专科医师规范化培训(专培)是住院医师规范化培训(住培)的进阶部分,目前在我国尚处于起步阶段。本研究以北京大学人民医院麻醉科专培基地为例,阐述其设计和实施过程,并通过过程性考核(完成病例数)和终结性考核(客观结构化临床考试)评价培训效果。结果显示,参与培训的学员每人完成病例数为(1 265±137)例,19名(100.0%)学员均达到合格标准;在客观结构化临床考试中,临床思维站评分为(78.39±3.53)分、高级生命支持站评分为(82.91±5.59)分、纤维支气管镜站评分为(93.17±3.68)分、亚专业技能站评分为(92.73±5.05)分,均超过70分,19名学员(100.0%)均达到通过标准。可见,麻醉科专培有利于学员掌握麻醉科的培训内容,提高麻醉科专培教学质量。
The specialist training program is an advanced stage of the standardized resident training program, and it is still in its infancy. This study takes Peking University People′s Hospital anesthesiology training base as an example to explain its design and result, and evaluate the training effect by formative and summative assessment. All 19 trainees who participated in the program passed formative and summative assessments organized by Peking University Health Science Center. The results showed that 19 trainees who participated in the training completed (1 265±137) anesthetic cases, 19 trainees (100.0%) met the qualified standards; in the objective structured clinical examination, the clinical thinking station scored (78.39±3.53) points, the advanced life support station scored (82.91±5.59) points, the fiberoptic bronchoscopy station scored (93.17±3.68) points, and the sub-specialty skill station scored (92.73±5.05) points, all exceeding 70 points, and 19 trainees (100.0%) met the passing standards. The trainee-centered training program focuses on the development of anesthesiology specialists and improves the clinical training quality.
[1] 王婷, 万文慧, 杨迅, 等. 消化内科专科医师规范化培训细则内容研究[J] .中华医学教育杂志,2022,42(3):276-279. DOI: 10.3760/cma.j.cn115259-20210823-01065.
[2] 杨英, 郑丽云, 汪偌宁, 等. 专科医师规范化培训体系建立的探索[J] .中华医学教育杂志,2020,40(6):471-475. DOI: 10.3760/cma.j.cn115259-20200121-00090.
[3] 马量, 张怡然. 美国六年一体化心胸外科专科医师培训体系及其启示[J] .中华医学教育杂志,2022,42(8):765-768. DOI: 10.3760/cma.j.cn115259-20211214-01531.
[4] 赵柏松, 陈茜, 潘永英, 等. 美国小儿麻醉专培体系促进我国专培医师交流能力的应用[J] .继续医学教育,2022,36(5):89-92. DOI: 10.3969/j.issn.1004-6763.2022.05.023.
[5] 闫琦, 张庆芬, 李奕楠, 等. 麻醉专科培训医师对超声引导下神经阻滞技术的掌握情况及对教学的启示[J] .中国高等医学教育,2022,(5):58-59,89. DOI: 10.3969/j.issn.1002-1701.2022.05.026.
[6] 冯越, 冯萌鸽, 王珏. 微课教学应用模式(五)—输出式学习[J] .中国信息技术教育, 2019, (Z4):125-128.
[7] 龚亚红, 王维嘉, 阮侠, 等. 不同年资和不同性别麻醉医师以患者为中心的医患沟通能力的比较[J] .中华麻醉学杂志,2021,41(2):201-206. DOI: 10.3760/cma.j.cn131073.20210107.00218.
[8] 刘宁, 沈艳, 徐颖, 等. 基于重症医学专科医师核心胜任力培养的多元化模拟教学研究[J] .中华医学教育杂志,2022,42(3):272-275. DOI: 10.3760/cma.j.cn115259-20210412-00474.
[9] 中国住院医师培训精英教学医院联盟. 中国住院医师培训精英教学医院联盟住院医师核心胜任力框架共识[J] .协和医学杂志,2022,13(1):17-23. DOI: 10.12290/xhyxzz.2021-0755.
[10] 李香蕊, 胡亚洲. 专科医师模块化培训的实践与思考[J] .中华医学教育杂志,2019,39(7):491-494. DOI: 10.3760/cma.j.issn.1673-677X.2019.07.003.
[11] 王燕萍, 张淑娥, 李庆林, 等. 高等医学院校课程思政实施现状的分析与思考[J] .中华医学教育杂志,2022,42(7):618-622. DOI: 10.3760/cma.j.cn115259-20211213-01521.
[12] 徐志渊, 李济时, 杨利, 等. 临床肿瘤学专科医师培训中基于工作场所评价的应用[J] .中华医学教育杂志,2022,42(5):477-480. DOI: 10.3760/cma.j.cn115259-20210902-01108.
[13] 杨英, 李烨, 汪偌宁, 等. 基于胜任力的专科医师培训考核体系设计与实施[J] .中华医学教育杂志,2020,40(11):849-852. DOI: 10.3760/cma.j.cn115259-20200701-00989.
[14] Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains[J] . Acad Med, 2004,79(10 Suppl):S70-81. DOI: 10.1097/00001888-200410001-00022.
[15] Offiah G, Ekpotu LP, Murphy S, et al. Evaluation of medical student retention of clinical skills following simulation training[J] . BMC Med Educ, 2019,19(1):263. DOI: 10.1186/s12909-019-1663-2.
