摘要
目的探讨提高社区全科医师临床能力的培训模式、教学方法，评估其效果，从而进一步完善培训方案。方法将2011年7月至2012年10月期间759名参加上海市全科医师临床能力培训及考核的学员设为培训组，同期仅参加上海市全科医师临床能力考核的703名学员设为对照组。培训组采用课堂讲授、专题讲座、小组讨论、角色扮演、模拟训练等多种形式进行理论课教学，采用视频影像演示、现场示教及模拟人训练相结合的形式进行体格检查和操作技能的培训；对照组不参加培训仅参加考核。比较两组学员培训前后的理论及操作能力，评价培训的效果。结果所有学员中男性占34.2%，女性65.8%；平均工作年限（13.9±7.0）年，本科学历占72.8%。两组在性别构成、工作年限、受教育程度方面差异均无统计学意义（均P〉0.05）。培训组培训前后的总成绩分别为（67.39±8.57）分和（73.62±7.19）分，对照组前后两次总成绩分别为（68.67±8.31）分和（65.73±9.02）分。培训前对照组总成绩和理论成绩显著高于培训组（均P〈0.01），体格检查和技能操作成绩两组比较差异无统计学意义。培训后培训组总成绩及各单项成绩（笔试、体格检查和技能操作）较其自身培训前均显著提高（均P〈0.01），且显著高于对照组（均P〈0.01）。结论经过培训的全科医师的临床实践能力，尤其是技能操作能力得到了大幅度的提高，本研究采取的教学方法切实有效。
Objective To evaluate the clinical competence training model for community general practitioners （GPs）. Methods Total 759 Gps participated in clinical ability training course （training group） between July 2011 and October 2012. The course included lectures, group discussion, role play, simulation for theoretical teaching; and video demonstration, scene teaching and medical simulator for physical examination and surgical skill training. Other 703 Gps without participating in training course were seleeted as contrnl group. The examination consisting of theoretical and clinical skill tests were carried out and the results were compared between two groups. Results The participants included 260 males （34.2%） and 499 females （65.8%） were with an average service year of 13.9 ±7.0 and 72.8% of them hold bachelor degree. There were no significant differences in gender composition, work seniority and educational level between the two groups （P 〉 0.05）. Before and after training the total scores of the training group were （67.39 ± 8.57 ） and （73.62 ± 7.19 ） respectively, （ 68.67 ± 8.31 ） and （ 65.73 ± 9.02） respectively for the control group. Before training, the total score and theoretical results of control group were significantly higher than those of training group （ all P 〈 0. 0l ） , and there was no significant difference between the two groups in physical examination and operation skill. After training, the total scores and the individual scores （written examination, physical examination and operation skill） of training group were significantly increased, compared with those befnre training （all P 〈 0. 01 ）, and those of control group （all P 〈 0. 01 ）. Conclusions The clinical competences training model can improve the theoretical knowledge and clinical ability of community general practitioners.
出处
《中华全科医师杂志》
2016年第5期346-350,共5页
Chinese Journal of General Practitioners
基金
上海市公共卫生人才培养计划（优秀学科带头人）（GWDTR201210）
上海市公共卫生重点学科建设计划（12GWZX1001）
关键词
临床工作能力
全科医师
培训
Clinical competence
General practitioner
Training
