目的 研究内科住院医师规范化培训(以下简称住培)基地指导医师教学查房培训的效果,为改进教学查房提供参考。方法 2020年6月选取中山大学附属第三医院内科专业基地的38名指导医师为研究对象,对其进行大班授课式的教学查房培训,统计培训后不同时段教学督导对他们教学查房的评分,并采用t检验和单因素方差分析对评价结果进行分析。结果 通过培训,2020至2022年,教学督导对指导医师教学查房的评分总分分别为(76.84±7.83)分、(78.89±6.74)分、(82.83±5.10)分,“培养住院医师教学能力”项目评分分别为(3.05±1.00)分、(3.78±0.67)分、(4.08±0.51)分,“指导住院医师读片和分析各种报告单,并提出自己的见解和诊疗思路”项目的评分分别为(3.62±0.64)分、(3.89±0.61)分、(4.17±0.72)分,其差异均具有统计学意义(均P<0.05);“结合病例,联系理论基础,讲解疑难问题和介绍医学的新进展”项目的评分分别为(3.97±0.50)分、(3.89±0.33)分、(3.75±0.75)分,“能够结合病例有层次地对住院医师进行提问,培养住院医师思考问题的深度和广度,训练住院医师思维能力”项目的评分分别为(3.70±0.62)分、(4.00±0.50)分、(3.92±0.67)分,其差异均无统计学意义(均P>0.05)。结论 教学查房培训可以在一定程度上提高内科住培指导医师的教学查房能力,但对于教学查房的具体项目培训效果有所不同,需要采用不同的有针对性的培训方式加以改进。

Objective To analyze the effectiveness of physicians' training in teaching ward rounds at internal medicine residency training base, and inform future improvement in the quality of teaching ward rounds. Methods In June 2020, 38 physicians from the internal medicine residency training base at The Third Affiliated Hospital of Sun Yat-Sen University were selected as study subjects. They received large-group teaching ward rounds training, and their supervisory evaluation scores during different periods were collected. T-test and one-way analysis of variance (ANOVA) methods were used for analysis. Results Through teaching rounds training, from 2020 to 2022, the total scores of supervisory evaluation were (76.84 ± 7.83), (78.89 ± 6.74), and (82.83 ± 5.10), respectively; the scores for ″cultivating residents' teaching ability″ were (3.05±1.00), (3.78±0.67) and (4.08±0.51), respectively; the scoresfor ″guide residents in reviewing medical images and analyzing various reports, encouraging them to present their own insights and diagnostic approaches″ were (3.62±0.64), (3.89±0.61) and (4.17±0.72), respectively; and there were statistical differences (all P<0.05). The scores for″linking clinical cases to theoretical foundations, address challenging issues and introduce new advancements in field of medicine″ were (3.97±0.50), (3.89±0.33), and (3.75±0.75), respectively; the scores for″pose systematical question integrated with case studies to residents, fostering both depth and breadth in problem-solving skills, nurturing their ability to think critically and comprehensively″ were (3.70±0.62), (4.00±0.50), and (3.92±0.67), respectively; and there were no statistical differences (all P>0.05). Conclusions Training for teaching ward rounds can improve the abilities of teaching ward rounds for instructors at internal medicine residency training base to some extent. However, the training effectiveness for specific components of teaching ward rounds varies, requiring the adoption of different targeted training methods.