临床医学专业学位研究生“医教协同”培养模式现状研究

发布时间：2018-05-06 02:11

本文选题：临床专业学位 + 医教协同　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:本研究旨在了解国外部分国家医学教育的基本情况以及国内“医教协同”培养模式的实行情况。并以天津某高校为例,通过问卷调查和实证研究了解“医教协同”背景下,我国临床医学专业学位研究生的培养现状及其存在的问题,并对影响其培养质量的内、外部培养流程进行全面再造。最后借鉴相关经验提出建议,为推进该模式的顺利进行提供依据。方法:本研究采用文献研究法了解国外部分国家医学教育的基本情况以及我国临床医学专业学位研究生培养模式的发展趋势。并通过实地调查法了解国内部分高校“医教协同”培养模式的实行情况。其次,以天津某高校为例,采用问卷调查法和实证研究法,了解专业学位研究生培养中存在的问题。最后引入流程再造理论,对临床医学专业学位研究生的内、外部培养流程进行全面再造。问卷由调查者统一发放并说明填写要求,填写完毕后由调查者统一回收。采用Epidata3.1进行数据录入,采用SPSS19.0进行数据统计。其中计数资料的统计描述采用率和百分比,组间率的比较采用χ~2检验,检验水准为α=0.05。结果:采用文献研究法了解了美国、英国、日本等国家的医学教育现况,通过比较发现,这些国家医学教育比较严格,极为注重医学生临床实践能力、自学能力和人文素质的培养。其中住院医师培训是成为临床医生的必经之路,继续医学教育是医学生终身学习的必修课。对国内南京、上海、重庆等6所高校进行实地调查,结果显示我国大部分高校均要求专业学位研究生在学期间进行为期33个月的临床轮转;其课程实行学分制,主要安排在第一学期的周末或晚上。此外,为促进“医教协同”培养模式的顺利过渡,安徽、广西、四川等地均按照教育部的相关要求和自身的实际情况对2015年以前入学的临床医学专业学位研究生的临床工作进行了认定。本研究共发放问卷1021份,其中管理人员问卷25份,有效回收22份;导师问卷300份,有效回收282份;专业学位研究生的调查分为两个部分,其中第一部分发放问卷348份,有效回收314份,第二部分发放348份,有效回收319份;肿瘤学实证研究共发放问卷250份,有效回收221份。调查结果显示,72.93%的研究生接受“医教协同”培养模式的意愿较高,但由于了解渠道存在一定的局限性,部分调查对象对该模式的认识程度较低,而且不同人群的认识程度存在一定的差异(χ~2=43.497,P=0.000)。招生方面,大部分人群认为该校专业学位研究生入学考试仍偏重于对理论知识的考察,因此分别有60.72%的管理人员、41.00%的导师和52.87%的研究生认为应该在入学考试中加大对专业学位研究生临床技能的考察比重。课程方面,超过50%的研究生认为目前的课程体系有待完善,近90%的课程采用教师单纯讲授的授课方式,授课方式单一;此外,大部分的调查对象建议学校开设一定的网络课程供研究生灵活选择。临床培训方面,经过一定的临床轮转,学生的各项技能均有了不同程度的提升,但仍有部分研究生表示临床轮转过程中培训基地及带教老师对其重视程度较低,管理状况不尽如人意,而且调查显示不同轮转基地的师资配备情况有所差异(χ~2=23.735,P=0.005)。技能考核方面,84.33%的研究生表示轮转科室的出科考核比较合理,但也有部分研究生表示出科考试流于形式,没有起到真正的反馈效果。此外,近90%的研究生表示目前的奖助体系不能满足其基本的生活要求。由于肿瘤学尚未被纳入国家住院医师规范化培训专业目录,而天津市也未出台相应的培训标准,所以目前该市肿瘤学科只能按照大内科或大外科的二级学科进行轮转。实证研究结果显示,79.64%的肿瘤学研究生认为有必要在学期间参加规培,但53.39%的研究生表示目前的规培体系不利于其今后肿瘤学工作的开展,因此希望将肿瘤学纳入国家规培体系,按照肿瘤专科的的轮转方式对其进行培养。此外,调查还发现目前大部分用人单位仍将规培证作为招聘的必要条件之一,而且各单位对科学学位毕业生的要求和专业学位没有太大区别。结论:“医教协同”培养模式实现了我国医学院校教育和毕业后教育的有效衔接,但该模式刚刚在全国范围内开始实行,还存在着一定的问题,例如,部分专业不对接、相关培养体系不完善、配套政策不健全以及经费保障不足。各高校要借国家大力发展专业学位和建设双一流学科的契机,借鉴国内、外的先进经验,不断创新培养方式,对影响专业学位研究生培养质量的内、外部培养流程进行全面再造,发挥各方面的力量提高临床医学专业学位研究生的培养质量,做好“医教协同”的衔接工作,推进我国医学教育改革的有效实施。
[Abstract]:Objective: the purpose of this study is to understand the basic situation of medical education in some foreign countries and the implementation of the training mode of "synergy of medical education" in China. And taking a university in Tianjin as an example, through a questionnaire survey and empirical study to understand the current situation of the training of graduate students of clinical medical professional degree and their existing questions under the background of "medical education synergy". In this study, the basic situation of medical education in some foreign countries and the training of postgraduate students in China's clinical medical specialty are studied by using the method of literature research. The development trend of the model. And through the field survey method to understand the implementation of the training mode of "medical education synergy" in some colleges and universities in China. Secondly, taking a university in Tianjin as an example, using the questionnaire survey method and the empirical research method to understand the problems existing in the training of professional degree graduate students. Finally, it is introduced into the theory of process reengineering and the professional degree of clinical medicine. In the postgraduate, the external training process was rebuilt in an all-round way. The questionnaire was issued by the investigators and explained the requirements. After the completion of the questionnaire, the investigators were reclaimed. The data were recorded by Epidata3.1 and SPSS19.0 was used to carry out data statistics. The statistics of counting data were used to describe the mining rate and percentage, and the comparison of inter group rates was checked by ~2. The test level is the result of alpha =0.05.: the medical education in the United States, Britain and Japan is understood by the literature research method. Through comparison, it is found that the medical education in these countries is more strict and pays great attention to the clinical practice ability of medical students, the ability of self-study and the cultivation of humanistic quality. The training of resident physicians is a must for clinicians. On the road, continuing medical education is a compulsory course for lifelong learning of medical students. 