【摘要】 目的探讨"导师制-学长制"模式在肾内科住院医师规范化培训中的实施效果。方法对肾内科遴选出来的导师和在肾内科参加规范化培训的住院医师,根据师生双方的意愿,实行双向选择,分别分为导师制-学长制组(规培医师208名,导师4名)、导师制组(规培医师236名,导师3名)和对照组(规培医师122名,无导师)。对规培医师和导师分别进行问卷调查,对调查结果进行统计分析。结果①规培医师方面:和对照组相比,导师制-学长制组和导师制组在学生管理、临床工作、定期考核等方面成绩均优于对照组,差异有统计学意义(均P<0.001)。在科研方面,导师制-学长制组和导师制组均优秀居多,两组分别和对照组比较,差异有统计学意义(均P<0.001)。和导师制组相比,导师制-学长制组在科研活动和定期考核方面成绩更优秀,差异有统计学意义(均P<0.001)。3组间上述指标比较,差异有统计学意义(均P<0.001)。②导师方面:与导师制组相比,导师制-学长制组对导师的日常工作影响更小,科研产出增多,两组比较,差异有统计学意义(P<0.05)。结论 "导师制-学长制"模式培养的规培医师工作积极性、学习计划、临床思维、动手能力均明显提高,带教能力得到锻炼,各项考核均取得好的成绩,导师科研产出也得到提高。"导师制-学长制"模式有望在住院医师规范化培训中广泛推广。更多还原

【Abstract】 Objective To investigate the effect of "tutorial-senior" system in standard training for nephrology residents.Methods In accordance with the wishes of the tutors and the residents, both were divided into 3 groups respectively, including tutorial-senior group(208 residents, 4 tutors), tutorial group(236 residents, 3 tutors), control group(122 residents, no tutor). One self-designed questionnaire was designed for survey and the obtained data were statistically analyzed.Results ①For residents: compared to the control group, the results of student management, clinical work and periodic assessment were better in the tutorial-senior group and the tutorial group, and the differences were statistically significant(all P<0.001). In scientific research, compared with the control group, the tutorial-senior group and the tutorial group were mainly excellent, and the differences were statistically significant(all P<0.001). Compared with the tutorial group, there were statistical differeces in scientific research and periodic assessment for the tutorial-senior group(all P<0.001). The above indexes were significantly different between the three groups(all P<0.001). ② For tutor: compared with the tutorial group, there was less impact on the daily work of the tutors and the output of scientific research was increased significantly in the tutorial-senior group. There were significant statistical differences between the two groups(P<0.05).Conclusion The training of "tutorial-senior" system has significantly improved the working enthusiasm, learning plan, clinical thinking, practical ability and teaching ability of residents, and all examinations has achieved good results. The scientific research output of the tutors has also been greatly improved. The model of "tutorial-senior" system is expected to be widely popularized in the standardized training of resident doctors.更多还原