Abstract:

Objective　To investigate the current problems in graduate education in clinical medicine under the integration of standardized residency training and clinical practice. Methods　One hundred and thirty-one clinical postgraduate students who studied at Binzhou Medical University, Shandong University, Shihezi University, and Shandong First Medical University from May 2018 to April 2020 were investigated in terms of the teaching mode, the influence of tutors, and the demand for ability improvement under the combined training mode of standardized resident training and clinical practice through questionnaire survey. The original data were exported from the questionnaire survey platform. WPS was used to transform the data. The data were expressed as single item support rate. Results　In the teaching for clinical medical graduate students, the teachers often used actual operation (79.4%, 104/131), case teaching (77.1%, 101/131), special lectures and discussion (72.5%,95/131), teaching theories through multimedia (67.9%,89/131), etc. The teaching methods the students liked were as below: case teaching (89.3%, 117/131), actual operation (82.4%, 108/131), special lectures and discussion (66.4%, 87/131), and teaching theories through multimedia (40.5%, 53/131). Under the integration of standardized residency training and clinical practice, the tutors influenced the students in knowledge improvement and eye opening (82.4%, 108/131), increasing practice ability (80.2%, 105/131), theoretical knowledge improvement (77.1%, 101/131), innovation cultivation (64.9%, 85/131), and knowledge systemization and education idea update (51.1%, 67/131). In the theory combining with practice process, 84.7% (111/131) thought that they could applied the theories in practice well, and 15.3% (20/131) did not think so; 92.4% (121/131) thought that the knowledge and abilities they got were enough for their future positions, and 7.6% (10/131) did not think so. Most topics of the students' theses were from their tutors' programs and projects. Lack of problem awareness, lack of source of topic selection, and difficulty in determining the topic were the main difficulties in the design of graduate dissertations. In order to adapt to the future post, the ability to analyze and solve problems, the expansion of comprehensive knowledge, basic skills, and practical ability should be strengthened during the postgraduate period under the integration of standardized residency training and clinical practice. Conclusion　The combination of multiple teaching modes and the establishment of a tutor team can not only fully mobilize the learning enthusiasm and solve the existing difficulties of clinical medical graduate students, but also help them meet the needs of future post ability.

Key words:

Education quality, Standardized residency training, Integration cultivation mode, Clinical medicine

摘要：

目的　调查并研究住院医师规范化培训与临床实习一体化教育模式框架下临床医学专业学位研究生教育存在的问题。方法　选取2018年5月至2020年4月期间在滨州医学院、山东大学、石河子大学、山东第一医科大学就读的131名临床医学研究生为研究对象，对住院医师规范化培训与临床实习一体化培养模式的教学模式、导师影响力以及能力提升需求等方面进行问卷调查，原始数据资料通过问卷平台直接导出，使用WPS进行数据转换，数据以单项支持率（%）表示。结果　在临床医学研究生的教学上，带教教师常采用的方式依次为实际操作（79.4%，104/131）、案例教学（77.1%，101/131）、专题讲座及讨论（72.5%，95/131）、使用多媒体理论讲授（67.9%，89/131）等，研究生喜欢的教学方式排名与其略有不同，依次为案例教学（89.3%，117/131）、实际操作（82.4%，108/131）、专题讲座及讨论（66.4%，87/131）、使用多媒体理论讲授（40.5%，53/131）。在住院医师规范化培训与临床实习一体化培养模式下，导师对研究生的影响度排名依次为增长知识开阔眼界（82.4%，108/131）、提高实践能力（80.2%，105/131）、加强理论修养（77.1%，101/131）、培养创新精神（64.9%，85/131）、知识系统化和更新教育理念（51.1%，67/131）。在理论联系实践过程中，84.7%（111/131）的研究对象认为可以很好或较好地把所学理论应用于实践中，15.3%（20/131）的研究对象则认为可能运用不太好或者运用不好；92.4%（121/131）研究对象认为研究对象期间所学知识与能力能满足或基本能满足未来岗位需要，7.6%（10/131）研究对象认为所学知识与能力不能满足未来岗位需要。专业学位研究生学位论文的大部分选题来自导师课题和个人研究项目，缺乏问题意识、选题来源和角度确定困难等是研究生学位论文选题设计时主要遇到的困难。根据目前住院医师规范化培训与临床实习一体化的培养模式，研究生学习期间需要加强适应未来任务的能力，主要是分析和解决问题能力、综合知识面的拓展、基本技能及动手能力等。结论　住院医师规范化培训与临床实习一体化培养相结合及建立导师团队既能充分调动临床医学研究生的学习积极性，解决现有的困难，又能帮助其满足未来岗位能力需求。

关键词:

教育质量, 住院医师规范化培训, 一体化培养模式, 临床医学