目的 分析住院医师规范化培训教学查房中存在的问题,为改进住院医师规范化培训提供参考。方法 选取西南某住院医师规范化培训基地2021年4月至2022年8月93名指导医师的教学查房督导检查结果,采用描述性统计分析并对评估内容进行K-means聚类分析。结果 93名指导医师中,33名(35.5%)医师运用外语词汇不足,24名(25.8%)查房物品准备不足,21名(22.6%)互动不足、时间分配不合理。聚类分析结果显示,具有中级专业技术职称的指导医师教学查房主要存在病例不合适、病情不熟悉、教学能力不足等问题;具有副高级专业技术职称的指导医师主要存在分析检查报告、病历书写点评、引导鉴别诊断和指导诊疗计划方面不足等问题;具有正高级专业技术职称的指导医师主要存在提问与解答不足的问题。结论 住院医师规范化培训教学查房存在的主要问题是运用外语词汇不足,专业技术职称不同的指导医师存在的问题不同,建议分层采用有针对性的措施以提升他们的教学能力。

Objective To analyze the problems of teaching ward round supervision in a standardized training base for residency, and provide reference for improving the teaching quality of the standardized training base for residency. Methods Results of the teaching ward rounds of the 93 supervising physicians in the standardized training base in the southwest China from April 2021 to August 2022 were collected, and descriptive statistical analysis and K-means clustering was used. Results Among the 93 supervising physicians,33(35.5%)supervising physicians were insufficient use of foreign words,24(25.8%)supervising physicians were insufficient item preparation of ward round, and21(22.6%)supervising physicians were insufficient interaction and unreasonable time allocation. It was showed by cluster analysis that the main problems of supervising physicians with intermediate titles were inappropriate clinical cases, unfamiliar with the case conditions and insufficient teaching ability; the problems of the supervising physicians with associate senior titles were mainly in the deficiencies of analysis the examination report, writing comments on medical records, guiding differential diagnosis and treatment plan; the main problems of supervising physicians with senior titles were insufficient questions & answers. Conclusions The main problems in the teaching ward round supervision for residency standardized training included insufficient use of foreign words, insufficient item preparation of ward round, and insufficient interaction and unreasonable time allocation. There were different problems in supervising physicians with different titles. It was suggested that targeted measures should be adopted to improve their teaching ability at different levels.