强化内隐胜任力教学在全科医师规范化培训中的实践效果

王烁珊; 杨贤盛; 颜梅; 丁婵; 符岳

doi:10.16766/j.cnki.issn.1674-4152.004143

强化内隐胜任力教学在全科医师规范化培训中的实践效果

doi: 10.16766/j.cnki.issn.1674-4152.004143

王烁珊¹,
杨贤盛²,
颜梅¹,
丁婵¹,
符岳^1, ,

1.
佛山市第一人民医院全科医学科，广东佛山 528000
2.
佛山市第一人民医院肛肠外科

基金项目:

佛山市卫生健康局医学科研课题 20240421

广东省继续医学教育省级项目 2023051600010

佛山市卫生健康局医学科研指令性课题立项 C20210005

佛山市卫生健康局医学科研课题 20240350

详细信息

通讯作者:
符岳，E-mail：drfyue@163.com

中图分类号: R192.3
计量
- 文章访问数: 7
- HTML全文浏览量: 8
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-12-16
- 网络出版日期: 2025-10-31

Research on the practical effect of strengthening implicit competence teaching in standardized training of general practitioners

1.
Department of General Practice, the First People ' s Hospital of Foshan, Foshan, Guangdong 528000, China

摘要

摘要: 目的目前国内外关于强化内隐胜任力教学模式在住院医师规范化培训中的应用研究甚少，本文旨在探索强化内隐胜任力教学模式在全科住院医师规范化培训中的实践效果。方法选取佛山市第一人民医院全科医学科2022、2023、2024级正在接受国家规范化培训的30名住院医师为研究对象，选用随机数字表法将3个年级的30名医生分成对照组(15人)和研究组(15人)。对照组采用常规教学模式，研究组运用强化内隐胜任力教学模式，经过为期5个月(2024年7—11月)培训后对全科医师内隐胜任力、岗位胜任力进行评估。结果重复测量数据主体内效应检验结果显示，不同测量时间点2组全科医师内隐胜任力、岗位胜任力评分差异均有统计学意义(P＜0.001)。培训第3个月、第5个月2组全科医师的内隐胜任力评分差异均有统计学意义[(54.60±3.18)分vs. (51.87±2.50)分；(61.07±3.35)分vs. (56.17±5.83)分，P＜0.05];培训第3个月、第5个月2组全科医师的岗位胜任力评分差异均有统计学意义[(46.70±1.99)分vs. (44.95±1.86)分；(48.52±2.17)分vs. (46.04±2.33)分，均P＜0.05], 并且研究组的估算边际平均值随时间的变化趋势相对对照组均更为陡峭。结论强化内隐胜任力较常规教学模式带教的全科医师内隐胜任力及岗位胜任力提升效果更加显著。
- 全科医师 /
- 规范化培训 /
- 内隐胜任力 /
- 岗位胜任力
Abstract: Objective At present, there is little application of the implicit competence teaching model in the standardized training of residents at home and abroad. This paper aims to explore the practical effect of the implicit competence teaching model in the standardized training of general residents. Methods Thirty residents of grade 2022, 2023 and 2024 in the General Practice Department of Foshan First People ' s Hospital who were receiving national standardized training were selected as the research objects, and those candicates were divided into control group and research group by random number table method. The research group adopted the intensive implicit competence teaching mode, while the control group adopted the conventional teaching mode. After a 5-month (July 2024-November 2024) training, the implicit competence and post competence of general practitioners were evaluated. Results The results of the repeated measurement data subject internal effect test showed that there were statistically significant differences in the implicit competence and post competence scores of the two groups of general practitioners at different measurement time points (P < 0.001). There were significant differences in the implicit competency scores between the two groups at the third month and the fifth month [(54.60±3.18) points vs. (51.87±2.50) points; (61.07±3.35) points vs. (56.17±5.83) points, P < 0.05]. There were significant differences in post competency scores between the two groups at the third month and the fifth month [(46.70±1.99) points vs. (44.95±1.86) points; (48.52±2.17) points vs. (46.04±2.33) points, P < 0.05]. The estimated marginal means of the research group showed a steeper trend over time compared to the control group. Conclusion The effect of enhancing implicit competence is more significant than that of general practitioners with conventional teaching mode.
- General practitioners /
- Standardized training /
- Implicit competence /
- Post competence

HTML全文

图 1 2组全科医师内隐胜任力不同测量时间变化趋势

Figure 1. Trend chart of changes in implicit competence between two groups of general practitioners at different measurement times

下载: 全尺寸图片幻灯片

图 2 2组全科医师岗位胜任力不同测量时间变化趋势

Figure 2. The changing trends of different measurement times for the job competency between two groups of general practitioners

