CAJ | 학술논문

目的针对目前医疗资源紧张、患者数量巨大、就诊困难的医疗状况,设立由医学生初诊的教授预约门诊,鼓励医学生完成门诊辅助工作,实现坚持以患者为中心原则的同时对医学生进行个性化教学的目的.方法在北京大学第三医院眼科中心设立65岁以上老年患者的教授预约门诊,由硕士研究生教育阶段临床医学专业学生先做出临床初步诊断、实施相关辅助检查,并为患者预约相对应的专科教授门诊就诊时间.自2009年3月至2010年12月对教授预约门诊患者进行就诊满意度调查及完成诊断所需要的平均有效就诊次数调查,分析出诊医学生理论考核成绩及多站式考查结果,并对教授预约门诊工作效率进行评估.结果教授预约门诊的设立大大提高了患者的就诊满意度和出诊效率,同时提高了医学生的考核成绩,锻炼了医学生的临床思维能力,增加了医学生的临床经验.结论教授预约门诊的设立大大方便了老年患者就诊,降低了患者就诊难度,并使患者完成诊断及治疗的有效就诊次数大大减少,就诊流程更加流畅,做到了以患者为中心.教授预约门诊的开展,为医学生的临床实践设立了一个安全有效的锻炼平台,通过教授完成诊断及对预约门诊书写病例的进一步评估的过程,有利于医学生临床能力锻炼以及个性化培养,同时也是合理、充分利用医疗资源的有效手段.
목적 침대목전의료자원긴장、환자수량거대、취진곤난적의료상황,설립유의학생초진적교수예약문진,고려의학생완성문진보조공작,실현견지이환자위중심원칙적동시대의학생진행개성화교학적목적.방법 재북경대학제삼의원안과중심설립65세이상노년환자적교수예약문진,유석사연구생교육계단림상의학전업학생선주출림상초보진단、실시상관보조검사,병위환자예약상대응적전과교수문진취진시간.자2009년3월지2010년12월대교수예약문진환자진행취진만의도조사급완성진단소수요적평균유효취진차수조사,분석출진의학생이론고핵성적급다참식고사결과,병대교수예약문진공작효솔진행평고.결과 교수예약문진적설립대대제고료환자적취진만의도화출진효솔,동시제고료의학생적고핵성적,단련료의학생적림상사유능력,증가료의학생적림상경험.결론 교수예약문진적설립대대방편료노년환자취진,강저료환자취진난도,병사환자완성진단급치료적유효취진차수대대감소,취진류정경가류창,주도료이환자위중심.교수예약문진적개전,위의학생적림상실천설립료일개안전유효적단련평태,통과교수완성진단급대예약문진서사병례적진일보평고적과정,유리우의학생림상능력단련이급개성화배양,동시야시합리、충분이용의료자원적유효수단.
Objective According to the condition of health care service in China,e.g.limited health care resources,great number of patients,difficulties in accessing health care service,we have established professor-level appointment based clinic service which led by junior residents and medical students,in order to encourage junior residents and postgraduate students to accomplish some assistance work in the clinic.With this mechanism,the aims of putting patient as the centre as well as providing continuous and individualized education to junior residents are achieved.Methods In the Eye Center of Peking University Third Hospital,we established professor-level appointment based clinic for the elderly over 65-year old.This service is led by postgraduate clinical medical students and junior residents.They are in charge of providing initial diagnosis and corresponding assistant examination.According to these initial results,they help the elderly to reserve appointments for the professors' clinical service.From March 2009 to December 2010,we have surveyed the satisfaction of patients,and the average time of visiting the clinic before final diagnosis and prescription.In the meantime,we appraised students' level of medical practicing after working at this appointment based clinic and the efficiency of this special clinic.Results The establishment of appointment based clinic has considerably improved the satisfactory rate of the patients,and the efficiency of the Professor-level clinic.Also,the medical students have developed their practical thoughts and skills,and accumulated clinical experiences,resulting in a growth in their assessment results.Conclusions The establishment of appointment based clinic has put the patients as the centre of our service,because firstly,it reduces the difficulty of getting service by the elderly,and secondly,it facilitates the diagnoses process and thus reduces the number of visits needed.On the other hand,the establishment of appointment based clinic has been a safe and sufficient platform for medical students to achieve clinical practical experience.By reviewing the medical records written by students in the appointment stage of the clinic and completing diagnosis,the professor on-duty is able to ease individualized education to the medical students and develop their clinical skills.Therefore,this mechanism has sensibly and efficiently used the medical care resources.