發(fā)布時間：2017-12-31 10:12

  本文關(guān)鍵詞：臨床醫(yī)學(xué)專業(yè)學(xué)位研究生�？苹嘤�(xùn)的研究　出處：《復(fù)旦大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 臨床醫(yī)學(xué)專業(yè)學(xué)位 研究生 住院醫(yī)師規(guī)范化培訓(xùn) 畢業(yè)后醫(yī)學(xué)教育

【摘要】：[背景]我國的醫(yī)學(xué)教育制度與西方教育制度存在很大差異。目前,我國正在積極探索建立適應(yīng)我國特點的醫(yī)學(xué)教育體系,逐步完善“三階段”醫(yī)學(xué)教育模式。研究生教育和住院醫(yī)師培養(yǎng)是畢業(yè)后醫(yī)學(xué)教育的兩條途徑,對培養(yǎng)高層次醫(yī)學(xué)人才、聯(lián)接醫(yī)學(xué)終身教育,有著重要作用。若能結(jié)合兩種培養(yǎng)模式,對于醫(yī)學(xué)人才培養(yǎng)的連貫性具有現(xiàn)實意義。另外,科學(xué)學(xué)位和專業(yè)學(xué)位的界限定位模糊,使住院醫(yī)師培訓(xùn)與臨床專業(yè)學(xué)位研究生培養(yǎng)存在重疊現(xiàn)象。但鑒于畢業(yè)的臨床專業(yè)學(xué)位研究生缺乏足夠的臨床能力,仍需進(jìn)入住院醫(yī)師規(guī)范化培訓(xùn)項目,進(jìn)行臨床�？婆嘤�(xùn)。 [研究目的]通過研究,探討臨床醫(yī)學(xué)專業(yè)學(xué)位研究生與住院醫(yī)師規(guī)范化培訓(xùn)結(jié)合的可能性,為臨床醫(yī)學(xué)碩士專業(yè)學(xué)位研究生教育改革試點提供參考依據(jù)。 [研究內(nèi)容與方法]本研究采取對臨床醫(yī)學(xué)專業(yè)學(xué)位研究生相關(guān)政策分析,對上海市某三級甲等醫(yī)院臨床型研究生培養(yǎng)現(xiàn)狀分析及對�？苹嘤�(xùn)的利益相關(guān)者評價分析,通過文獻(xiàn)查閱、醫(yī)院調(diào)查、問卷調(diào)查和專家訪談,收集相關(guān)數(shù)據(jù),并采用了方差分析、非參數(shù)檢驗、x2檢驗、Logistic回歸分析等統(tǒng)計方法。 [研究結(jié)果]通過研究發(fā)現(xiàn),1998年國務(wù)院學(xué)位委員會正式頒發(fā)的《臨床醫(yī)學(xué)專業(yè)學(xué)位試行辦法》,明確規(guī)定了臨床醫(yī)學(xué)專業(yè)學(xué)位旨在培養(yǎng)具有較強的臨床分析和思維能力,并能較熟練地掌握該專業(yè)臨床技能和臨床科研方法的臨床型人才。醫(yī)學(xué)專業(yè)學(xué)位制度成為我國培養(yǎng)高層次臨床醫(yī)師的主要途徑。但是,隨著我國醫(yī)療事業(yè)快速發(fā)展,政府對醫(yī)療衛(wèi)生問題日益重視,并且嘗試把專業(yè)學(xué)位培養(yǎng)與住院醫(yī)師培訓(xùn)有機結(jié)合起來。當(dāng)前,建立全國性的住院醫(yī)師規(guī)范化培訓(xùn)制度已有可能。 上海市某三級甲等醫(yī)院的在讀專業(yè)學(xué)位研究生和臨床帶教老師的問卷調(diào)查顯示,把研究生臨床輪轉(zhuǎn)培訓(xùn)和住院醫(yī)師培訓(xùn)結(jié)合起來是可行的。技術(shù)層面上,兩者輪轉(zhuǎn)科室與輪轉(zhuǎn)要求基本相同,帶教老師基本相似；社會層面上,臨床型研究生的臨床能力培養(yǎng)與住院醫(yī)師培訓(xùn)的方式是趨同的,兩者互認(rèn)只是形式問題；經(jīng)濟(jì)層面上,把臨床型研究生培養(yǎng)納入住院醫(yī)師培訓(xùn),可以充分利用國家給予研究生的補貼優(yōu)勢,減少重復(fù)的教育經(jīng)費投入。 研究顯示,學(xué)生和帶教老師對目前的臨床專業(yè)學(xué)位研究生的臨床能力培養(yǎng)成果表示肯定,81.7%學(xué)生認(rèn)為臨床型研究生能夠達(dá)到或者大部分能夠達(dá)到住院醫(yī)師規(guī)范化培訓(xùn)的要求,68.4%的帶教老師表示基本滿意臨床型研究生的臨床能力,73.7%的老師認(rèn)為其能夠達(dá)到或者大部分能夠達(dá)到住院醫(yī)師規(guī)范化培訓(xùn)的要求。 研究還顯示,專業(yè)學(xué)位培養(yǎng)與住院醫(yī)師培訓(xùn)結(jié)合的難點是：1、研究生的執(zhí)業(yè)醫(yī)師資格：46.2%的學(xué)生和42.2%的帶教老師認(rèn)為臨床專業(yè)學(xué)位研究生沒有執(zhí)業(yè)醫(yī)師資格是不能參加科室診療操作的主要原因,研究生只有在畢業(yè)當(dāng)年才能參加執(zhí)業(yè)醫(yī)師資格考試；2、臨床能力：臨床型研究生輪轉(zhuǎn)時間能否算作住院醫(yī)師培訓(xùn)時間,49.77%的學(xué)生希望對臨床型研究生按達(dá)到培訓(xùn)階段水平給予證明,由開展住院醫(yī)師規(guī)范化培訓(xùn)的醫(yī)院直接認(rèn)定,而目前臨床型學(xué)生輪轉(zhuǎn)水平認(rèn)定方式并不贊同,84.2%的帶教老師認(rèn)為有必要把臨床專業(yè)學(xué)位研究生培養(yǎng)納入住院醫(yī)師培訓(xùn)中,而只有51.7%的學(xué)生認(rèn)為有必要,其中77.8%的臨床型博士認(rèn)為沒有必要。 [討論與建議]根據(jù)研究結(jié)果,作者建議：①完善我國住院醫(yī)師規(guī)范化培訓(xùn)的模式,規(guī)范�？漆t(yī)師準(zhǔn)入制度,盡快建立臨床專業(yè)學(xué)位與住院醫(yī)師規(guī)范化培訓(xùn)相結(jié)合的學(xué)位授予制度；②簡化臨床專業(yè)研究生培養(yǎng)層次,改革我國的醫(yī)學(xué)教育制度；③建立統(tǒng)一、嚴(yán)格而具體的考核和考試制度,建立全國性的住院醫(yī)師培訓(xùn)資格認(rèn)證標(biāo)準(zhǔn)和認(rèn)證體系；④允許經(jīng)過一定時間輪轉(zhuǎn)實踐的專業(yè)學(xué)位研究生提前參加醫(yī)師資格考試,配合建立和完善與臨床醫(yī)療教學(xué)工作相關(guān)的法律法規(guī)；⑤不斷完善上海市的臨床醫(yī)學(xué)碩士專業(yè)學(xué)位研究生教育綜合改革試點項目。
[Abstract]:There is a big difference [background] our medical education system and western education system. At present, China is actively exploring the establishment of China's characteristics of the medical education system to gradually improve the medical education three stage "mode. The postgraduate education and residency training are two ways for graduate medical education, to cultivate the high level of medical personnel, medical connection of lifelong education, plays an important role. If we can combine the two kinds of training mode, it has practical significance for the training of medical personnel continuity. In addition, the fuzzy boundary location of scientific degree and professional degree, the residency training and clinical professional postgraduates training are overlapped. But in view of the clinical professional degree graduate students lack clinical ability enough, still need to be in the program of residency training, clinical specialty training.
[Objective] the purpose of this study is to explore the possibility of combination of clinical medicine professional degree graduate and resident resident standardized training, so as to provide reference for the pilot program of clinical medicine master degree graduate education reform.
