CAJ | 학술논문

目的：调查临床医学专业实习生掌握医疗核心制度现状及认知状况，为制定临床医学生医疗核心制度培训计划提供依据。方法以遵义医学院2009级临床医学专业实习结束时的部分学生共188名为调查对象。设计调查表内容包括：接受核心制度培训情况和掌握程度自我评估等；医疗核心制度测试试卷。采用Excel及SPSS 17.0统计软件收集、处理数据，描述性分析计算各指标百分率。结果①实习前和实习阶段接受过医疗核心制度培训的分别为78人/41.34%和117人/62.33%。实习医院及实习科室进行系统培训的比例分别为74人/39.43%和70人/37.30%。带教教师进行系统或非系统讲解的比例分别为42人/22.29%和61人/32.37%。②测试结果显示，掌握首诊负责制度、医患沟通制度、疑难病例讨论制度的分别为178人/94.68%、170人/90.43%和168人/89.36%。掌握危重病人抢救制度、手术分级管理制度及临床用血审核制度的分别为84人/44.68%、67人/35.64%和34人/18.28%。③完全掌握医疗核心制度情况的为8人/6.90%。165人/87.71%认为临床医学专业学生应该掌握医疗核心制度，157人/83.43%认为掌握医疗核心制度能更好适应临床医疗工作。结论临床医学专业实习生医疗核心制度系统化培训亟待加强，掌握医疗核心制度有助于其更好地适应临床医疗工作。
목적：조사림상의학전업실습생장악의료핵심제도현상급인지상황，위제정림상의학생의료핵심제도배훈계화제공의거。방법이준의의학원2009급림상의학전업실습결속시적부분학생공188명위조사대상。설계조사표내용포괄：접수핵심제도배훈정황화장악정도자아평고등；의료핵심제도측시시권。채용Excel급SPSS 17.0통계연건수집、처리수거，묘술성분석계산각지표백분솔。결과①실습전화실습계단접수과의료핵심제도배훈적분별위78인/41.34%화117인/62.33%。실습의원급실습과실진행계통배훈적비례분별위74인/39.43%화70인/37.30%。대교교사진행계통혹비계통강해적비례분별위42인/22.29%화61인/32.37%。②측시결과현시，장악수진부책제도、의환구통제도、의난병례토론제도적분별위178인/94.68%、170인/90.43%화168인/89.36%。장악위중병인창구제도、수술분급관리제도급림상용혈심핵제도적분별위84인/44.68%、67인/35.64%화34인/18.28%。③완전장악의료핵심제도정황적위8인/6.90%。165인/87.71%인위림상의학전업학생응해장악의료핵심제도，157인/83.43%인위장악의료핵심제도능경호괄응림상의료공작。결론림상의학전업실습생의료핵심제도계통화배훈극대가강，장악의료핵심제도유조우기경호지괄응림상의료공작。
Objective To investigate clinical interns' mastery and understanding status of medical core systems in order to provide reference for formulating training programs. Methods The questionnaires including medical core systems trained and self-assessment and test paper were de-signed. Then survey was carried out among 188 clinical interns of Grade 2009 of Zunyi Medical Col-lege at the end of training. All data were obtained, collected and analyzed with Excel and a SPSS 17.0. The result was described with percentage. Results ①78/41.34% and 117/62.33% clinical interns accepted training of medical core systems respectively before or during clinic training. 74/39.43%hos-pitals or 70/37.30% departments were systematically trained by medical core systems and the propor-tion of teachers who systematically or non-systematically explained medical core systems for clinical interns was 42/22.29%and 61/32.37%respectively.②The clinical interns who mastered first diagnosis responsibility systems, patient communication system, and systems of discussing difficult cases were 178/94.68%, 178/90.43%or 168/89.36%. The clinical interns who mastered rescue systems in critically ill patients, surgical classification management systems and audit system in clinical blood transfusion were 84/44.68%, 67/35.64%or 34/18.28%respectively.③8/6.90%interns fully grasped the core system of the medical situation. 165/87.71% and 165/83.43% clinical interns believed medical core systems should be mastered and 157 interns (83.43%) thought that mastering medical core system can help them better adapt to clinical medical work. Conclusion Systematic training of medical core system should be enhanced for clinical interns and mastering medical core systems is better for their future.