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Investigation on the Core Competency of Residents during Coronavirus Disease 2019 Outbreak
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摘要:
目的 探讨新型冠状病毒肺炎(简称“新冠肺炎”)疫情作为突发干预因素对于不同阶段住院医师培养的影响，以及基于胜任力为核心的毕业后医学培养方案对住院医师能力培养的提升作用，为优化研究生阶段医学教育提供参考。 方法 在新冠肺炎疫情防控工作取得阶段性胜利后，采用问卷调查的方式对169名临床医学博士后及515名临床医学专业型研究生进行匿名网络问卷调查。分析临床医学博士后和专业型研究生对于核心胜任力的认知及自评差异。 结果 临床医学博士后回收有效问卷141份(83.43%，141/169)，专业型研究生回收有效问卷264份(51.26%，264/515)，两群体中，均超过85%的学员“认同”或“非常认同”疫情期间对于医生职业有了更深刻的理解。胜任力自评结果显示，除“自我提高”条目无差别外，其他条目临床医学博士后自评得分均显著高于专业型研究生(P均＜0.05)。 结论 新冠肺炎疫情作为突发干预因素，对住院医师胜任力认知具有提升作用；采用住院医师核心胜任力为核心的毕业后医学教育模式能够全面提升学员的综合能力，是有效的住院医师培养方案；建议院校教育阶段应注重住院医师职业规划教育，进一步探索与毕业后教育紧密结合的院校教育新模式。 Abstract:Objective To investigate the impact of the outbreak of coronavirus disease 2019 (COVID-19) as an intervention factor on residency training at different stages, and look into the enhancement effect of post-graduation medical training program based on competency of residency training, so as to provide reference for the optimization of medical education at the postgraduate stage. Methods After the initial success of COVID-19 prevention and control, 169 clinical postdoctoral trainess(clinical postdocs) and 515 graduate students specializing in clinical medicine(professional postdocs) were surveyed by an anonymous online questionnaire. To analyze the differences of cognition and self-evaluation of core competence between the two groups. Results There were 141 valid questionnaires collected from clinical postdocs (83.43%, 141/169) and 264 valid questionnaires collected from professional postdocs (51.26%, 264/515). In both groups, more than 85% of the students agreed or strongly agreed that they had a deeper understanding of the profession of doctors during the epidemic. The results of competency self-evaluation showed that, except for the items of "self-improvement", the self-evaluation scores of clinical postdoctoral students on other items were significantly higher than those of professional postdoctoral students (all P < 0.05). Conclusions COVID-19, as a factor of emergency intervention, can improve the competency cognition of residents. The core-competency based post-graduation medical education model can comprehensively improve the students' comprehensive ability, which is an effective training program for residents. It is suggested that the vocational planning education for residents should be paid attention to in the stage of college education, and a new mode of college education that is closely combined with the post-graduation education should be further explored. -
Key words:
- coronavirus disease 2019 /
- clinical postdoctoral trainee /
- resident /
- core competency
利益冲突 无 -
表 1 住院医师核心胜任力18个自评指标
住院医师核心胜任力 评价指标 职业素养 职业道德、敬业精神、人文素养、系统改进能力 病人照护 临床决策、病人管理、病人教育 沟通合作 医患沟通、团队合作、领导能力、管理能力 教学能力 临床带教、医学科普、跨专业教学 终生学习 自我提高、循证医学、审辨性思维、学术研究 
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表 2 临床医学专业型研究生与临床医学博士后对住院医师核心胜任力自评得分比较(x±s，分)
指标 临床医学专业型研究生 临床医学博士后 均值差(95% CI) P值 职业素养 职业道德 3.70±0.87 3.89±0.68 -0.19(-0.34, -0.04) 0.014 敬业精神 3.42±1.02 3.90±0.80 -0.48(-0.66, -0.30) ＜0.001 人文素养 3.55±0.95 3.87±0.77 -0.32(-0.49, -0.15) ＜0.001 系统改进能力 3.06±1.08 3.35±0.90 -0.29(-0.49, -0.09) 0.004 病人照护 临床决策 3.44±1.07 3.84±0.86 -0.40(-0.59, -0.21) ＜0.001 病人管理 3.22±1.17 3.68±0.95 -0.45(-0.66, -0.24) ＜0.001 病人教育 3.38±1.02 3.76±0.85 -0.38(-0.57, -0.19) ＜0.001 沟通合作 医患沟通 3.41±1.04 3.68±0.87 -0.27(-0.46, -0.08) 0.006 团队合作 3.50±0.89 3.86±0.69 -0.36(-0.52, -0.20) ＜0.001 领导能力 2.99±1.08 3.36±0.91 -0.37(-0.57, -0.17) ＜0.001 管理能力 3.01±1.06 3.42±0.86 -0.41(-0.60, -0.22) 0.001 教学能力 临床带教 2.81±1.25 3.45±0.87 -0.64(-0.85, -0.43) ＜0.001 医学科普 3.26±1.04 3.48±0.84 -0.22(-0.41, -0.03) 0.023 跨专业教学 2.89±1.19 3.31±0.97 -0.42(-0.64, -0.20) ＜0.001 终生学习 自我提高 3.67±0.95 3.84±0.75 -0.17(-0.34, 0) 0.054 循证医学 3.21±1.05 3.48±0.88 -0.27(-0.46, -0.08) 0.010 审辩性思维 3.06±1.07 3.48±0.87 -0.42(-0.61, -0.23) ＜0.001 学术研究 3.26±1.08 3.48±0.96 -0.22(-0.42, -0.02) 0.038
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