下载: 全尺寸图片幻灯片

表 1 2组全科医师基线资料比较

Table 1. Comparison of baseline data between two groups of general practitioners

组别	人数	性别(男性/女性，人)	年龄(x ± s，岁)	规培年级(1/2/3，人)	取得医师执业/资格证书(人)
研究组	15	4/11	25.60±1.35	3/6/6	10
对照组	15	3/12	24.87±0.74	3/7/5	11
统计量		0.186^a	1.841^b	0.168^a	0.159^a
P值		0.666	0.076	0.920	0.690
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 2 2组全科医师不同时间点内隐胜任力评分比较(x ± s，分)

Table 2. Comparison of implicit competency scores between two groups of general practitioners at different time points (x ± s, points)

组别	人数	基线期	第1个月	第3个月	第5个月
研究组	15	48.73±5.34	50.13±4.29	54.60±3.18	61.07±3.35
对照组	15	49.87±3.56	51.53±2.75	51.87±2.50	56.17±5.83
F值		0.468	1.132	6.841	76.434
P值		0.500	0.296	0.014	＜0.001

下载: 导出CSV

表 3 2组全科医师不同时间点岗位胜任力评分比较(x ± s，分)

Table 3. Comparison of job competency scores between two groups of general practitioners at different time points(x ± s, points)

组别	人数	基线期	第1个月	第3个月	第5个月
研究组	15	43.84±2.66	44.43±1.87	46.70±1.99	48.52±2.17
对照组	15	43.25±3.56	43.86±1.83	44.95±1.86	46.04±2.33
F值		0.424	0.703	6.208	11.607
P值		0.520	0.409	0.019	0.002

下载: 导出CSV

参考文献(19)

