摘要
目的评价深圳市国际全科医生技能培训效果,为全科医生的培训及评价提供参考和建议。方法于2016年6—7月,以深圳市宝安区国际全科医生技能培训项目第一期22例学员为评价对象(学员组),并按1∶1匹配对照组。由1名课题组人员和1名资质较高的全科医生,采用莱斯特评估套件(LAP)对两组的接诊过程进行现场评价,对每例全科医生原则上评价接诊患者数为8例。LAP包括7个类别,分别为:1.接诊和病史采集、2.体格检查、3.患者管理、4.解决问题、5.医生行为和与患者的关系、6.预防性治疗、7.病历记录。结果两组最终各纳入20例全科医生参与LAP评价,共评价接诊患者263例,对照组和学员组分别评价129例和134例。学员组单位接诊时间长于对照组,差异有统计学意义(P<0.05)。学员组1~7类别得分及LAP总分均高于对照组,差异有统计学意义(P<0.05)。多重线性逐步回归分析结果显示,组别是1、3~5、7类别得分及LAP总分的影响因素(P<0.05),去除权重因素影响后,两组得分差异由大到小依次为1、3、7、4、5类别;职称是1、3、4类别得分及LAP总分的影响因素;注册执业医师专业是3、6类别得分的影响因素(P<0.05)。结论该培训项目对全科医生的应诊技能有很大帮助,主要体现在接诊和病史采集、患者管理、病历记录方面,其成效因学员职称、注册执业医师专业有所差异。今后全科医生培训应注重全科思维和医患沟通的训练,多提供真实的患者接诊、案例讨论、学术沙龙等方式,促进受训者综合素质的提升,评价考核可以借鉴LAP,注重评价实效。
Objective To assess the effect of international skills training program for general practitioners（GPs） conducted in Shenzhen so as to provide references for training for GPs and assessment of the training effect.Methods This study was conducted between 2 groups from June to July 2016.The trainee group we assigned were the 22 GPs attending the first training course of international skills training program for GPs conducted in Bao′an District,Shenzhen,and the control group were 22 GPs who did not attend the training,but were well-matched with the trainee group in the ratio of 1∶1.Every participant was hypothesized to consult 8 patients,and the consultation competence of them was evaluated on the spot by a member from the research group of this study and a well-qualified general practitioner by using the Leicester assessment package（LAP） covering 7 categories,interviewing/history taking,physical examination,patient management,problem solving,behavior/relationship with patients,anticipatory care and record keeping.Results The final participants were 20 in the trainee group as well as in the control group.The 20 trainees and their paired doctors were finally assessed for 263 consultations in total,129 and 134 consultations for control and training group respectively.The average consultation length of the trainee group was significantly longer than that of the control group（P〈0.05）.The scores for every category and total points of the trainee group were all higher than those of the control group（P〈0.05）.Stepwise multiple linear regression analysis of the associated factors for the scores allocated to the participants by LAP criteria found that,grouping was the factor associated with the scores for categories of interviewing/history taking,patient management,problem solving,behaviour/relationship with patients,record keeping and total points（P〈0.05）.After excluding the weightings,it was found that the significant differences between the two groups in the categories of interviewing/history t
出处
《中国全科医学》
CAS
北大核心
2017年第16期1987-1993,共7页
Chinese General Practice
基金
深圳市科技创新项目(JCYJ20160428103500561)--全科诊疗服务的标准化全科思维模型分析
关键词
全科医生
临床工作能力
教育考核
莱斯特评估套件
General practitioners
Clinical competence
Educational measurement
Leicester assessment package
