刘泽林 翟官忠 王清华

[摘要] 目的 评价泌尿外科疾病诊断治疗指南应用于泌尿外科住院医师规范化培训（以下简称“规培”）中的临床教学效果。 方法 选择2016年9月～2019年9月武汉大学人民医院泌尿外科轮转的规培生共80名，按照规培生的教育程度（学士、硕士、博士）进行分层随机化分为两组，指南组参照《中国泌尿外科疾病诊断治疗指南》指导临床诊疗（40名），对照组参照《外科学》指导临床诊疗（40名），规培时间均为3個月。出科时统一对两组进行出科考核和问卷调查，比较两组规培生的专业理论知识、病例分析、病历书写、临床技能操作能力及对教学的满意度。 结果 指南组规培生的专业理论知识、病例分析、病历书写得分和总分均高于对照组，差异有统计学意义（P < 0.05）。两组规培生的临床技能操作得分，差异无统计学意义（P > 0.05）。指南组规培生对教学的满意度高于对照组，差异有统计学意义（P < 0.05）。 结论 诊疗指南应用于泌尿外科住院医师规培可以提高临床规培效果，增强规培生的学习兴趣和满意度，为诊疗指南进一步在住院医师规培中的应用和推广提供理论依据。

[关键词] 诊疗指南;住院医师;规范化培训;泌尿外科;临床教学

[中图分类号] R33          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0058-04

[Abstract] Objective To evaluate the clinical teaching effect of urological disease diagnosis and treatment guidelines in the standardized training of urological residents. Methods From September 2016 to September 2019， a total of 80 students in the standardized training were selected for rotation in the Department of Urology， Renmin Hospital of Wuhan University. According to the educational level of the regular students （bachelor， master， doctor）， stratified and randomly divided into two groups. Guideline group guides clinical diagnosis and treatment with reference to Chinese Guidelines for Diagnosis and Treatment of Urological Diseases （40 cases）. The control group referred to Surgery for guidance in clinical diagnosis and treatment （40 cases）， the normalized training time both were 3 months. The two groups of were evaluated and surveyed by questionnaire when they were leaving the department， and their professional theoretical knowledge， case analysis， writing of medical records， clinical skills and operational ability and satisfaction with teaching were compared between the two groups. Results The scores of professional theoretical knowledge， case analysis， and writing of medical records in the guide group were all higher than those in the control group， with statistically significant differences （P < 0.05）. There was no statistically significant difference between the two groups in clinical skill operation scores （P > 0.05）. The students′ satisfaction with teaching in the guide group was higher than that in the control group， and the difference was statistically significant （P < 0.05）. Conclusion The application of the diagnosis and treatment guidelines to the standardized training in urology residency can improve the training effect， and enhance the learning interest and satisfaction of students. This provides a theoretical basis for further application and popularization of diagnosis and treatment guidelines in the resident doctor standardization training.

[Key words] Guideline; Resident doctor; Standardized training; Urology; Clinical teaching

2015年原国家卫生和计划生育委员会宣布在全国范围内推进住院医师规范化培训制度，计划到2020年，我国所有医疗机构新进临床医疗岗位本科及以上学历临床医师必须接受住院医师规范化培训（简称“规培”）。住院醫师规培制度的建立旨在提高我国临床医师的技术能力和业务水平，同时为医疗单位培养大批均等化的合格医师，实现分级诊疗体系。临床教学是将医学理论知识转化为临床医疗实践的重要阶段，是培养造就合格临床医生的重要环节[1]。……