目的 了解并轨培养模式下临床医学硕士专业学位研究生(简称专硕)的临床培训和科研能力现状,分析存在的问题,并为优化培养方案提供参考。方法 2022年3月,采用目的抽样方法,对湖南某高校附属医院2020级和2021级专硕进行问卷调查,调查内容包括专硕临床工作时长、带教教师工作态度和教学方法、对住院医师规范化培训(简称住培)体系的评价与反馈、并轨培养对专硕的职业发展及科研能力提升的影响。 采用描述性统计分析相关数据。结果 共回收有效问卷418份。75.6%(316/418)的专硕称每周工作时间超过50小时,导致加班的前3个主要原因是临床诊疗工作[90.4%(378/418)]、病历文书工作[88.3%(369/418)]和科研任务[82.8%(346/418)];54.8%(229/418)的专硕认为临床轮训期间带教教师给予了有效的指导与监督,33.3%(139/418)的专硕称带教教师经常基于循证医学数据进行教学查房;86.1%(360/418)的专硕认同采用360度评估定期对住院医师进行评估反馈,但只有38.5%(161/418)的专硕能够收到其临床轮训时表现的反馈结果;71.3%(298/418)的专硕认为并轨培养对未来的临床医学事业有所帮助,仅有47.1%(197/418)的专硕认为此培养模式对提升科研能力有所帮助。结论 并轨培养模式虽然获得多数专硕认可,但临床培训体系在学业压力、师资水平和住培评价机制等方面需要系统性优化。科研能力作为高素质临床应用型人才的必备能力,亟待强化。
Objective To comprehend the present status of clinical training and research capabilities among clinical medical master's degree students operating within a concurrent training model, it is imperative to undertake a thorough analysis of the prevailing challenges and to formulate recommendations and insights that will facilitate the enhancement of the training programme. Methods A questionnaire survey was conducted in March 2022 on second- and third-year postgraduate students of a clinical masters degree in medicine at certain hospital affiliated with a university in Hunan, China. The survey encompassed the clinical working hours of postgraduate students, the work attitude and teaching methods of lead instructors, the evaluation and feedback on the residency system, and the impact of concurrent training on career development in specialised masters degrees and on the enhancement of scientific research ability. Descriptive statistics were used to analyze relevant data. Results A total of 418 valid questionnaires were collected. Furthermore, 75.6%(316/418) of the students reported working in excess of 50 hours per week, with the most prevalent reasons for this being clinical work [90.4%(378/418)], medical record paperwork [88.3%(369/418)] and research tasks [82.8%(346/418)]. In addition, 54.8%(229/418) of the students expressed the opinion that the teaching faculty provided effective guidance and supervision during clinical rotations. A mere 33.3%(139/418) of the students reported that the teaching faculty frequently conducted teaching visits based on evidence-based medical data. A significant majority of 86.1%(360/418) of the students agreed that 360-degree evaluations were used to provide regular feedback to residents, but only 38.5%(161/418) of the students agreed with the use of 360-degree assessments, and only 38.5%(161/418) of the students agreed with the use of 360-degree assessments to provide regular feedback on resident evaluations. In the present study, the authors sought to ascertain the extent to which feedback on performance during clinical rotations was received by masters of specialties. The results indicated that 161 out of 418 masters of specialties had received such feedback, while 71.3%(298/418) of these believed that concurrent training would be beneficial for a future career in clinical medicine. Furthermore, only 47.1%(197/418) of masters of specialties believed that this training model would be beneficial for improving research skills. Conclusions Whilst the concurrent training model is endorsed by the majority of experts in the field, there is a necessity for the systematic optimisation of the clinical training system with regard to academic pressure, faculty level and evaluation mechanism for residency training. Furthermore, there is an urgent need to strengthen scientific research ability, which is a necessary skill for high-quality talents in clinical application.
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