Development Of Clinical Competence Of Master Of Medicine Under The Background Of Medicine-Education Coordination Cultivat Model:Status Quo And Countermeasures

Objective: Beginning in 2015,China has implemented the reform of "double-track integration" training mode under the medicine-education coordination cultivation for master of medicine.The purpose of this study is to investigate the current situation and effect of the clinical competence training of master of medicine,analyze the main problems and causes in the process of clinical competence training and management,and explore the suggestions and countermeasures to improve the quality of clinical competence training.To provide practical basis and decision-making reference for promoting the reform of "medicine-education coordination" and "double-track integration of postgraduate training mode".Methods: Through the questionnaire star platform,the master of medicine of Grade 2015 and Grade 2016 of Chongqing Medical Universitywere surveyed online,and interviews were conducted among postgraduates,managers,clinical teachers and tutors.SPSS21.0 software was used to describe the questionnaire data,Wilcoxon rank sum test,t test,variance analysis and chi-square test.The difference was statistically significant(P<0.05).Results: 1.The 1234 master of medicine,67.99% thought that the current situation of training was "clinical-oriented,slightly academic",57.86% thought that the reasonable orientation should be "clinical-oriented,slightly academic";23.82% thought that the arrangement of rotation departments was unreasonable;55.67% thought that they were more motivated to study in their own professional departments,more than 50%of graduate students think that their comprehensive clinical ability can meet the requirements of rotation training more than 70%.2.In the aspect of clinical competence training,the frequency of clinical teaching activities,clinical training and teacher's correction of medical records are better than other rotating departments in general;the theoretical examination is better than the operational examination;The overall satisfaction score of students was(3.42 ± 0.95),There were differences in the overall satisfaction evaluation of master of medicine of different ages and grades(P<0.05).The factors affecting the quality of clinical competence training are students' subjective initiative,practical operation opportunities,etc.The ways to cultivate their clinical competenceare as follows: tube bed,skill operation training,teaching rounds.3.On the effect of clinical competence training,in the self-evaluation of clinical competence,the subjects scored the lowest on their "clinical processing ability" and "clinical operation ability",respectively(3.45 ±0.72)and(3.46 ± 0.77).The pass rate of the Grade 2015 and 2016 is99.54% and 98.49% respectively,which are higher than the overall pass rate of the Chongqing Examination Area in the same year,and the difference is statistically significant.The average scores of the theoretical and practical assessment of Grade 2015 are 148.12 and 401.00 respectively,which are higher than resident physician in the same period,and the difference is statistically significant(P < 0.05).Conclusions: This study found that the following problems exist in the cultivation of clinical competence of master of medicine at present: the clinical rotation scheme is not reasonable;the training of clinical skills to be strengthened;the relationship between clinical competence and scientific research ability to be straightened out;the system of clinical competence assessment still needs to be improved;there are differences in training,homogeneous management to be strengthened;and the inadequate investment in postgraduate funds,The incentive mechanism needs to be improved.The self-learning consciousness and ability of clinical postgraduates needs to be improved.In view of the above problems,the following suggestions are put forward: to optimize the clinical rotationprogram;to strengthen clinical training and enrich the forms of clinical training;to clarify the relationship between clinical and scientific research work,to give overall consideration to clinical research;to strengthen the assessment of clinical competence;to deepen the concept of medical and educational cooperation,to strengthen homogenization cultivation;to increase the investment of postgraduate funds,to improve the incentive mechanism;and to change the concept of learning among students,improve self-learning ability.