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目的:分析北京地区外科住院医师临床基本能力的现状。方法:北京地区250名(完成两年规范化培训)的外科住院医师参加比赛,大赛包括初赛、复赛和决赛,比赛形式为多站式客观结构化考核,内容包括医学基础理论、病史采集、体格检查、辅助检查判读、临床思维、医疗文书书写、病情解释、沟通技巧、外科手术、修改病例、团队合作以及医疗相关法律法规等。每一站采用百分制评分量表,每个打分要点2-3分。结果:250名外科住院医师,来自23个培训基地。初赛总平均分(295.38±32.88)分,按百分制80分计算,及格率27.6%。区县医院住院医师总分明显低于卫计委直属系统、市属系统(P<0.05)。进入复赛住院医师占初赛人数的35.20%,博士学位医师(54.81%)进入复赛比例最高。卫计委直属系统住院医师进入复赛的比例最高,达53.19%,其后依次是市属系统、北医系统、部队系统和区县医院。复赛总平均分(233.98±25.15),按百分制60分及格计算,及格率42.5%。决赛为团队手术,平均分(89.05±5.17),按百分制80分计算,及格率60%。结论:北京地区不同培训基地外科住院医师临床基本能力存在一定的差异,总体能力有待提高;当前迫切需要加强住院医师临床实践培训、师资队伍和基地建设与管理。
Objective: To analyze the status quo of clinical resident residency in Beijing. METHODS: A total of 250 surgical residencies in Beijing who completed standardized training for two years participated in the competition. The competitions included the preliminary rounds, the semi-finals and the finals. The format of the competition included the objective and structured examination of multiple bases, including basic medical theories, medical history collection, and physical examination , Auxiliary examination and interpretation, clinical thinking, writing of medical documents, explanation of illness, communication skills, surgery, case modification, teamwork and medical related laws and regulations. Each station using percentile rating scale, each score points 2-3 points. Results: 250 surgical residents, from 23 training bases. The overall average score of the preliminary round (295.38 ± 32.88) points, according to 80 percentage points, the passing rate of 27.6%. The total score of residents in district and county hospitals was significantly lower than that of the direct system of Weihang Committee and the municipal system (P <0.05). Referees residing in the quarterfinals accounted for 35.20% of the number of preliminary rounds, doctoral physicians (54.81%) entered the semi-finals the highest proportion. Health System Planning Commission directly under the system residency to enter the semi-finals the highest proportion, up to 53.19%, followed by the municipal system, the North Medical System, the military system and district hospital. The average overall score of the semi-finals (233.98 ± 25.15) was calculated according to the 60th percentile pass rate with a pass rate of 42.5%. The final for the team surgery, the average score (89.05 ± 5.17), calculated according to 80 percentage points, the passing rate of 60%. Conclusion: There are some differences in the basic clinical residency of surgical residents in different training bases in Beijing, and the overall abilities need to be improved. There is an urgent need to strengthen the training of resident clinical practical training, teaching staff and base construction and management.