全科住院医师规范化培训中急救能力培养的实践研究
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摘要
社区急救是急诊医疗服务体系中至关重要的组成部分,社区全科医师在社区急救中占据时间与地域上的优势,应当成为社区急救的中坚力量,但目前我国全科医师的急救能力普遍偏低,大部分未接受过系统的急救训练。全科住院医师规范化培训是培养高质量全科医师的重要途径,南京市江宁医院全科住院医师规范化培训团队在实践中,首先加强师资团队建设,急诊师资和全科师资共同培养全科住院医师规范化培训学员的急救能力,同时辅以配套的急救技能中心建设。在培训中,一方面调整了急救知识理论体系以适应全科的诊疗思维模式,另一方面着重训练住培学员的急救技能,切实提升其急救能力。此外,还建立了完善且严格的考核反馈体系,保证培训质量。本文所做的实践探索和经验总结,旨在为我国全科医师的人才培养提供参考与借鉴。
Community first aid is an important part of emergency medicine services system, general practitioners of community have great advantages in terms of time and locations and should become the backbone in first aid. However, most of the general practitioners in community lack of basic first aid knowledge and skills. Therefore, it's urgent to implement intensive and systematized first aid training for general practice residents. The Jiangning Affiliated Hospital with Nanjing Medical University is a standardized training base for residents, during their practice, a team of experienced teachers was firstly constructed, the emergency doctor and general practitioners jointly cultivated the first-aid ability of general medicine residents. Meanwhile a first aid skill training center containing necessary hardware devices such as simulant patient was built. In the training, the firstaid knowledge theory system was adjusted to adapt to the general practice thinking mode, on the other hand, the first-aid skills of the trainees were trained to improve their first-aid ability. In addition, a comprehensive and rigorous assessment feedback system has been established to ensure the quality of training. The practical exploration and experience summary made in this paper is intended to provide reference for the training of general practitioners in China.
Community first aid is an important part of emergency medicine services system, general practitioners of community have great advantages in terms of time and locations and should become the backbone in first aid. However, most of the general practitioners in community lack of basic first aid knowledge and skills. Therefore, it's urgent to implement intensive and systematized first aid training for general practice residents. The Jiangning Affiliated Hospital with Nanjing Medical University is a standardized training base for residents, during their practice, a team of experienced teachers was firstly constructed, the emergency doctor and general practitioners jointly cultivated the first-aid ability of general medicine residents. Meanwhile a first aid skill training center containing necessary hardware devices such as simulant patient was built. In the training, the firstaid knowledge theory system was adjusted to adapt to the general practice thinking mode, on the other hand, the first-aid skills of the trainees were trained to improve their first-aid ability. In addition, a comprehensive and rigorous assessment feedback system has been established to ensure the quality of training. The practical exploration and experience summary made in this paper is intended to provide reference for the training of general practitioners in China.
引文
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[11]应明真,刘夙璇,徐晓璐,等.基于胜任力的多元化评价体系在住院医师规范化培训考核中的应用研究[J].卫生职业教育,2018,36(19):138-140.
[12]高璐,高晶,李红伟,等.以DOPS为工具的形成性评价在临床技能教学中的应用研究[J].中国医学教育技术,2017,31(6):714-716.
[13]李超男,尚丹丹,王佳,等.Mini-CEX联合DOPS在儿科住院医师规范化培训中的多次应用[J].中国病案,2018,19(4):64-66.
[2]黄娇甜,罗海燕,仇君,等.湖南省乡镇卫生院儿科急救能力的现状分析[J].中国小儿急救医学,2018,25(7):521-525,529.
[3]陈朔慧.社区医生急救技能培训现状与需求调查[J].现代养生,2016,(3):295.
[4]胡金伟,尹文强,赵延奎,等.山东省乡村医生对全科医学培训认知、意愿及需求分析[J].中国卫生事业管理,2019,36(1):43-45.
[5]Sidwell RA,Spilman SK,Huntsman RS,et al.Efficient hemorrhage control skills training for healthcare employees[J].J Am Coll Surg,2018,226(2):160-164.
[6]武秀昆.急诊医师应有全向思维[J].中华危重病急救医学,2013,25(7):386.
[7]Alam R,Cheraghi-Sohi S,Panagioti M,et al.Managing diagnostic uncertainty in primary care:a systematic critical review[J].BMC Fam Pract,2017,18(1):79.
[8]钮柏琳,苏艳新,朱婧,等.建立以急诊医学为主要平台、多科轮转全科医师培养新模式的探讨[J].当代医学,2018,24(10):179-183.
[9]Hunn?lvatn KH,Ivan D,Wisborg T.Emergency medicine in the general practice internship in Finnmark county[J].Tidsskr Nor Laegeforen,2017,137:23-24.
[10]陈倩,张向杰,许淼,等.客观结构化临床考试在新疆维吾尔自治区全科住院医师规范化培训结业考核中的应用研究[J].中华全科医师杂志,2018,17(5):353-358.
[11]应明真,刘夙璇,徐晓璐,等.基于胜任力的多元化评价体系在住院医师规范化培训考核中的应用研究[J].卫生职业教育,2018,36(19):138-140.
[12]高璐,高晶,李红伟,等.以DOPS为工具的形成性评价在临床技能教学中的应用研究[J].中国医学教育技术,2017,31(6):714-716.
[13]李超男,尚丹丹,王佳,等.Mini-CEX联合DOPS在儿科住院医师规范化培训中的多次应用[J].中国病案,2018,19(4):64-66.