Construction and practical application of a risk management model for clinical professional master's education

doi:10.3760/cma.j.cn115259-20250722-00816

Abstract

Abstract: 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.

Key words: Education, medical, graduate, EFMEA, Clinical diagnosis and treatment capability, Clinical medicine professional master, Medical licensing examination, Management model

CLC Number:

Lyu Ying, Wu Yajun, Han Bing, Cui Wenjing, Lyu Tingyu, Zhou Jing. Construction and practical application of a risk management model for clinical professional master's education[J]. Chinese Journal of Medical Education, 2026, 46(7): 527-533, DOI: 10.3760/cma.j.cn115259-20250722-00816.

References

[1] 陈慧玲, 柏勇平, 谢明萱, 等. 某高校临床医学硕士专业学位研究生并轨培养模式的评价与思考[J].中华医学教育杂志,2025,45(4):298-303. DOI: 10.3760/cma.j.cn115259-20240821-00873.
[2]牛建敏, 朱斌. 临床医学专业硕士学位研究生住院医师规范化培训中存在的问题与对策[J].基础医学与临床,2023,43(5):857-860. DOI: 10.16352/j.issn.1001-6325.2023.05.0857.
[3] Guiñón L, Soler A, Gisell Díaz M, et al. Analytical performance assessment and improvement by means of the Failure mode and effect analysis (FMEA)[J]. Biochem Med (Zagreb), 2020,30(2):020703. DOI: 10.11613/BM.2020.020703.
[4] 陶静怡, 张达颖, 王志剑, 等. FMEA模式在带状疱疹神经痛病人HIV筛查期医院感染防控中的应用[J].中国疼痛医学杂志,2022,28(6):433-438. DOI: 10.3969/j.issn.1006-9852.2022.06.006.
[5] Martins N, Martinez EZ, Simões CM, et al. Analyzing and mitigating the risks of patient harm during operating room to intensive care unit patient handoffs[J]. Int J Qual HealthCare, 2025,37(1):mzae114.DOI: 10.1093/intqhc/mzae114.
[6] 付婷婷, 杨潇, 徐智, 等. 医疗失效模式与效应分析在骨折及开颅手术Ⅰ类切口手术部位感染防控中的应用[J].华西医学,2024,39(8):1246-1251. DOI: 10.7507/1002-0179.202401032.
[7] Teofili L, Bianchi M, Valentini CG, et al. Validation plan of bone marrow collection, processing and distribution using the failure mode and effect analysis methodology: a technical report[J]. Cytotherapy, 2022,24(3):356-364. DOI: 10.1016/j.jcyt.2021.10.005.
[8] 李飞, 杨琪琪. 基于失效模式及效应分析提高针灸临床实习教学质量的应用与实践[J].九江学院学报(自然科学版),2023,38(1):1-6,16. DOI: 10.19717/j.cnki.jjun.2023.01.001.
[9] 蔚静, 赵国艳, 张凤, 等. 基于FMEA的个体化教学对手术室实习医生的带教效果[J].中华医学教育探索杂志,2022,21(7):886-890. DOI: 10.3760/cma.j.cn116021-20200918-00926.
[10] 高竹妍, 李宁, 厉宁, 等. 基于FMEA的多维联合教学模式在外科护理实习生医院感染教学中的探索[J].全科医学临床与教育,2024,22(7):630-633,封2. DOI: 10.13558/j.cnki.issn1672-3686.2024.007.014.
[11] 吴红曼, 赖静敏, 陈乐陶, 等. 基于措施优先级的失效模式和效应分析在结直肠术手术部位感染防控中的应用[J].中国感染控制杂志,2024,23(7):881-888. DOI: 10.12138/j.issn.1671-9638.20245158.
[12] 谢阿娜, 赵悦, 王维民, 等. 基于医师资格考试成绩的北京市某高校八年制临床医学教育培养模式改革成效的评估研究[J].医学与社会,2024,37(2):124-130. DOI: 10.13723/j.yxysh.2024.02.020.

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