6 colleges and universities in Nanjing, Shanghai and Chongqing have conducted field investigations. The results show that most colleges and universities in China require the graduate students of professional degree to carry out the clinical rotation for 33 months during the semester; the curriculum implementation of the credit system is mainly arranged at the weekend of the first semester. In addition, in order to promote the smooth transition of the training mode of "medical education synergy", the clinical work of the graduate students of clinical medical degree enrolment before 2015 was identified according to the requirements of the Ministry of education and the actual conditions of the Ministry of education in Anhui, Guangxi, Sichuan and other places. 1021 questionnaires were issued in this study, among which the managers asked. There were 25 copies, 22 copies of the questionnaire and 282 copies of the tutor's questionnaire. The investigation of professional degree graduate students was divided into two parts, of which the first part issued 348 copies of the questionnaire, 314 were effectively recycled, second parts were distributed 348 and 319 copies were effectively recovered. The oncology empirical study issued a total of 250 questionnaires and effectively recycled 221. The survey results showed 72.9 3% of the graduate students have a higher willingness to accept the training mode of "medical education synergy", but due to the limitations of the understanding channel, some of the respondents have a low degree of understanding of the model, and there are certain differences in the degree of understanding among the different groups of people (x ~2=43.497, P=0.000). There are 60.72% of managers, 41% of tutors and 52.87% of graduate students think that the proportion of clinical skills of graduate students should be increased in the entrance examination. In the course, more than 50% graduate students think that the current curriculum system needs to be improved and nearly 90% courses are required. In addition, most of the respondents suggested that the school set up a certain network course for the flexible selection of graduate students. In clinical training, the students' skills have been promoted in different degrees after a certain clinical rotation, but there are still some postgraduates representing clinical rotation. In the process, the training base and the teaching teacher paid less attention to it, and the management situation was not satisfactory. Moreover, the investigation showed that there were differences in Teachers' staffing in different rotation bases (x ~2=23.735, P=0.005). In terms of skill assessment, 84.33% of the graduate students indicated that the examination of the rotation department was more reasonable, but some graduate students also expressed their studies. In addition, nearly 90% of the graduate students say that the current system does not meet their basic living requirements. Oncology has not been included in the national resident standard training catalogue, and Tianjin has no corresponding training standards, so the city is currently only oncology. The results show that 79.64% of the oncology graduate students believe that it is necessary to participate in the discipline of the two semester, but 53.39% of the graduate students say that the current regulatory system is not conducive to the development of oncology in the future, so it is hoped that oncology will be incorporated into the national regulation system to follow the swelling. In addition, the survey also found that most of the employers still have one of the necessary conditions for recruitment, and there is no big difference between the requirements and professional degrees of Science degree graduates. Conclusion: the training mode of "medical education synergy" has realized the education of medical colleges and universities in China and The effective link of education after graduation, but the model has just started in the country, there are still some problems, for example, some specialties are not docked, the related training system is not perfect, the supporting policies are not perfect and the funds are inadequately guaranteed. The advanced experience of internal and external, the continuous innovation training mode, the overall reengineering of the internal and external training processes that affect the quality of professional degree graduate students, improve the training quality of the graduate students of clinical medicine professional degree, do a good job of "cooperation of medical education", and promote the effective implementation of the reform of medical education in China.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R-4;G643

【参考文献】