained the international certification of post-graduate medical education in 2019, a competency questionnaire survey was conducted for the guidance physicians responsible for the standardized training of residents in hospital, to study the impact of the certification process on the cognitive level of the guidance physicians' competency and the training results of residents. The data of rates were compared by Chi-square test. Results This study included 348 valid questionnaires in 2017 and 196 valid questionnaires in 2019. The results showed that after the certification, the rate of meeting the standards of the three roles of leader, health advocate and scholar who guide the competency indicators of doctors has been greatly improved, among which, the selection of leadership that can be demonstrated in clinical practice has increased from 265 (76.1%) to 183 (93.4%), the promotion of the health of patients, communities and people from 283 (81.3%) to 188 (95.9%), and the promotion of the development and dissemination of medical knowledge from 306 (87.9%) to 190 (96.9%), all P<0.05. In terms of the evaluation of resident training effect, the evaluation of the guidance physician on the three roles of resident medical experts, leaders and health advocates has been greatly improved. Among them, the selection and reasonable use of prevention and treatment measures has increased from 268 (77.0%) to 173 (88.3%), and the ability to demonstrate leadership in clinical practice has increased from 220 (63.2%) to 143 (73.0%), which can promote the health of patients, communities and people was from 246 (70.7%) to 162 (82.7%), all P<0.05. Conclusions The international certification of medical education after graduation is helpful to improve the teaching ability of doctors and the competency evaluation of residents, and promote the quality of standardized training of residents.