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全科/家庭医学培训对日本初级住院医师的影响:一项描述性研究。

Impact of general practice / family medicine training on Japanese junior residents:a descriptive study.

机构信息

Department of Community and Family Medicine, Fukushima Medical University.

Fukushima Centre for General Physicians, Fukushima Medical University.

出版信息

Fukushima J Med Sci. 2023 Aug 10;69(2):133-141. doi: 10.5387/fms.2022-35. Epub 2023 May 11.

Abstract

BACKGROUND

Despite international recognition of the impact of general practice / family medicine training on postgraduate training outcomes, there have been few reports from Japan.

METHODS

Junior residents who participated in community medicine training for one month between 2019 and 2022 were enrolled in the study. The settings were five medical institutions (one hospital and four clinics) that had full-time family doctors. The junior residents were assigned to one of these institutions. The training content mainly consisted of general ambulatory care, home medical care, community-based care, and reflection. The junior residents evaluated themselves at the beginning and end of their training, and the family doctors evaluated the junior residents at the end. The evaluation items were 36 items in 10 areas, based on the objectives outlined in the Guidelines for Residency Training - 2020 Edition, and were rated on a 10-point Likert scale. In the statistical analysis, Wilcoxon signed rank test of two related groups was performed to analyze changes between pre and post self-evaluation, and the effect size r was calculated.

RESULTS

Ninety-one junior residents completed the study. Their self-evaluations showed statistically significant increases in all 36 items. The effect size was large in 33 items. The family doctors' evaluation was 8-9 points for all 36 items.

CONCLUSION

General practice / family medicine training may greatly contribute to the acquisition of various required clinical abilities in postgraduate training even in Japan.

摘要

背景

尽管国际上已经认识到全科/家庭医学培训对研究生培训结果的影响,但来自日本的报告却很少。

方法

本研究纳入了 2019 年至 2022 年期间参加为期一个月社区医学培训的初级住院医师。培训地点为五家医疗机构(一家医院和四家诊所),这些机构均配备全职家庭医生。初级住院医师被分配至其中一家机构。培训内容主要包括一般门诊护理、家庭医疗护理、基于社区的护理和反思。初级住院医师在培训前后对自己进行评估,家庭医生在培训结束时对初级住院医师进行评估。评估项目共有 10 个领域的 36 个项目,基于《住院医师培训指南-2020 版》中列出的目标,采用 10 分制 Likert 量表进行评分。在统计分析中,采用两相关样本的 Wilcoxon 符号秩检验分析自我评估前后的变化,并计算效应量 r。

结果

91 名初级住院医师完成了研究。他们的自我评估显示所有 36 个项目均有统计学显著增加,其中 33 个项目的效应量较大。家庭医生对所有 36 个项目的评价均为 8-9 分。

结论

即使在日本,全科/家庭医学培训也可能极大地促进研究生培训中各种所需临床能力的获得。

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