[1]	楚晓婧, 王崇贤, 张园园, 等. 基于岗位胜任力的内分泌科住院医师规范化培养模式优化研究[J]. 山西医药杂志, 2021, 50(12): 1981-1983. CHU X J, WANG C G, ZHANG Y Y, et al. Optimization of Standardized Training Model for Endocrinology Resident Physicians Based on Job Competence[J]. Shanxi Medical Journal, 2021, 50(12): 1981-1983.
[2]	张建国, 谢姿, 李颜, 等. 高质量发展背景下北京市住院医师规范化培训招收及考核探析[J]. 中国卫生人才, 2024(8): 6-9. ZHANG Y G, XIE Z, LI Y, et al. Analysis of standardized training, recruitment, and assessment of resident physicians in Beijing under the background of high-quality development[J]. Chinese Health Journal, 2024(8): 6-9.
[3]	杨阳, 吕冰洁, 闫晓红, 等. 全科住院医师规范化培训临床思维能力培养模式的探讨[J]. 中国继续医学教育, 2022, 14(9): 182-185. YANG Y, LV B J, YAN XH, et al. Exploration of the Standardized Training Model for Clinical Thinking Ability of General Practitioners[J]. Chinese Journal of Continuing Medical Education, 2022, 14(9): 182-185.
[4]	马志强, 郭乐, 李钊, 等. 签约服务情境下基于扎根理论的全科医生胜任力模型构建研究[J]. 中国全科医学, 2023, 26(4): 460-466, 485. MA Z Q, GUO L, LI Z, et al. Research on the Construction of a General Practitioner Competency Model Based on Grounded Theory in the Context of Contract Service[J]. Chinese General Practice, 2023, 26(4): 460-466, 485.
[5]	马志强, 王培蕊, 潘荷君. 全科医生内隐胜任力量表的编制及应用研究[J]. 中国全科医学, 2023, 26(4): 467-476. MA Z Q, WANG P R, PAN H J. Research on the Development and Application of Implicit Competency Scale for General Practitioners[J]. Chinese General Practice, 2023, 26(4): 467-476.
[6]	李婷, 林瑗, 路孝琴, 等. 中国全科医师岗位胜任力评价指标体系研究现状: 一项系统综述[J]. 中华全科医师杂志, 2024, 23(4): 345-353. LI T, LIN Y, LU X Q, et al. Research status of competency evaluation index system for Chinese general practitioners: a systematic review[J]. Chinese Journal of General Practitioners, 2024, 23(4): 345-353.
[7]	唐皓, 刘江辉, 陈崴, 等. 穗-伯全科师资培训项目探索与实践[J]. 中国毕业后医学教育, 2024, 8(3): 219-223. TANG H, LIU J H, CHEN W, et al. Exploration and Practice of the Sui Bo General Practitioner Training Program[J]. Chinese Journal of Post-Graduation Medical Education, 2024, 8(3): 219-223.
[8]	叶晨静, 王佳玉, 史霆, 等. 多学科协作联合情境模拟教学在全科医师规范化培训教学中的应用[J]. 中华全科医学, 2024, 22(6): 915-918. doi: 10.16766/j.cnki.issn.1674-4152.003533 YE C J, WANG J Y, SHI T, et al. Application of Multidisciplinary Collaboration and Situational Simulation Teaching in Standardized Training for General Practitioners[J]. Chinese Journal of General Practice, 2024, 22(6): 915-918. doi: 10.16766/j.cnki.issn.1674-4152.003533
[9]	国务院办公厅. 国务院办公厅关于加快医学教育创新发展的指导意见(国办发〔2020〕34号)[EB/OL]. (2020-09-23)[2023-04-03]. https://www.gov.cn/zhengce/content/2020-09/23/content_5546373.htm. The General Office of the State Council Guiding Opinions of the General Office of the State Council on Accelerating the Innovative Development of Medical Education (Guobanfa[2020] No. 34)[EB/OL]. (2020-09-23)[2023-04-03]. https://www.gov.cn/zhengce/content/2020-09/23/content_5546373.htm.
[10]	朱伟, 周峰. 基于CiteSpace探究我国医院管理人员胜任力的研究热点与可视化分析[J]. 中国医药导报, 2024, 21(23): 170-175. ZHU W, ZHOU F. Research hotspots and visualization analysis on the competence of hospital management personnel in China based on CiteSpace[J]. Chin Med Herald, 2024, 21(23): 170-175.
[11]	齐殿君, 于晓松. 全科医生置信职业行为评价框架的初步应用研究[J/OL]. 中国全科医学, 1-7. (2023-04-04)[2025-02-10]. https://doi.org/10.12114/j.issn.1007-9572.2023.0464. QI D J, YU X S, Preliminary application research on the evaluation framework of general practitioners' confidence in professional behavior[J/OL]. Chinese General Practice, 1-7. (2023-04-04)[2025-02-10]. https://doi.org/10.12114/j.issn.1007-9572.2023.0464.
[12]	刘小璇, 叶珊, 赵海燕, 等. 胜任力为导向的神经内科住院医师规范化培训的课程效果评价[J]. 中国卒中杂志, 2021, 16(2): 13-218. LIU X X, YE S, ZHAO H Y, et al. Evaluation of the course effectiveness of competency oriented standardized training for neurology resident physicians[J]. Chinese Journal of Stroke, 2021, 16(2): 13-218.
[13]	李一萱, 张阳, 于晓松. 中外全科医生岗位胜任力模型分析与借鉴[J]. 中华全科医师杂志, 2021, 20(2): 248-252. LI Y X, ZHANG Y, YU X S. Analysis and Reference of Competency Models for General Practitioners in China and Abroad[J]. Chinese Journal of General Practitioners, 2021, 20(2): 248-252.
[14]	王培蕊. 全科医生内隐胜任力对其服务价值的影响研究[J]. 镇江: 江苏大学, 2023. WANG P R. A study on the impact of implicit competence of general practitioners on their service value[J]. Zhenjiang: Jiangsu University, 2023.
[15]	冯俊雅, 王佳峰, 林铮, 等. 住院医师规范化培训学员的胜任力调查研究[J]. 中国高等医学教育, 2021(8): 10-11. FENG J Y, WANG J F, LIN Z, et al. A Study on the Competence of Standardized Training Students for Resident Physicians[J]. China Higher Medical Education, 2021(8): 10-11.
[16]	张青松, 薛慧敏, 詹东昂, 等. 湖北省2所地市级医院住院医师规范化培训学员岗位胜任力的调查[J]. 中华医学教育杂志, 2021, 41(3): 256-259. ZHANG Q S, XUE H M, ZHAN D A, et al. Survey on the Job Competence of Standardized Training Trainees for Resident Physicians in Two City level Hospitals in Hubei Province[J]. Chinese Journal of Medical Education, 2021, 41(3): 256-259.
[17]	邢宏微, 隋娜娜, 宋芳婷, 等. 以岗位胜任力为导向的医学人才培养改革路径研究[J]. 中国继续医学教育, 2024, 16(5): 14-17. XING H W, SUI N N, SONG F T, et al. Research on the Reform Path of Medical Talent Cultivation Guided by Job Competence[J]. Chinese Journal of Continuing Medical Education, 2024, 16(5): 14-17.
[18]	王孟, 高圆圆, 金沈樱, 等. 全科住院医师规范化培训质量评价体系构建研究: 以WONCA 6大核心能力为框架[J]. 中国医院管理, 2024, 44(8): 72-76. WANG M, GAO Y Y, JIN S Y, et al. Research on the Construction of Standardized Training Quality Evaluation System for General Hospital Residents[J]. Chinese Hospital Management, 2024, 44(8): 72-76.
[19]	王智力, 刘金洁, 李颖, 等. 管理参与型教学模式在全科住院医师规范化培训中的应用与探索[J]. 全科医学临床与教育, 2023, 21(6): 530-532. WANG Z L, LIU J J, LI Y, et al. Application and Exploration of Participatory Teaching Mode in Standardized Training for General Practitioners[J]. General Medicine Clinical and Education, 2023, 21(6): 530-532.