CAJ | 학술논문

目的临床实习是医学生培养计划中的重要组成部分.本研究于2004年、2014年2次开展问卷调查,以了解医学生对临床实习教学的满意度以及医患信任的变化,分析新形势下医患信任对医学生临床实习与职业规划的影响,为临床实习教育的改革提供科学依据.方法以在同济大学医学院3所附属医院中实习时间超过3个月的临床医学专业学生作为研究对象,于2004年和2014年采用随机抽样问卷调查方式,就医学生对实习教学、医患信任与临床实习、职业规划等问题的认识进行调查分析.结果共计227名实习学生完成了问卷调查(2004年128名,2014年99名).超过50％的实习学生对实习教学表示满意,2014年的满意率较2004年有明显升高,P=0.013,差异具有统计学意义.2014年有更大比例的实习学生认为医患关系紧张,但其中认为医患关系影响了临床实习人数比例较10年前降低,P=0.000,差异具有统计学意义.超过60％的实习学生表示医患信任不足对职业规划有影响.结论实习学生对临床实习教学的总体满意度较10年前升高;临床实习教学中医患信任障碍的发生率有所降低但仍然常见;医患信任是影响医学生职业规划的因素之一.
목적 림상실습시의학생배양계화중적중요조성부분.본연구우2004년、2014년2차개전문권조사,이료해의학생대림상실습교학적만의도이급의환신임적변화,분석신형세하의환신임대의학생림상실습여직업규화적영향,위림상실습교육적개혁제공과학의거.방법 이재동제대학의학원3소부속의원중실습시간초과3개월적림상의학전업학생작위연구대상,우2004년화2014년채용수궤추양문권조사방식,취의학생대실습교학、의환신임여림상실습、직업규화등문제적인식진행조사분석.결과 공계227명실습학생완성료문권조사(2004년128명,2014년99명).초과50％적실습학생대실습교학표시만의,2014년적만의솔교2004년유명현승고,P=0.013,차이구유통계학의의.2014년유경대비례적실습학생인위의환관계긴장,단기중인위의환관계영향료림상실습인수비례교10년전강저,P=0.000,차이구유통계학의의.초과60％적실습학생표시의환신임불족대직업규화유영향.결론 실습학생대림상실습교학적총체만의도교10년전승고;림상실습교학중의환신임장애적발생솔유소강저단잉연상견;의환신임시영향의학생직업규화적인소지일.
Objective Clinical clerkship is an important session for medical student education.The present survey analyzed the interns' comments about the clinical clerkship and doctor-patient relationship in 2004 and 2014,in order to investigate the impact of doctor-patient trust on clinical clerkship and career plan of medical students in the recent decade.Methods Medical students from three teaching hospitals of Shanghai and had been on clinical clerkship for longer than 3 months were recruited in the questionnaire survey.The questionnaire included muhiple-choice questions about assessment about clerkship education,doctor-patient trust and relationship,as well as career plan.Results 227 interns finished the questionnaires with 128 in 2004 and 99 in 2014,respectively.More than 50％ interns were satisfied with their clinical clerkship education and the percentage increased significantly in 2014 (81.8％in 2014 vs.64.1％ in 2004,P=0.013).There were more interns in 2014 assessed the current doctorpatient relationship as ‘ not so good’ or ‘ bad’,however,less interns thought the bad doctor-patient relationship had influenced their clinical clerkship (22.2％ in 2014 vs.37.5％ in 2004,P=0.000).Lack of trust between doctor and patient had influenced the career plan in more than 60％ interns in both 2004 and 2014.Conclusions More interns are satisfied with the clinical clerkship education compared to 10 years ago.Less interns experienced rejection from patients in 2014 but it is still common during clinical clerkship.Lack of trust between the doctor and patient is one determinates of career plan in medical students.