我国全科医学人才实践教学中的关键问题及对策研究

邵涵; 管清燕; 杨双华; 刘方花; 吴炳义; 于云

doi:10.16766/j.cnki.issn.1674-4152.004268

我国全科医学人才实践教学中的关键问题及对策研究

doi: 10.16766/j.cnki.issn.1674-4152.004268

1.
青岛滨海学院护理学院，山东青岛 266400
2.
青岛大学附属医院重症医学科，山东青岛 266555
3.
山东第二医科大学管理学院，山东潍坊 261053

基金项目:

山东省教育厅教学改革课题面上项目 M2020224

潍坊医学院2023年教学成果奖源头培育项目 2023JXCGPY006

山东省教育教学研究课题 2024JXY619

青岛滨海学院人文社会科学研究项目 2025RGY03

青岛滨海学院科研创新平台/团队支持计划项目 PTK202501

详细信息

通讯作者:
于云，E-mail：404912159@qq.com

中图分类号: R192 R499
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-12
- 网络出版日期: 2026-01-07

Research on critical issues and countermeasures in practice teaching of general practitioners in China

1.
School of Nursing, Qingdao Binhai University, Qingdao, Shandong 266400, China

摘要

摘要: 目的系统界定我国定向医学生实践教学中存在的关键问题，为提升定向医学生实践教学管理水平提供参考。方法通过中国知网、万方、维普中文期刊数据库，检索我国定向医学生实践教学领域相关期刊论文; 以“史密斯模型”为理论框架，系统评阅和归类形成问题系统，并依据问题类别计算问题的严重性指数、重要性指数以及优先解决性指数; 结合四象限法、变异系数法综合确定关键问题并提出对策建议。结果最终纳入87篇期刊论文，形成20类问题清单; 我国定向医学生实践教学中的问题主要集中于政策执行主体部分; 监督体系(R=0.045)、教学理念(R=0.042)、绩效考核(R=0.027)、协调机制(R=0.026)是我国定向医学生实践教学领域现存的关键问题，而实习安排(R=0.108)、管理制度(R=0.087)是需要随时关注的潜在关键问题。结论我国定向医学生实践教学的发展主要受制于实践教学监督协调机制的不足、考核标准的多样化以及实践教学理念尚未达到预期科学化水平。因此，未来应在宏观政策指导下，健全学校与实习基地的监督协调机制、构建科学实践教育理念，并调整实习方案以增强实习的有效性。同时，遵循以人为本的教育理念，注重定向医学生道德情感的培养也是提高定向医学生实习质量的必要手段。
- 定向医学生 /
- 关键问题 /
- 文献分析 /
- 史密斯模型
Abstract: Objective To systematically define the critical issues in the practical teaching of oriented medical students in China and to provide a reference for the management of practical teaching. Methods Via CNKI, Wanfang Data, and VIP Journal Database, we searched for journal articles in the field of practical teaching of targeted medical students in China. The Smith model was used as the theoretical framework to systematically review and categorize the problem system, and the severity index, importance index and priority index were calculated according to the problem categories; the four-quadrant method and the coefficient of variation method were used to identify the key problems and propose countermeasures. Results Eighty-seven journal articles were finally included to form a list of 20 categories of problems; the problems in the practice teaching of oriented medical students in China were mainly concentrated in the part of the main body of policy implementation; the supervisory system (R=0.045), the teaching concept (R=0.042), the performance appraisal (R=0.027), and the coordination mechanism (R=0.026) were the existing key problems in the field of practice teaching of oriented medical students in China. While internship arrangement (R=0.108), and management system (R=0.087) were potential key issues that need to be kept in mind. Conclusion The development of practice teaching for oriented medical students in China is mainly limited by the insufficiency of supervision and coordination mechanisms for practice teaching, the diversity of assessment standards, and the fact that the concept of practice teaching has not yet reached the expected level of scientization. Therefore, in the future, under the guidance of macro policies, we should improve the supervision and coordination mechanism between schools and internship bases, construct scientific concepts of practical education, and adjust internship programs to enhance the effectiveness of internship. At the same time, following the concept of human-centered education and focusing on the cultivation of moral and emotional development of oriented medical students is also a necessary means to improve the quality of internship for oriented medical students.
- Oriented medical students /
- Critical issues /
- Literature analysis /
- Smith' s model