[] the research contents and methods adopted in this study on the clinical medical professional degree graduate related policy analysis, the clinical research of a Shanghai City three Jiadeng hospital training present situation analysis and stakeholder analysis of specialized training evaluation, through literature review, hospital survey, questionnaire survey and expert interview, collect relevant data. Using variance analysis, nonparametric test, x2 test, Logistic regression analysis and other statistical methods.
[results] the study found that the degree of Clinical Medicine Academic Degrees Committee of the State Council in 1998 officially issued "Interim Measures", defined the professional degree of clinical medicine to develop a strong analysis and clinical thinking ability, and can skillfully master the clinical talents in the professional clinical skills and clinical research methods of medical professional. The degree system has become the main way to cultivate high-level clinicians in our country. However, with the rapid development of medical industry in China, the government pay more attention to health problems, and try to put the professional degree training and residency training organically. At present, the establishment of a national standardized residency training system has been possible.
Shanghai City three hospitals in the study of reading professional degree students and clinical teachers with questionnaire survey showed that the postgraduate clinical rotation training and residency training combination is feasible. The technical level, the two departments and rotary rotary requirements are basically the same, teachers are similar; the social level, way the clinical ability of postgraduate training and clinical residency training is convergence, just two forms of mutual recognition; the economic level, the training in residency training clinical postgraduates, can make full use of the state to give Graduate Students Subsidy advantage, reduce duplication of education funding.
Research shows that students and teachers affirmed the clinical ability of clinical professional degree of current students' achievements, 81.7% of students think that clinical postgraduates can achieve or most can reach the residency training requirements, 68.4% clinical teachers expressed satisfaction of basic ability of clinical postgraduates, 73.7% the teacher thinks it can achieve or most can reach the residency training requirements.
The study also showed that the professional degree training difficulty and residency training combination: 1, graduate qualification: teachers think clinical professional postgraduates without qualification is the main reason not to participate in the Department of medical operation with 46.2% students and 42.2% graduate students, only in the year of graduation to participate in the practice the physician qualification examination; 2, clinical competence: clinical postgraduates training time cycle time can be counted in hospital physicians, 49.77% of the students hope for Clinical Postgraduate Certificate in accordance with the training to achieve level given, directly determined by the development of the standardized training of residents and hospital, the current clinical student level recognition does not agree with the rotation. Teachers think it is necessary to clinical professional degree graduate education into the training of residents in 84.2%, while only 51.7% of the students think it is necessary, the 77.8% of the clinical doctorates do not think it is necessary.
[] discussion and suggestions according to the research results, the author suggested: perfecting mode of our country of residency training, standardized specialist access system, the establishment of clinical professional degree as soon as possible with a combination of residency training degree granting institution; the reduced levels training of clinical postgraduates, the reform of China's medical education system the establishment of a unified,; strict and specific assessment and examination system, the establishment of a national residency training certification standards and certification system; the allowed after a certain time of professional degree rotation practice students to participate in pre qualification examination, establish and improve relevant laws and regulations of clinical teaching work and constantly improve the pilot; the comprehensive reform of Education Master's degree in clinical medicine graduate student in Shanghai city.

【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：G643;R-4

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