目的 探讨住院医师规范化培训领域的现实问题,即规培医师在临床环境中职业素养的“渐进累积”及其患者的获益。其中,患者的评判具有其他评价方式所无法替代的价值。方法 以与规培医师有互动经历的慢性病患者为调查对象,从患者角度对影响规培医师职业素养展现的相关因素进行识别。结果 规培医师对患者的关怀展现,是一个影响患者对规培医师职业素养感知的独立因素。在患者看来,就诊等待和接诊时间、医疗费用、医疗机构环境和医保政策等因素,都会影响其对规培医师职业素养展现的评价,制约规培医师职业素养的展现。中西部地区的患者对规培医师职业素养展现的期望落差小于东部地区。不同性别患者对规培医师职业素养各维度的评价差异无统计学意义。年长患者更倾向于选择医保政策覆盖更为全面的公立医院,对规培医师处方中的药品价格也更为敏感。结论 对临床规培而言,记录患者对规培医师的职业素养评价,可以形成对规培医师职业素养养成过程的形成性评价,有助于规培医师职业生涯各阶段职业素养敏感度的提升。
Objective The identify the challenge and weakness in standardized training medical students and their clinical exposure are essential for capacity building of healthcare providers.Methods Select the patients with chronic diseases who have an interactive experience with the standardized training medical students as the subjects for investigation, this paper identifies the relevant factors affecting the professionalism demonstration of the standardized training medical students from the perspective of patients.Results The demonstration of care for patients by the resident physician is an independent factor affecting the patients' perception of the standardized training medical students' professionalism accomplishment. From the perspective of chronic diseases patients, waiting, diagnosis and therapy time, medical expenses, medical institution environment and insurance policy will affect the evaluation of the professionalism demonstration of the standardized training medical students, and the above factors will restrict the standardized training medical students' demonstration of professionalism. Patients in the central and western districts of China showed less expectation gap of professionalism than those in the eastern districts. There was no significant difference in the evaluation of professionalism demonstration of standardized training medical students by different gender patients. Aged patients prefer to visit public hospitals with more comprehensive coverage of health insurance policies and are more sensitive to the price of medicines in prescriptions for trained standardized training medical students.Conclusions For the clinical standardized training education, the evaluation of the professionalism of the medical students can form a formative evaluation in the professionalism developing process, which may help the standardized training medical students improve their professionalism sensitivity.
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