【作者】 王梅；

【导师】 李静；

【作者基本信息】 重庆医科大学 ， 社会医学与卫生事业管理， 2016， 硕士

【摘要】 目的:通过问卷调查了解重庆市住院医师规范化培训实施现状,分析其影响因素。为卫生行政管理部门制定具体的规培政策和促进重庆市住院医师规范化培训的同质化发展提供参考依据。方法:1、文献分析法:大量阅读与本课题相关的研究资料及文献,对本课题的研究背景和现实意义有了充分认识,了解住院医师规范化培训的相关概念、观点、理论及研究热点,为本研究提供借鉴。2、小组讨论法\专家访谈法:在课题进行过程中,根据遇到的问题,组织重庆市卫生行政部门科教处的领导及邀请部分重庆市各临床专业专科委员会专家进行小组讨论、深度访谈,从管理者角度了解重庆市住院医师规范化培训在实施过程中遇到的问题及相应的处理办法。3、问卷调查法:采用分层随机抽样的方法对重庆市住院医师规范化培训学员、科教主任及基地秘书等分别进行问卷调查,了解其对住院医师规范化培训的态度和现状。4、统计分析法:利用EXCELL表对问卷数据进行整理和录入,利用SPSS17.0软件对数据进行描述统计、方差分析、logistic回归分析等,以p值≤0.05为差异有统计学意义。结果:1、本次共发放学员学员问卷300份,其中有效问卷286份,问卷有效率98.6%。基地及其管理队伍问卷50份,收回46份,问卷收回率92%,其中有效问卷42份,问卷有效率84%。2、学员的人口学因素对规培政策制度的认知和效果评价差异有统计学意义(p≤0.05),且多数学员赞成规培制度,认为规培是利大于弊的,通过规培帮助他们巩固了理论知识,提升了实践能力和医患沟通水平,并期望基地导师能提升自身的教学水平及对规培的责任心等,大致一半的学员认为规培总体是满意的(51.79%)。3、在学员“环境”信息中,多数学员表示参加规培有一定压力或较大压力,而原因主要在于收入太低导致的经济压力(78.26%)、个人婚恋生育计划难以实施(48.52%)、难以适应高负荷的工作等(39.73%)。4、学员所在基地对规培工作实施现状差异有统计学意义(p≤0.05),大多数医院对规培工作很重视(88.10%),并制定了规培质量控制措施(76.19%),对规培实行导师制(71.42%),为学员配备了统一宿舍(83.33%),但是大多数医院对导师每年培训次数在1—2次(70.73%),多数医院的学员中途退学比例在0-1%之间(52.5%),且大多数学员中途退学是因为编制内就业,而医院基地近年招生情况逐年递增的有16家(40%)。5、重庆市近3年结业考试合格率波动大,规培结业考试合格率与执医考试合格率、能否按计划轮转、是否开展三基训练、出科考核组织情况等指标差异具有统计学意义(P≤0.05)。对策与建议:1.加强思想引导,制定个性化的培训方案。2.关注学员经济压力,完善薪酬待遇实施细则。3.加强人才培养,强化师资队伍建设。4.搭建多方互动平台,学习先进地区经验。5.专人专职,切实落实规培责任制。6.加强科室管理,缓解规培学员工学矛盾。更多还原

【Abstract】 Objective:Through the questionnaire survey to understand the status of implementation of the standardized training of residents in Chongqing City, and analyze its influence factors. For the health administrative departments to develop specific training policy and promoting the development of homogenization the standardized training of residents in Chongqing city to provide reference.Methods:1, Literature analysis: read a lot and this topic related research and literature on this topic research background and practical significance to have the full understanding, understanding of hospital related concepts of the standardized training of residents, ideas, theories, and research focus, this study provides reference.2, Group discussion method\expert interview method, in the research process, according to the problems encountered, organization of Chongqing municipal public health administrative department of science and Technology Department of leadership and invited some of Chongqing city the clinical specialist committee expert group discussions, interviews, from the perspective of managers in the solution of Chongqing city hospital standardized training of residents in the implementation of the problems encountered in the process and the corresponding solution.3, Questionnaire investigation method: using stratified random sampling method of Chongqing city hospital physician trainees in standardized training, director of science and education and the base of the secretary were conducted a questionnaire survey, understand their attitude and status of the standardized training of residents in the hospital.4,Statistical analysis: using excell table on the questionnaire data of collation and entry, using SPSS17.0 software to describe the data statistics, variance analysis and logistic regression analysis, with P values less than or equal to 0.05, the difference was statistically significant.Result:1, The participants issued a total of 300 questionnaires of students, of which 286 valid questionnaires, the questionnaire was 98.6%. The base and its management team of 50 questionnaires, 46 copies of the questionnaire, the recovery rate of 92%, of which 42 valid questionnaires, the questionnaire was 84%.2, Students of demographic factors on compliance training policy system cognition and evaluation of the effect of difference has statistical significance(P < 0.05) and mathematics in favor of compliance training system, that compliance training is more advantages than disadvantages, through compliance training help them to consolidate the theoretical knowledge, enhance the ability of practice and medical patient communication level, and expect instructor base can improve their teaching level and the compliance training responsibility, roughly half of the students think compliance training is generally satisfactory(51.79%).3, Students in the "environment" of information, most of the students that participate in the standardized training has certain pressure or pressure, but the main reason is that the income is too low due to economic pressure(78.26%), individual marriage family planning difficult to implement(48.52%), it is difficult to adapt to the high load of work(39.73%).4, Hospital and compliance training status difference was statistically significant(P < 0.05), most hospitals of compliance training attaches great importance to(88.10%), and to develop a compliance training quality control measures(76.19%), the compliance training tutorial system(71.42%), for students with a unified dormitory(83.33%), but most hospitals to tutor training each year in the number of 1- 2 times(70.73%), most of the hospital midway through the students dropped out of proportion between 0-1%(52.5%) and most of the students in middle school is because the establishment of employment, and base hospital in recent years, enrollment is increasing year by year the have 16(40%).5, Chongqing city nearly 3 years Doctor graduation exam pass rate fluctuation, the graduation examination qualified rate and practicing physician examination qualified rate, whether planned rotation, whether to carry out the three basics training, departmental rotation examination organization and index difference was statistically significant(P < 0.05).Countermeasures and suggestions:1, To strengthen the ideological guidance, the development of personalized training program. 2, Pay attention to the economic pressure of the students, improve the implementation details of the remuneration package. 3,Strengthen personnel training, strengthen the construction of teaching staff. 4,To build multi interactive platform, learning advanced experience in the area. 5,Full-time staff, and effectively implement the regulatory responsibility system.6,To strengthen the management of the Department, to alleviate the contradiction between the rules and the students.更多还原