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标准化住院医师培训:中国上海不同医院住院医师的均衡器?

Standardized residency training: An equalizer for residents at different hospitals in Shanghai, China?

机构信息

Key Lab of Health Technology Assessment, National Health Commission, School of Public Health, Fudan University, Shanghai, China.

Administrative Office, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Int J Health Plann Manage. 2020 Mar;35(2):592-605. doi: 10.1002/hpm.2970. Epub 2019 Nov 19.

Abstract

BACKGROUND

The residency training programme in Shanghai is the first in China to become standardized; however, there has been no evidence that the programme equalizes training quality. This cross-sectional study examined whether residents in all disciplines at different hospitals perceived equivalent improvement in professional competency after this programme.

METHODS

We recruited all 2283 residents who enrolled in the programme in 2013. Before graduation, the residents reported their perceived competency improvement as the primary outcome and their hospital of residency, awareness of the programme's requirements and policies, and demographic information as explanatory variables. We ran multivariate linear regressions and mixed-effect multilevel regression to examine whether the hospital type and the university affiliation were associated with perceived improvement.

RESULTS

A total of 2208 residents completed the survey. Although the adjusted multilevel regression analysis showed that the improvement scores at tertiary specialty hospitals and tertiary general hospitals were lower than those at secondary general hospitals, the difference was not statistically significant. No variance in improvement scores could be explained by the hospital type or university affiliation.

CONCLUSION

Receiving residency training at hospitals that were traditionally less resourced did not compromise educational quality based on the perception of the residents.

摘要

背景

上海的住院医师规范化培训项目是中国第一个标准化的项目;然而,没有证据表明该项目能够使培训质量均等化。本横断面研究旨在调查在该项目实施后,不同医院的不同专业住院医师是否认为其专业能力有同等程度的提高。

方法

我们招募了 2013 年参加该项目的所有 2283 名住院医师。在毕业前,住院医师将其感知到的能力提高作为主要结果,将其所在的住院医院、对项目要求和政策的认知以及人口统计学信息作为解释变量进行报告。我们进行了多变量线性回归和混合效应多层回归分析,以检验医院类型和大学附属关系是否与感知到的改善相关。

结果

共有 2208 名住院医师完成了调查。尽管调整后的多层回归分析显示,在三级专科医院和三级综合医院接受住院医师培训的住院医师的提高分数低于二级综合医院,但差异无统计学意义。医院类型或大学附属关系并不能解释提高分数的差异。

结论

根据住院医师的看法,在传统资源较少的医院接受住院医师培训并不会损害教育质量。

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