目的 构建临床医学硕士专业学位研究生(以下简称专硕)培养的风险管理模式,并评价该模式在优化培养管理流程、提升培养质量中的应用效果。方法 采用试验对照方法。2023年9月至2024年10月,采用整群抽样方法,选择哈尔滨医科大学附属第二医院2022级传统模式培养的406名专硕(传统管理组)与2023级教育失效模式与效应分析(education failure mode and effects analysis, EFMEA)管理模式培养的368名专硕(EFMEA质控组)为研究对象。基于失效模式与效应分析(failure mode and effects analysis,FMEA),结合专硕培养特点,构建“风险前瞻—量化评估—精准干预—动态调整—效果验证”的EFMEA管理模式。采用Wilcoxon秩和检验和卡方检验分析相关数据。结果 EFMEA管理模式共识别出传统管理模式的23项潜在失效模式,并锁定了8项高风险项。对比传统管理组,EFMEA质控组的风险优先级系数(risk priority number,RPN)总值从566.78分降低至167.24分,降幅达70.5%,8项高风险项等级均降为低风险;医师资格考试的实践技能考试通过率从97.3%(395/406)提升至100.0%(368/368),医学综合考试通过率从86.2%(350/406)提升至98.4%(362/368),其差异均具有统计学意义(均P<0.001)。EFMEA质控组的专硕对EFMEA管理模式的积极评价占比较高,60.9%(224/368)的专硕认为对临床诊疗能力的提升有所帮助。结论 EFMEA管理模式可以系统识别和有效降低专硕培养过程中的关键风险,优化培养管理流程,助力提升专硕的培养质量。

Objective To construct a risk management model for the training of professional master's degree candidates in clinical medicine and empirically evaluate the application effect of this model in optimizing the training management process and improving training quality. Methods This study was conducted from September 2023 to October 2024 at the Second Affiliated Hospital of Harbin Medical University. A cluster sampling method was used to select 406 clinical professional master's students from the 2022 cohort trained under the traditional model (traditional management group) and 368 clinical professional master's students from the 2023 cohort trained under the education failure mode and effects analysis (EFMEA) management model (EFMEA quality control group) as the study subjects.Based on failure mode and effects analysis and the characteristics of professional master's training, an EFMEA management model was constructed following a cycle of ″risk anticipation, quantitative assessment, precise intervention, dynamic adjustment, and outcome validation.″Wilcoxon rank-sum test and Chi-square test were used to analyze the relevant data. Results The EFMEA management model identified 23 potential failure modes in the traditional management model and pinpointed 8 high-risk items. Compared with the traditional management group, the total risk priority number (RPN) value of the EFMEA quality control group was significantly reduced from 566.78 to 167.24, with a decrease of 70.5%. The pass rate for the skills exam of the Medical Licensing Examination increased from 97.3% (395/406) to 100.0% (368/368), and the pass rate for the comprehensive medical exam increased from 86.2% (350/406) to 98.4% (362/368), with statistically significant differences (all P<0.001). The professional master's candidates in the EFMEA quality control group reported a relatively high proportion of positive evaluations of the EFMEA management model, and 60.9% (224/368) of them believed that it was helpful to improve the clinical diagnosis and treatment ability. Conclusions The EFMEA management model can systematically identify and effectively reduce key risks in the training process of professional master's candidates, optimize the training management process, and help improve the training quality of clinical professional master's candidates.