全科医师教育培训与评估PPT模板

全科医师教育培训与评估TrainingandAssessmentforGeneralPractitioners复旦大学医学院全科医学系复旦大学附属中山医院全科医学科祝墡珠教授ZhuShanzhuFacultyofGeneralPractice,FuDanMedicineInstituteDepartmentofGeneralPractice,ZhongShanHospitalaffiliatedtoFuDanUniversity：据统计，所有到医院就诊的患者中只有5%左右需要专科医师的诊治，而人群中80％~90%的健康问题可以由以全科医师（家庭医师）为骨干的社区卫生服务队伍来解决Accordingtotherecentstatistics,only5%ofthepatientswhogotohospitalneedthehealth-carefromspecialists,and80%~90%healthproblemscanbesolvedbyGPs-basedcommunityhealth-caresystem发达国家的实践经验也告诉我们：控制医疗费用，有效利用有限的医疗保险资源的关键措施是发展以全科医师为骨干的社区卫生服务近10年来，我们致力于毕业后全科医师的教育培训，探索建立新型的全科医师教育培训与评估模式TheexperiencegainedindevelopedcountriesreinforcestheideathattodevelopGPs-basedhealth-careincommunitysettingisacrucialmeasuretoreducemedicalcostsandmakeuseofthelimitedresourcesofMedicaremoreeffectivelyIntherecentdecade,wehavedevotedourselvestotrainingGPsanddevelopingaworkablesystemforGPs’trainingandassessmentinthepastdecade研究目的ResearchObjective：在综合性教学医院进行全科医师规范化培训的探索，建立适应生物－心理－社会医学模式的新型教学方式，取代专科医学以知识和技能掌握为重点、以疾病为中心的传统教学模式TodevelopanewefficientsystemforstandardizedGPs’trainingincomprehensiveteachinghospital,correspondingwithbiological-psychological-socialmedicalpatternandreformingthedisease-orientedtraditionalsystemwhichfocusessolelyonmedicalknowledgeandskills研究方法ResearchMethod对象以高等院校临床医学本科毕业，有志于从事社区卫生服务工作的医师为培训对象ObjectsWerecruitstudentsgraduatedfrommedicaluniversitiesasourtrainees,whohaveobtainedbachelordegreesinclinicalmedicine,andwillingtobecomeGPs方法参考发达国家和地区的培训要求，结合我院多年的住院医师培训经验，制定全科医师规范化培训大纲和要求、考核内容和评估方法。在教学实施过程中不断接受来自培训者和受训者的反馈意见，对培训和考核的方法、内容进行改进和完善MethodsWetriedtowork-outanewsetofregulations,acurriculumforstandardizedGPs’training,themethodsofexaminationandassessment,whichdrewonGPs’trainingmethodsinthedevelopedcountryanddistrict,aswellasthelong-termresidents’trainingexperienceofourhospital.Duringtheprocess,wetriedtoimprovethemethodsofteachingandthecontentofthetrainingcoursesandassessmentstepbystepthroughcollectingconstructivefeedbackfromthetrainersandthetrainees培训方法TrainingMethods分理论学习、临床轮转和社区实践三个阶段理论课程分别由资深全科医师和专科医师担任授课，并邀请美、英、中国台湾等地的资深全科医师来访讲学Thetrainingprocessinvolved3phases:academiclearning,clinicalrotationandcommunitypracticeSeniorGPsandspecialistsassumedtheteachingtaskstogetherinacademiccurriculum.Atthesametime,weinvitedsophisticatedGPscomingfromTaiwan,UK,UStoholdacourseoflectures临床轮转要求病区主治以上医师带教，由我院全科医学科负责教学的医师（副高职称）全程监控，及时掌握学员的反馈信息，与带教老师协调Attendingdoctorsinwardstookchargeoftrainees’clinicalrotationandadjunctprofessorofDepartmentofGeneralPractice,withresponsibilityfortraining,supervisedthewholecourse,whowouldlearnfromthefeedbackfromtraineesintimeandcoordinatewiththesupervisorsofallwards培训方法TrainingMethods社区实践期间，学员由所在社区的资深医师带教。带教老师先由我科统一进行全科医学理论的培训，并通过电话联系、每半年度集中座谈等方式及时反映社区带教过程中遇到的问题。学员则每周回我科集中1次，利于双向交流Duringcommunitypractice,theseniorphysiciansincommunitywouldsuperviseourtrainees,whoreceivedtheacademictrainingofGeneralPracticeinadvanceandreflectedtheexistingproblemsintrainees’practicethroughfrequenttelephonecommunicationandrapsessionseveryhalfanyear.Traineescamebacktoourhospitaleveryweeksoastocommunicatewithus学年结束，举行学员座谈会，听取学员意见和建议，改进培训方法Whenacademicyearwasover,wewouldholdasessionfortrainees,collectingconstructiveideasandsuggestions,toimprovetrainingmethods培训内容和期限TrainingContentsandSchedule培训围绕以下六方面的能力培养1.患者的照顾2.医学知识的掌握3.实践中的学习和提高4.人际交流5.职业道德6.立足于卫生保健系统的医疗行为,为期4年Ittook4yearstoperformthetrainingbasedonsixaspectsasfollow:patientcare,medicalknowledge,practice-basedlearningandimprovement,interpersonalcommunicationskills,professionalismandhealth-caresystem-basedpractice培训内容和期限TrainingContentsandSchedule理论课程2个月，包括全科医学概论、预防医学、综合课程（社区诊所的管理、社区合理用药、老年病学、医患交流技巧及计算机应用课程等）和专业英语Academiccoursestook2months,includingPanoramaofGeneralPractice,PreventiveMedicine,comprehensivecourses(suchasmanagementofclinicincommunity,rationalprescriptionincommunityclinic,Geriatrics,skillsofphysician-patientcommunicationandcomputerapplicationaswell)andmedicalspecializedEnglish临床轮转26个月，包括内、外、妇、儿、急诊科、五官科、皮肤科、眼科、康复科、中医科、CDC等社区实践20个月轮转期间每月安排学员集中1次，讲授临床医学进展Clinicalrotationtook26months,includingdepartmentofInternalMedicine,Surgery,Gynecology&Obstetrics,Pediatrics,Emergency,ENT,Dermatology,Ophthalmology,Rehabilitation,TraditionalMedicine,CDCandPsychologyetc.Communitypracticetook20monthsWeheldaseminareverymonthtointroducetheadvancementofclinicalmedicinefortrainees考核和评估ExaminationandAssessment围绕上述6方面的能力培养，制定相关知识、技能和态度要求，以及相应的考核和评估表格：如病史质量评估表、临床能力考评表、医师接诊评估表、文献综述评估表、医患交流患者评估表、医患交流患者家属评估表、同事评价表、职业道德评价表等，每半年考评1次，由全科教学组完成对学员的考评Accordingtothe6aspectswementionedabove,weworked-outrelevantrequirementsofknowledge,skillsandattitudes,aswellasexaminationandassessmentformsrespective:suchascasehistoryqualityassessmentform,clinicalabilitytestingform,literatureandreviewassessmentform,physician-patientcommunicationassessmentform,patient’srelative-basedcommunicationassessmentform,co-workers'evaluationformandprofessionalmoralityevaluationformetc.Theseexaminationsandassessmentswereperformedbyeducationalgroupofourdepartmentandrelevantprofess