目的 了解武汉大学中南医院住院医师岗位胜任力现状,为提升住院医师岗位胜任力提供参考。方法 2022年采用问卷调查方法,针对2021年参加住院医师规范化培训的185名住院医师的岗位胜任力,分别于入职时和培训半年后进行自评和责任导师评价。对评价结果进行配对样本t检验和单因素方差分析。结果 培训半年后住院医师自评和责任导师评价结果与入院时相比均有所提升,如在职业精神指标方面,住院医师自评分为(4.31±0.76)分,高于入院时的(3.87±0.95)分;责任导师评分为(4.70±0.50)分,高于入院时的(4.54±0.65)分,其差异均具有统计学意义(均P＜0.001)。培训半年后,住院医师职业精神的自评分数最高[(4.31±0.76)分],医疗体系自评分数最低[(3.15±1.07)分]。培训半年后,不同身份类型住院医师岗位胜任力自评结果差异均无统计学意义(均P＞0.05),如面向社会招收的住院医师、外单位委托培养的住院医师、临床医学硕士专业学位研究生和本单位住院医师的职业精神自评结果分别为(4.30±0.75))分、(4.28±0.80)分、(4.29±0.77)分、(4.46±0.71)分。结论 住院医师规范化培训能够提升住院医师岗位胜任力,但住院医师在医疗体系、患者管理、学术等方面均有待进一步提升。后期将增加督导、同行、患者评价和考核成绩等,以实现对住院医师岗位胜任力的全方位评价和分析,切实提升住院医师岗位胜任力。

Objective To explore the status of standardized residency training in Zhongnan Hospital of Wuhan University with competency-based medical education evaluation system, and to provide suggestions for improving the competency of residents. Methods In 2022, a questionnaire survey was conducted to evaluate the job competency of 185 resident physicians from the 2021 cohort, both at the time of admission and after six months of training. Both self-evaluations and evaluations by tutors were collected. Paired-sample t-tests and one-way ANOVA analysis were performed on the evaluation results. Results After six months of training, both the self-evaluation of the residents and the evaluations by their tutors showed significant improvement compared to their initial admission. For example, in terms of professionalism, the self-evaluation score of the residents increased to (4.31±0.76), higher than the initial score of (3.87±0.95); the evaluation score by tutors was (4.70±0.50), also higher than the initial score of (4.54±0.65), all P<0.001. After six months of training, the self-evaluation score for professionalism among residents was the highest [(4.31±0.76)], while the self-evaluation score for the healthcare system was the lowest [(3.15±1.07)]. Furthermore, after six months of training, there were no statistically significant differences in the self-evaluation results of job competency among resident physicians of different identities (all P>0.05). For instance, the self-evaluation scores for professionalism among residents recruited from society, those under the entrusted training of other institutions, professional master in clinical medicine, and residents within the same institution were (4.30±0.75), (4.28±0.80), (4.29±0.77), and (4.46±0.71), respectively. Conclusions Standardized residency training can improve the competency of residents. But at the same time, the weakness of medical quality assurance system, patient management and academic performance should be strengthened. Therefore, supervision, peer, patient evaluation and assessment results will be increased in the later stage to achieve a comprehensive evaluation and analysis of the residents and improve the residents competency.