目的 在“四证合一”并轨培养模式下,评估不同年级专业学位硕士研究生达到相应年级住院医师临床胜任力水平的情况。方法 选择武汉大学人民医院全部“四证合一”并轨培养模式下的272名专业学位硕士研究生为本研究对象,采用问卷调查方法对其进行相关调查。问卷所涉及的临床胜任力结构包含5个维度和15个项目。按照住院医师临床胜任力标准,将每个项目分为3个年级能力层次,并与住院医师规范化培训的结业标准进行匹配。根据专业学位硕士研究生自评水平是否达到相应标准计算达标情况,包含整体达标率、维度达标率和项目达标比例3个层面。结果 临床胜任力分年级标准比结业标准更能够有效区分不同年级专业学位硕士研究生的能力水平。临床胜任力分年级标准的达标情况表现出研究生年级越高、相应能力层次的达标率越低的变化。在三年级研究生的自评中,虽然结业标准达标情况较好,但临床胜任力分年级标准达标情况却较差。结论 在并轨培养模式下,虽然“四证合一”专业学位硕士研究生能够达到住院医师规范化培训的结业标准,但尚不能达到其临床胜任力标准。因此,在住院医师规范化培训中,不仅要完成国家标准的培训时长、项目和数量,还要有效监测和提升不同年级研究生的临床胜任力水平。
Objective To evaluate the accomplishment of residency training on different level of postgraduate residents' self-assessment of competencies under the “unification of four certificates” postgraduate residency training model.Methods The study conducted a cross-sectional survey of all the postgraduate residents in the hospital. The competency included 5 domains with 15 items, 3 levels were designed for each item from ACGME competency, and matched to the Chinese residency accomplished standard. The accomplished rates were counted from self-assessment results.Results There were 272 validated questionnaires received. The phased competency assessment could evaluate the difference between grades than accomplished standard. The accomplished rates of each domain and as a whole were lower as the grade up, with a significant difference. There was the same trend in all the 15 competency items.Conclusions The “unification of four certificates” postgraduate students could finish Chinese residency accomplished standard well, but couldn't get the ACGME competency. It's important to monitor and improve residents' competency levels of different grades, not only to finish the residency training time, contains and numbers.
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