我国全科住院医师规范化培训教学模式及应用效果研究

doi:10.12114/j.issn.1007-9572.2021.00.201

摘要/Abstract

摘要： 背景　国内全科住院医师规范化培训（全科住培）教学模式种类繁多，熟悉每种教学模式的特点，才能更好地综合运用这些教学模式。目的　分析我国全科住培教学模式、应用现状及其效果。方法　2020年1月，以“全科医学”“全科住院医师规范化培训”“全科规培”“全科规范化培训”联合“教学模式”为检索词，检索万方数据知识服务平台、中国知网、维普网2010-01-01至2019-12-31收录的关于全科住培教学模式的文献，阅读并进行总结和分析。结果　研究共入选来自国内53家全科住培基地的75篇文献。文献讨论的共性问题是全科现有教学模式在全科住培带教中的应用效果分析，相对于传统授课式教学模式，新的教学模式分别在学员理论知识培训、临床实践能力培训、人文教育和满意度方面有明显优势。全科相关的教学模式主要有以问题为基础的学习（PBL）教学模式29篇、针对门诊教学的17篇、以案例为基础的学习（CBL）教学模式11篇、导师小组教学模式9篇，其余为情景模拟教学模式、以团队为基础的学习（TBL）教学模式、运用标准化病人的教学模式、巴林特小组教学模式、督导式教学模式、“互联网+”思维下的线上线下混合教学各3篇，医护联合教学模式、研讨式教学模式、“翻转课堂”式教学模式、思维导图、专科-全科联合教学查房（CSGR）、全病程管理、精准教学、形成性评价、学生讲课模式、循证医学、以需求为导向的教学模式各1篇。PBL、CBL、TBL、情景模拟教学、导师小组、形成性评价教学模式适用于提高学员综合能力；翻转课堂式、学生讲课、思维导图教学模式则侧重于学员理论知识水平的提高；运用标准化病人评价和培训学员的教学模式侧重提高学员接诊和查体基本功；CSGR和全病程管理、循证医学和研讨式教学模式适用于提高学员独立思考能力；巴林特小组教学模式侧重提高学员医患沟通能力；“互联网+”思维下的线上线下混合教学模式适用于疫情期间；垂直分层的门诊教学模式、GP-IP全科带教模式和督导式门诊能够提高全科门诊的培训质量。结论　不同的教学模式适用于学员不同能力的培养，针对全科住培教学大纲制定针对全科住培的精准教学目标，各轮转科室结合自身实际情况选择新的教学模式或者进行不同教学模式的整合是提高全科住培教学质量的关键。

关键词: 全科医学；全科医生；教育, 医学；住院医师规范化培训；教学方法；教育考核

Abstract: Background　There are many kinds of standardized training teaching models for domestic general practitioners. Only by being familiar with the characteristics of each teaching mode can we better comprehensively use these teaching modes. Objective　To analyze the teaching mode，application status and effect evaluation of standardized training for general resident physicians in our country（general resident training）. Methods　In January 2020，the literatures about the teaching mode of national standardized training of general practitioners collected from Wanfang database，China National Knowledge Infrastructure（CNKI），and Weipu database from January 1，2010 to January 31，2017 were analyzed. The key words were "全科医学" "全科住院医师规范化培训" "全科规培" "全科规范化培训" and "教学模式". Results　A total of 75 articles from 53 domestic hospitals were selected for the study. The common problem discussed in the literature is the analysis of the application effect of the existing teaching model of general subjects in the residential training of general subjects. Compared with the traditional teaching model，the new teaching model is in the theoretical knowledge training，clinical practice ability training，and training of students. There are significant advantages in humanities education and satisfaction. The teaching models related to general subjects mainly include 29 papers related to problem-based learning（PBL） teaching model，17 papers related to out-patient teaching model，11 papers related to case-based learning（CBL） teaching model，and 9 papers related to tutor group teaching modes. The rest are 3 papers related to scenario simulation teaching mode，team-based（TBL）learning and teaching mode，standardized patient（SP） teaching mode，3 papers related to Balint group teaching mode，3 papers related to supervised teaching mode，and 3 papers related to online combined with offline teaching mode based on "Internet +" thinking. And one paper related to each teaching modes including medical and nursing joint teaching mode，seminar-style teaching mode，"flipped classroom" teaching mode，mind map teaching mode，specialist-general practice joint teaching rounds（CSGR） mode，whole course managementteaching mode，precision teaching teaching mode，formative evaluationteaching mode，student lecture mode，inquiry there is one paper for each of the card medicine and demand-oriented teaching mode. PBL，CBL，TBL，situational simulation teaching，mentor group，formative evaluation teaching mode is suitable for improving students' comprehensive ability；flipped classroom，student lecture，mind map teaching mode focuses on the improvement of students' theoretical knowledge level；SP evaluate and train the teaching model of trainees focus on improving the basic skills of the trainees' reception and physical examination；CSGR and whole-course management，evidence-based medicine and seminar-style teaching models are suitable for improving trainees' independent thinking ability；the Balint group teaching model focuses on improving trainees' medical skills. The online and offline hybrid teaching model under the "Internet+" thinking is suitable for the period of the epidemic. The vertically hierarchical outpatient teaching model，GP-IP general practice teaching model and supervised outpatient clinic can improve the training quality of general practice. Conclusion　Different teaching modes are suitable for the cultivation of students' different abilities. According to the general residential training syllabus，the key to improve the quality of general residential training is to formulate precise teaching goals for general residential training. Each rotating department selects a new teaching mode or integrates different teaching modes based on its own actual conditions.

Key words: General practice；General practitioners；Education, Medical；Standardized resident training；Teaching methods；Educational measurement

战京燕,娄景秋,王少坤,等. 我国全科住院医师规范化培训教学模式及应用效果研究[J]. 中国全科医学, 2021, 24(19): 2401-2407. DOI: 10.12114/j.issn.1007-9572.2021.00.201.
ZHAN Jingyan,LOU Jingqiu,WANG Shaokun, et al. The Standardized Training Teaching Mode in Standardized Training of Domestic General Practice Residents and Its Application Effect　[J]. Chinese General Practice, 2021, 24(19): 2401-2407. DOI: 10.12114/j.issn.1007-9572.2021.00.201.

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