Evaluation Of Standardized Training Of Resident Doctors In Hunan Province

Objective: To understand the current situation of the construction,management and implementation of the standardized training base for resident doctors in Hunan province;To explore the implementation effect,influencing factors and existing problems of standardized training for resident doctors.Investigation and analysis of training students and teachers' awareness of the training policy,satisfaction with the training policy,management,effect and guarantee mechanism,and its influencing factors.Methods: To collect,sort out and analyze the policies and regulations,organizational framework and guarantee mechanism of the implementation of the standardized training system for resident doctors,relevant documents and the participation of Hunan province's regulated trainees in the qualification examination for practicing doctors.Using stratified random sampling method,238 people were selected from 2 provincial training bases and 212 people from 2 municipal training bases from 2016 to 2018 in Hunan province.a total of 450 regular training students were selected.86 teachers from among 450 regular training students were randomly selected as the research object.The self-designed questionnaire "resident standardized training base questionnaire,student questionnaire and teacher questionnaire" was used to conduct a questionnaire survey on the research object.At the same time,the hospital management personnel of the training base,some representative training students and teachers were selected for in-depth interviews to better understand the problems existing in the training.Results:1.Situation of Standardized Training for Residents in Hunan Province: At present,there are 44 standardized training hospitals for residents in Hunan Province,including 14 base hospitals,30 cooperative hospitals and 538 qualified professional bases.3 years of training with a total capacity of 17,098 people;The total number of recruits in the three years 2015-2017 was 7,823.2.A cognitive survey on the necessity of standardized training of resident doctors in Hunan Province: 182(40.44%)of 450 trainees considered it necessary to train resident doctors regularly.173(38.44%)students think it is necessary,while 95(21.11%)students think it is not too necessary.among them,students with different academic qualifications,identity attributes,training years,contracting units and training level bases have different awareness of the necessity of resident training(all P?0.01);The teachers' cognition level of the necessity of resident training is higher than that of the trainees(P?0.01).3.Standardized training effect of resident doctors in Hunan Province: 450 trainees hold a positive attitude towards the training effect on the whole.The trainees believe that the dimensions of training for improving resident doctors' post competence from high to low are: clinical professional skills,medical theoretical knowledge level,interpersonal communication and communication ability,doctors' professional quality,teaching and scientific research ability.The highest self-improvement score in all items of resident's post competency is "accurate medical history collection(3.95± 0.74)",which is between "a certain improvement" and "a great improvement".The lowest score is "subject design ability(2.64 ±0.99)",which is between "not obvious improvement" and "certain improvement"."Does the training base attach importance to the training of resident doctors" is the most influential factor to enhance the trainees' job competence;In 2016 and 2017,the passing rates of the qualification examination for medical practitioners of the students from the Hunan province residential training base were 83.35% and 69.82% respectively.Among them,the passing rate of the trainees living in the training base in 2016(84.55%),It is significantly higher than that of the trainees from the cooperative units(80.06%);In 2017,the passing rate of the unified master students(94.66%)was significantly higher than that of the resident students(65.04%)4.Investigation on satisfaction degree of standardized training of resident doctors in Hunan Province and analysis of influencing factors: Liken5 scale was used to score the satisfaction degree of regular trainees(very satisfied with 5 points,satisfied with 4 points,generally 3 points,not satisfied with 2 points,not very satisfied with 1 point).The overall satisfaction score of 450 discipline training students was 3.58 ±0.56.The average satisfaction scores of all dimensions from high to low were: with teachers(3.92± 0.67),base conditions(3.80±0.62),process management(3.70±0.57),training effect(3.61± 0.61),system design(3.42±0.74)and guarantee mechanism(3.04± 0.85).The satisfaction of students with different status attributes,educational background,training years and training base level is different.(all P?0.05).Conclusions:1.The standardized training of residents in Hunan Province has a complete organizational structure and a standardized training base.The current training capacity can meet the needs of standardized training of residents in Hunan Province.However,with the increasing incidence of psychological diseases and the full opening of the second child,it is necessary to gradually expand the training capacity of psychiatric,obstetrics and gynecology and paediatric residents.2.Most of the students and teachers in Hunan province hold a positive attitude towards resident training,but suggest that the training period should be controlled within 2 years.Teachers' awareness of the necessity of discipline training is higher than that of discipline training students.3.The standardized training of resident doctors in Hunan province has a definite effect: the regular training of resident doctors can obviously improve the passing rate of the trainee's qualification examination for practicing doctors;Both the training trainees and the teachers believe that the training can improve the job competence of the training trainees.4.The overall satisfaction score of residents' standardized training students in Hunan Province is 3.58 ±0.56,which is above the average level.Students have a higher level of satisfaction with the two dimensions of teachers' qualifications and base conditions,and the lowest level of satisfaction with the security mechanism.Education background,identity attribute,training years,contracted units and training level bases are the main influencing factors of students' satisfaction.5.The standardization training base of resident doctors in Hunan province should attach great importance to the regulation training work,especially the coordination unit of standardization training of resident doctors should be further improved in terms of supporting policies,process management and incentive mechanism.