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香港与中国内地眼科住院医师对培训差异的认知调查。

A survey of perceived training differences between ophthalmology residents in Hong Kong and China.

作者信息

Young Alvin L, Jhanji Vishal, Liang Yuanbo, Congdon Nathan, Chow Simon, Wang Fenghua, Zhang Xiujuan, Man Xiaofei, Yang Mingming, Lin Zhong, Yuen Hunter G L, Lam Dennis S C

机构信息

Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, Hong Kong.

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.

出版信息

BMC Med Educ. 2015 Sep 28;15:158. doi: 10.1186/s12909-015-0440-0.

Abstract

BACKGROUND

To study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR).

METHODS

Training programs were selected from among the largest and best-known teaching hospitals. Ophthalmology residents were sent an anonymous 48-item questionnaire by mail. Work satisfaction, time allocation between training activities and volume of surgery performed were determined.

RESULTS

50/75 residents (66.7 %) from China and 20/26 (76.9 %) from HKSAR completed the survey. Age (28.9 ± 2.5 vs. 30.2 ± 2.9 years, p = 0.15) and number of years in training (3.4 ± 1.6 vs. 2.8 ± 1.5, p = 0.19) were comparable between groups. The number of cataract procedures performed by HKSAR trainees (extra-capsular, median 80.0, quartile range: 30.0, 100.0; phacoemulsification, median: 20.0, quartile range: 0.0, 100.0) exceeded that for Chinese residents (extra-capsular: median = 0, p < 0.0001; phacoemulsification: median = 0, p < 0.0001). Chinese trainees spent more time completing medical charts (>50 % of time on charts: 62.5 % versus 5.3 %, p < 0.0001) and received less supervision (≥90 % of training supervised: 4.4 % versus 65 %, p < 0.0001). Chinese residents were more likely to feel underpaid (96.0 % vs. 31.6 %, p < 0.0001) and hoped their children would not practice medicine (69.4 % vs. 5.0 %, p = 0.0001) compared HKSAR residents.

CONCLUSIONS

In this study, ophthalmology residents in China report strikingly less surgical experience and supervision, and lower satisfaction than HKSAR residents. The HKSAR model of hands-on resident training might be useful in improving the low cataract surgical rate in China.

摘要

背景

研究中国内地与香港特别行政区眼科住院医师培训的差异。

方法

从规模最大、最知名的教学医院中选取培训项目。通过邮件向眼科住院医师发放一份包含48个项目的匿名问卷。确定工作满意度、培训活动时间分配以及手术量。

结果

中国内地75名住院医师中有50名(66.7%)、香港特别行政区26名住院医师中有20名(76.9%)完成了调查。两组之间年龄(28.9±2.5岁对30.2±2.9岁,p=0.15)和培训年限(3.4±1.6年对2.8±1.5年,p=0.19)具有可比性。香港特别行政区受训者进行的白内障手术数量(囊外摘除术,中位数80.0,四分位数间距:30.0,100.0;超声乳化术,中位数:20.0,四分位数间距:0.0,100.0)超过中国内地住院医师(囊外摘除术:中位数=0,p<0.0001;超声乳化术:中位数=0,p<0.0001)。中国内地受训者花费更多时间完成病历(>50%的时间用于病历:62.5%对5.3%,p<0.0001)且接受的监督较少(≥90%的培训有监督:4.4%对65%,p<0.0001)。与香港特别行政区住院医师相比,中国内地住院医师更有可能觉得报酬过低(96.0%对31.6%,p<0.0001)且希望自己的孩子不要从事医学工作(69.4%对5.0%,p=0.0001)。

结论

在本研究中,中国内地眼科住院医师报告的手术经验和监督明显少于香港特别行政区住院医师,且满意度更低。香港特别行政区的住院医师实践培训模式可能有助于提高中国内地较低的白内障手术率。

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