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重慶市住院醫(yī)師規(guī)范化培訓(xùn)現(xiàn)狀調(diào)查及影響因素分析

發(fā)布時(shí)間:2018-07-17 20:40
【摘要】:目的:通過問卷調(diào)查了解重慶市住院醫(yī)師規(guī)范化培訓(xùn)實(shí)施現(xiàn)狀,分析其影響因素。為衛(wèi)生行政管理部門制定具體的規(guī)培政策和促進(jìn)重慶市住院醫(yī)師規(guī)范化培訓(xùn)的同質(zhì)化發(fā)展提供參考依據(jù)。方法:1、文獻(xiàn)分析法:大量閱讀與本課題相關(guān)的研究資料及文獻(xiàn),對(duì)本課題的研究背景和現(xiàn)實(shí)意義有了充分認(rèn)識(shí),了解住院醫(yī)師規(guī)范化培訓(xùn)的相關(guān)概念、觀點(diǎn)、理論及研究熱點(diǎn),為本研究提供借鑒。2、小組討論法\專家訪談法:在課題進(jìn)行過程中,根據(jù)遇到的問題,組織重慶市衛(wèi)生行政部門科教處的領(lǐng)導(dǎo)及邀請(qǐng)部分重慶市各臨床專業(yè)?莆瘑T會(huì)專家進(jìn)行小組討論、深度訪談,從管理者角度了解重慶市住院醫(yī)師規(guī)范化培訓(xùn)在實(shí)施過程中遇到的問題及相應(yīng)的處理辦法。3、問卷調(diào)查法:采用分層隨機(jī)抽樣的方法對(duì)重慶市住院醫(yī)師規(guī)范化培訓(xùn)學(xué)員、科教主任及基地秘書等分別進(jìn)行問卷調(diào)查,了解其對(duì)住院醫(yī)師規(guī)范化培訓(xùn)的態(tài)度和現(xiàn)狀。4、統(tǒng)計(jì)分析法:利用EXCELL表對(duì)問卷數(shù)據(jù)進(jìn)行整理和錄入,利用SPSS17.0軟件對(duì)數(shù)據(jù)進(jìn)行描述統(tǒng)計(jì)、方差分析、logistic回歸分析等,以p值≤0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1、本次共發(fā)放學(xué)員學(xué)員問卷300份,其中有效問卷286份,問卷有效率98.6%;丶捌涔芾黻(duì)伍問卷50份,收回46份,問卷收回率92%,其中有效問卷42份,問卷有效率84%。2、學(xué)員的人口學(xué)因素對(duì)規(guī)培政策制度的認(rèn)知和效果評(píng)價(jià)差異有統(tǒng)計(jì)學(xué)意義(p≤0.05),且多數(shù)學(xué)員贊成規(guī)培制度,認(rèn)為規(guī)培是利大于弊的,通過規(guī)培幫助他們鞏固了理論知識(shí),提升了實(shí)踐能力和醫(yī)患溝通水平,并期望基地導(dǎo)師能提升自身的教學(xué)水平及對(duì)規(guī)培的責(zé)任心等,大致一半的學(xué)員認(rèn)為規(guī)培總體是滿意的(51.79%)。3、在學(xué)員“環(huán)境”信息中,多數(shù)學(xué)員表示參加規(guī)培有一定壓力或較大壓力,而原因主要在于收入太低導(dǎo)致的經(jīng)濟(jì)壓力(78.26%)、個(gè)人婚戀生育計(jì)劃難以實(shí)施(48.52%)、難以適應(yīng)高負(fù)荷的工作等(39.73%)。4、學(xué)員所在基地對(duì)規(guī)培工作實(shí)施現(xiàn)狀差異有統(tǒng)計(jì)學(xué)意義(p≤0.05),大多數(shù)醫(yī)院對(duì)規(guī)培工作很重視(88.10%),并制定了規(guī)培質(zhì)量控制措施(76.19%),對(duì)規(guī)培實(shí)行導(dǎo)師制(71.42%),為學(xué)員配備了統(tǒng)一宿舍(83.33%),但是大多數(shù)醫(yī)院對(duì)導(dǎo)師每年培訓(xùn)次數(shù)在1—2次(70.73%),多數(shù)醫(yī)院的學(xué)員中途退學(xué)比例在0-1%之間(52.5%),且大多數(shù)學(xué)員中途退學(xué)是因?yàn)榫幹苾?nèi)就業(yè),而醫(yī)院基地近年招生情況逐年遞增的有16家(40%)。5、重慶市近3年結(jié)業(yè)考試合格率波動(dòng)大,規(guī)培結(jié)業(yè)考試合格率與執(zhí)醫(yī)考試合格率、能否按計(jì)劃輪轉(zhuǎn)、是否開展三基訓(xùn)練、出科考核組織情況等指標(biāo)差異具有統(tǒng)計(jì)學(xué)意義(P≤0.05)。對(duì)策與建議:1.加強(qiáng)思想引導(dǎo),制定個(gè)性化的培訓(xùn)方案。2.關(guān)注學(xué)員經(jīng)濟(jì)壓力,完善薪酬待遇實(shí)施細(xì)則。3.加強(qiáng)人才培養(yǎng),強(qiáng)化師資隊(duì)伍建設(shè)。4.搭建多方互動(dòng)平臺(tái),學(xué)習(xí)先進(jìn)地區(qū)經(jīng)驗(yàn)。5.專人專職,切實(shí)落實(shí)規(guī)培責(zé)任制。6.加強(qiáng)科室管理,緩解規(guī)培學(xué)員工學(xué)矛盾。
[Abstract]:Objective: to investigate the status of standardized training of resident doctors in Chongqing and analyze its influencing factors. It provides a reference for health administrative departments to formulate specific policies and promote the homogeneous development of standardized training for resident doctors in Chongqing. Methods: 1. Literature analysis: read a lot of research materials and documents related to this subject, have a full understanding of the research background and practical significance of this subject, understand the relevant concepts, viewpoints, theories and research hot spots of standardized training of resident doctors. To provide reference for this study. 2, group discussion methods / expert interviews: in the course of the project, according to the problems encountered, To organize the leadership of the Science and Education Department of the Chongqing Municipal Health Administration and to invite some experts of the specialized clinical committees of Chongqing to conduct group discussions and in-depth interviews, From the perspective of managers, the problems encountered in the implementation of standardized resident training in Chongqing and the corresponding treatment methods .3. questionnaire survey method: stratified random sampling method of Chongqing resident standardized training students, The director of science and education and the secretary of the base carried on the questionnaire investigation separately, understood its attitude and the present situation to the resident doctor standardized training .4. the statistical analysis method: use the excel table to organize and input the questionnaire data, uses the SPSS 17.0 software to carry on the description statistics to the data, The variance analysis and logistic regression analysis showed that p 鈮,

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