目的 了解指导教师对规范化培训人员(以下简称规培人员)各方面能力的评价情况,分析不同类型规培人员在培训过程中能力发展的同质化情况。方法 由254名指导教师对2017年11月至2018年6月在某国家级住院医师规范化培训基地有过轮转出科的规培人员进行多维度能力评估。结果 377名规培人员接受评估,其各项能力的发展并不均衡,教学能力、专业知识和临床技能评分最低。不同类型规培人员,无论是单项能力评分还是总评分,其差异均具有统计学意义(均P<0.05)。控制学历和年级后,logistic回归结果仍然呈现本院住院医师(OR=2.106,95%CI=1.185～3.745)、八年制医学生(OR=3.121,95%CI=1.836～5.306)和临床医学专业学位研究生(OR=1.374,95%CI=0.976～1.934)综合评分优于委培住院医师。结论 不同类型规培人员在培训过程中各项能力的发展不具有同质性。因此,需要从制度上对各类规培人员实现身份的统一,培训中提供相同的资源并执行相同的标准,如此才能实现住院医师规范化培训的同质化目标。

Objective To understand the instructors' evaluation of the capabilities of residents, and analyze the homogenization of the capabilities of different types of residents during residency training program. Methods Totally 254 instructors were investigated about residents' capabilities between November 2017 to June 2018. Results Totally 377 residents were evaluated and showed imbalance capabilities, among which, teaching skills and professional knowledge and clinical skills were defects. There were statistically significant differences between the different types of residents in terms of individual ability and total score. After controlling for education and grades, logistic regression results showed staff (OR=2.106, 95% CI=1.185～3.745), eight-year medical students (OR=3.121, 95% CI=1.836～5.306) and medical graduate student (OR=1.374, 95% CI=0.976～1.934) had better capabilities than the residents from other hospitals. Conclusions The capabilities of different types of residents were not homogeneous. Only defining the same identity in laws, providing the same resources and implementing the same standards in training, can the homogenization of residency program be achieved.