中医临床硕士研究生对实习质量主要影响因素的评价研究

【作者】 杨淑；

【导师】 乔旺忠；

【作者基本信息】 北京中医药大学 ， 社会医学与卫生事业管理， 2010， 硕士

【摘要】 临床实习是临床医学教育的最后阶段,临床实习质量的优劣直接影响着整个医学教育的质量和医学生毕业后的临床实践能力。本研究的目的是通过了解当前临床硕士研究生临床实习质量的现状及其相关情况,明确临床硕士研究生临床实习质量的主要影响因素,从而针对存在的问题,提出改善临床硕士研究生临床实习质量的建议及对策。通过本文的研究,以期为提高临床专业硕士研究生培养质量提供参考。本研究从研究生临床实习质量的现状出发,分析本科生临床实习质量的相关影响因素,及临床硕士研究生的培养情况,根据文献研究确定临床硕士研究生实习质量的主要影响因素,主要有：带教老师的带教情况,找工作、备考执业医师资格考试、考博、做实验等,本科阶段临床实习状况,实习教学资源,考核制度的实施情况,临床实习计划的合理性,实习态度等。然后根据确定的主要影响因素进行问卷设计,调查临床硕士研究生对临床实习质量影响因素的评价,分析当前临床实习质量影响因素的影响程度、影响范围及最主要影响因素。最后将调查结果进行统计分析、综合归纳。研究发现,临床硕士研究生临床实习质量是由多种影响因素综合作用的结果。实习生对客观影响因素的满意程度和各影响因素对实习质量的影响程度各不相同。通过调查,带教老师是临床硕士研究生临床实习质量的最主要影响因素,各影响因素对实习质量的影响程度所占比例依次排序为：“带教老师”、“实习教学资源”、“实习态度”、“临床实习计划”、“找工作、备考执业医师资格考试、考博、做实验等”、“本科阶段临床实习状况”、“考核制度”、“其它”。在某些方面,“性别”、“年级”、“专业”之间差异有统计学意义。根据以上研究结论,建议如下：实习教学医院要加强临床实习教学管理,提高带教老师的整体素质,充分合理地利用实习教学资源,完善临床实习计划,规范考核管理,严格执行考核制度。高校要加强研究生教学管理,控制研究生招生规模,学校与实习教学医院之间应该明确教学管理责任。国家教育主管部门要制定相关政策解决与临床实习相关的矛盾。实习生在临床实习过程中要端正实习态度,加强自身综合素质的培养,不断提高自身能力。更多还原

【Abstract】 Clinical practice is the final stage of medical education, and the quality of clinical practice will directly affect the quality of the whole medical education and clinical practice competence of medical students. The study is designed to understand the current situation of the quality of clinical practice of postgraduates, define the main influential factors upon quality of clinical practice and come up with effective countermeasures aimed at the existing problems. The aim is to provide the reference for improving postgraduates’clinical training through this research.The study is to investigate the current situation of the quality of postgraduates’clinical practice, analyze the influential factors upon quality of undergraduates’clinical practice and cultivation situation of postgraduates, and define the main influential factors upon quality of clinical practice towards postgraduates through documents research. The main factors are:teachers who execute the practice education; applying for jobs, Practicing Physician Qualifications Test and Entrance Examination for Doctoral Education, doing experiments and other things; the situation of undergraduates’clinical practice; teaching resources in training hospital; assessment system; the reasonableness of the clinical practice plan, and postgraduates attitude. Then the questionnaire was designed by the definite influential factors to investigate the postgraduates’ estimation of influential factors upon quality of clinical practice and analyze the influence, influence range and the leading influential factor. Finally, the investigation result is analyzed statistically, and received the conclusion comprehensively.The study finds that the quality of postgraduates’clinical practice is the result of combined action of several factors; Interns’satisfaction at objective factors and the influence of every factor upon quality of clinical practice vary respectively; Through the study, we find teachers who execute the practice education is the leading influential factor. The proportion of each factors’ influence ranks as:"teachers who execute the practice education", "teaching resources in training hospital", "postgraduates attitude", " the reasonableness of the clinical practice plan", "applying for jobs, Practicing Physician Qualifications Test and Entrance Examination for Doctoral Education, doing experiments and other things", "the situation of undergraduates’clinical practice"; "assessment system" and "others". Study also shows that gender, grade and major have statistically significant difference on some aspects. According to the above conclusion, this study propose:training hospital should strengthen management of clinical practice teaching, improve the overall competence of teachers, utilize the teaching resources sufficiently and reasonably, perfect the clinical practice plan and implement the assessment system strictly; The universities should strengthen the teaching management of postgraduates, control postgraduate enrollment number, and clear responsibility of teaching hospital upon teaching management; State Education Ministry should make some policies to solve contradiction related to clinical practice. The interns should take a correct attitude towards clinical practice, promote comprehensive quality and improve abilities.更多还原