中华医学教育探索杂志
中華醫學教育探索雜誌
중화의학교육탐색잡지
Chinese Journal of Medical Education Research
2013年
4期
338-341
,共4页
吴曦%杨鑫然%汪斌%黄清海%杨志刚%陈剑春%刘建民
吳晞%楊鑫然%汪斌%黃清海%楊誌剛%陳劍春%劉建民
오희%양흠연%왕빈%황청해%양지강%진검춘%류건민
病史采集%住院医师规范化培训%医患沟通%医学教育%评估
病史採集%住院醫師規範化培訓%醫患溝通%醫學教育%評估
병사채집%주원의사규범화배훈%의환구통%의학교육%평고
History taking%Standardized training of resident physicians%Communication skills%Medical education%Evaluation
目的 评估2010年在长海医院接受住院医师规范化培训(规培)的医师病史采集方式在不同学位间以及规培前后的分布差异,并以此评估未来规培住院医师接受规范化临床沟通技能培训的必要性.方法 分别在规培前后,对2010年起在长海医院接受规培的81名临床医学专业毕业生进行病史采集方式分类,分为:无效沟通方式、传统方式、疾病-患病方式及卡尔加里-剑桥方式4类.以Fisher确切概率法计算规培前不同学位医师应用病史采集方式的差异(α=0.05),以Pearson x2检验计算规培前后所有医师应用病史采集方式的差异(α=0.05).结果 规培前19.8％的医师应用无效沟通方式采集病史,53.0％应用传统方式采集病史,使用疾病-患病方式和卡尔加里-剑桥方式的分别为22.2％、4.9％.不同学位医师应用沟通方式的差异有统计学意义(P =0.008).规培后医师病史采集方式发生显著的改变,差异有统计学意义(P =0.001)；仅有约1.2％的医师仍应用无效沟通方式,59.3％应用传统方式采集病史,34.6％应用疾病-患病方式,而应用卡尔加里-剑桥方式的医师没有增加.结论 不同学位的规培医师间,病史采集方式存在显著差异.住院医师病史采集方式在规培前后有着显著差异,但部分住院医师的病史采集方式仍不适宜临床工作.住院医师在临床沟通技能方面有接受规范化培训及考核的必要.
目的 評估2010年在長海醫院接受住院醫師規範化培訓(規培)的醫師病史採集方式在不同學位間以及規培前後的分佈差異,併以此評估未來規培住院醫師接受規範化臨床溝通技能培訓的必要性.方法 分彆在規培前後,對2010年起在長海醫院接受規培的81名臨床醫學專業畢業生進行病史採集方式分類,分為:無效溝通方式、傳統方式、疾病-患病方式及卡爾加裏-劍橋方式4類.以Fisher確切概率法計算規培前不同學位醫師應用病史採集方式的差異(α=0.05),以Pearson x2檢驗計算規培前後所有醫師應用病史採集方式的差異(α=0.05).結果 規培前19.8％的醫師應用無效溝通方式採集病史,53.0％應用傳統方式採集病史,使用疾病-患病方式和卡爾加裏-劍橋方式的分彆為22.2％、4.9％.不同學位醫師應用溝通方式的差異有統計學意義(P =0.008).規培後醫師病史採集方式髮生顯著的改變,差異有統計學意義(P =0.001)；僅有約1.2％的醫師仍應用無效溝通方式,59.3％應用傳統方式採集病史,34.6％應用疾病-患病方式,而應用卡爾加裏-劍橋方式的醫師沒有增加.結論 不同學位的規培醫師間,病史採集方式存在顯著差異.住院醫師病史採集方式在規培前後有著顯著差異,但部分住院醫師的病史採集方式仍不適宜臨床工作.住院醫師在臨床溝通技能方麵有接受規範化培訓及攷覈的必要.
목적 평고2010년재장해의원접수주원의사규범화배훈(규배)적의사병사채집방식재불동학위간이급규배전후적분포차이,병이차평고미래규배주원의사접수규범화림상구통기능배훈적필요성.방법 분별재규배전후,대2010년기재장해의원접수규배적81명림상의학전업필업생진행병사채집방식분류,분위:무효구통방식、전통방식、질병-환병방식급잡이가리-검교방식4류.이Fisher학절개솔법계산규배전불동학위의사응용병사채집방식적차이(α=0.05),이Pearson x2검험계산규배전후소유의사응용병사채집방식적차이(α=0.05).결과 규배전19.8％적의사응용무효구통방식채집병사,53.0％응용전통방식채집병사,사용질병-환병방식화잡이가리-검교방식적분별위22.2％、4.9％.불동학위의사응용구통방식적차이유통계학의의(P =0.008).규배후의사병사채집방식발생현저적개변,차이유통계학의의(P =0.001)；부유약1.2％적의사잉응용무효구통방식,59.3％응용전통방식채집병사,34.6％응용질병-환병방식,이응용잡이가리-검교방식적의사몰유증가.결론 불동학위적규배의사간,병사채집방식존재현저차이.주원의사병사채집방식재규배전후유착현저차이,단부분주원의사적병사채집방식잉불괄의림상공작.주원의사재림상구통기능방면유접수규범화배훈급고핵적필요.
Objective To evaluate the needs of performing a standardized communication skill training program for residents according to the differences in history taking mode of residents with different degrees and before and after the standardized training in Shanghai Changhai Hospital in 2010.Methods History taking modes of 81 residents in 2010 before and after the standardized training in Shanghai Changhai hospital were categorized.History taking modes were classified into:no effectiveness mode,traditional mode,disease-sickness mode and Calgary-Cambridge Guide mode.Distribution differences of history taking mode of residents with different medical degrees were analyzed by Fisher exact probability method (α =0.05).Distribution differences of history taking mode of residents before and after standardized training were analyzed by Pearson x2 test (α =0.05).Results 19.8％ residents took no effectiveness mode,53.0％ took traditional mode and 27.2％ used disease-sickness mode.There were significant differences in history taking modes among residents with different medical degrees (P =0.008).After training,history taking modes of residents were significantly changed (P=0.001),only 1.2％ residents used no effectiveness mode,59.3％ used traditional mode and 34.6％ used disease-sickness mode.But residents using the Calgary-Cambridge mode were not increased.Conclusions There are significant differences in history taking modes among residents with different medical degrees.History taking mode of residents changed after standardized training.But some of the residents still use non-optimal history taking modes; therefore a standardized communication skill training program might be needed in the future.
