全科教学门诊双师培训在康健社区中实践.docVIP

全科教学门诊双师培训在康健社区中实践 　　摘 要 全科师资存在专业基础薄弱、教学方法生疏、教学技能缺乏等诸多问题，其中全科门诊教学不足问题突出。本中心在教学门诊实践中探索培养“医师”和“师资”的“双师”模式，采用纵横双维相结合的培训方法，横向上考核-培训-再考核-反馈-再培训的模式，纵向上培养具有精细化管理患者能力的全科医师，并形成自评-带教师资点评-专家点评的三级带教模式。通过“双师”培训，提高了社区全科医师的临床能力和教学能力，培养了一批临床能力和教学能力兼备的社区全科医师。 　　关键词 全科医学 教学门诊 职后培训 社区带教 　　中图分类号：G712； R192.3 文献标识码：C 文章编号：1006-1533（2018）05-0058-03 　　Practice of ‘double teacher’ training in the health community of the general education outpatient department* 　　YU Zhijie1**， ZHU Shanzhu2， YANG Hua2， TANG Yuezhong1， XU Donghao1*** 　　（1. Department of General Medical， Kangjian Community Healthcare Center of Xuhui District， Shanghai 200233， China； 2. Department of General Medical， Zhongshan Hospital， Fudan University， Shanghai 200032， China） 　　ABSTRACT There exist many problems in general practice teaching， such as the weak professional foundation， the unfamiliar teaching method and the lack of teaching skills， especially in the lack of outpatient teaching. The ‘double teacher’ mode to train both ‘doctor’ and ‘teacher’ was explored by adopting a training method of the combination of two dimensional aspects in teaching clinic practice， so as to reach a mode including horizontal assessment-training-reassessment-feedback-retraining and to train general practitioners （GPs） with ability of meticulous management of patients in longitudinal aspect， and meanwhile to form a three level teaching mode including self assessment-tutor comment-expert comment. Both of clinical diagnosis and treatment ability and teaching ability have been improved by ‘double teacher’ training， and a group of community GPs with both clinical and teaching abilities have been trained. 　　KEY WORDS general practice； teaching outpatient； post training； community education 　　全科医学作为独立的临床二级学科，在20世纪60年代正式成型。自1966年英联邦启动第一个全科医学住院医师培训项目以来，经过半个多世纪的发展，全科医师的培养体系已有许多成功经验。英、美、德、澳等国及我国的台湾和香港地区，都建立了十分成熟而又各具特色的全科医师培养体系。我国全科起步较晚，历经20多年的发展，逐步建立和完善中国特色的全科医师培养体系，但我国全科医师数量不足，质量还不高，这些仍然是健全基层医疗卫生服?仗逑档钠烤保?全科医师培养的体系化、标准化、程度化还有待提高，在全科医师培养使用的投入