HTML全文

图 1 全科医学人才实践教学问题的文献筛选流程

Figure 1. Document screening process for practical teaching issues among general practitioners

下载: 全尺寸图片幻灯片

图 2 全科医学人才实践教学问题的文献评阅饱和曲线

Figure 2. Saturation curve of literature review on practical teaching of general practitioners

下载: 全尺寸图片幻灯片

图 3 全科医学人才实践教学中问题的严重性和重要性聚类分析

Figure 3. Cluster analysis of the severity and importance of problems in the practical teaching of general practitioners

下载: 全尺寸图片幻灯片

表 1 全科医学人才实践教学中的问题系统

Table 1. Problem system in the practical training of general medical professionals

编号	问题描述	提及次数	问题归类	问题类别
1	定向医学生的培养体系没有实现真正的科学化	6	培养体系	政策执行主体
2	实习基地管理体制不健全、执行程度不规范	10	管理制度
3	教学质量的监控存在局限性	5	监督体系
4	基层医疗机构的绩效考核流于形式、发展动力不足	3	绩效考核
5	教学基地与学校、班级、辅导老师缺乏联系	1	协调机制
6	临床教师能力不足，缺乏足够的教学经验	5	教学能力
7	指导教师对学生实习指导积极性不高	3	教学态度
8	尚未真正树立正确的教育发展理念	4	教学理念
9	临床带教教师数量不足、结构不合理	2	教师数量
10	实习地点分散、时间分配不合理	20	实习安排
11	定向医学生普遍存在家庭情况困难	4	家庭条件	政策执行对象
12	实习期间定向医学生的学习积极性不高	13	学习态度
13	定向医学生对未来的就业环境存在抵触，心理压力较大，容易产生焦虑。	15	心理素质
14	定向医学生对政策缺少了解、职业认同感较低	25	认同程度
15	定向医学生基层意识淡薄，存在违约风险	9	基层意愿
16	医疗技能操作和临床专科知识掌握不牢	2	知识水平
17	带教老师、同学以及患者间存在人际关系的焦虑	4	人际关系
18	基层人才缺口大、质量较低、服务能力不足	14	基层环境	政策执行环境
19	实践基地硬件设施不齐全	2	硬件设施
20	实践基地建设经费投入不足、落实困难	3	经济环境

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表 2 全科医学人才实践教学中问题的重要性、严重性和优先解决性的排序

Table 2. Ranking of the importance, severity, and priority of problems in the practical training of general medical professionals

问题编号	严重性指数		重要性指数		优先解决指数
问题编号	Si	排序	Ii	排序	Ri	排序
1	0.039	8	0.038	16	0.039	10
2	0.095	4	0.058	5	0.087	4
3	0.033	10	0.084	2	0.045	8
4	0.015	14	0.064	4	0.027	13
5	0.013	16	0.064	3	0.026	14
6	0.024	12	0.045	12	0.029	12
7	0.015	13	0.032	20	0.019	16
8	0.024	11	0.097	1	0.042	9
9	0.009	19	0.048	10	0.019	17
10	0.126	2	0.055	6	0.108	2
11	0.011	17	0.032	19	0.016	18
12	0.088	6	0.045	13	0.077	6
13	0.091	5	0.045	11	0.080	5
14	0.172	1	0.032	18	0.137	1
15	0.065	7	0.043	14	0.060	7
16	0.004	20	0.048	9	0.015	20
17	0.033	9	0.048	8	0.036	11
18	0.120	3	0.041	15	0.100	3
19	0.013	15	0.048	7	0.022	15
20	0.010	18	0.032	17	0.015	19

下载: 导出CSV

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