Study On The Training Effect Of Clinical Practice Ability Of Trainees In A Third-class Hospital

Objectives:According to the contents and standards of resident standardized training(trial implementation),this study investigated the training situation of a national resident standardized training base in recent years,analyzed the basic situation of clinical skills training of some students in the resident training base from 2013 to 2015,the basic situation of clinical skills operation assessment(completion assessment(?),6 stations),the homogenization level and shadow of training quality.Noise factors.In view of the shortcomings in the training,this paper puts forward some corresponding suggestions,which can provide reference for the study of the quality of clinical skills training in standardized resident training in Yunnan Province.Methods:(1)Current situation study.A comparative analysis was made on the passing results of the assessment of the completion of standardized resident training in a national resident training base at the levels of 2013,2014 and 2015.Among them,we pay attention to different variables:students' grade,gender,age,educational background,marital status,profession,training years,identity type,time to obtain licensed physician qualification certificate,whether there are differences in the passing of the completion assessment(?);different variables on the completion assessment(?)analysis of the factors affecting the passing of the assessment;residential training system before(2013)and after(2014,2015).The difference analysis of passing situation;the analysis of influencing factors of passing the overall examination by the 6 stations of the completion examination(?);the analysis of the difference of passing rate of each station in the 6 stations of the completion examination(?);and the analysis of the difference of passing rate of students with different identities.(2)Interview method:Personal in-depth interviews were conducted on the classifications of teachers and resident trainees in residential training bases.The main content of the interview is the interviewees' assessment of clinical skills in standardized resident training(?)The factors influencing the homogenization of the assessment quality and training quality and training effect in the public sector,as well as the corresponding suggestions.Results:1.3 grade overall pass:411 people from 2013 to 2015 passed 379 people,accounting for 92.2%of the total;32 people failed,accounting for 7.8%of the total.Residents' standardized training and completion assessment(?)The passing rate of assessment in the public sector is higher.2.The influence of each factor on the passing rate of the final examination(?)The passing rate of the students aged<30(96.4%)was higher than that of the students aged>=30(83.6%)(x2=20.634,p<0.001);the passing rate of the final examination in 2015(96.6%)>that in 2014(95.9%)>that in 2013(82.6%)(x2=21.921?p<0.001);and the passing rate of the final examination in 2015(96.6%)was higher than that in 2013(82.6%)(x2=21.921,p<0.001).Pass rate(98.1%)>Social pass rate(93.4%)>Overall pass rate(92.2%)>Academic link pass rate(89.0%)and the passing rate of the completion examination for the time of obtaining the licensed doctor's qualification certificate in 2017(100.0%)and other years(100.0%)>the time of obtaining the licensed doctor's qualification certificate in 2016(89.0%)and the time of obtaining the licensed doctor's qualification certificate in 2017(100.0%).The passing rate of the completion examination(96.4%)>the passing rate of the completion examination in 2015(95.6%)>the passing rate of the completion examination in 2014(83.8%)>the passing rate of the completion examination in 2013(81.5%)(x2=21.310,p=0.02).3.Graduation Assessment(?)Overall Pass of 6 Stations:Sixth Station(98.3%)>Fifth Station(98.1%)>First Station(97.8%)=Third Station(97.8%)>Second Station(97.6%)>Overall Station(97.2%)>Fourth Station(93.7%)(x2=23.036,p<0.001).The fourth station has the lowest pass rate of clinical operation,and is lower than the overall pass rate of 6 stations.4.Three grades,Three types of status assessment(?)Pass:(1)The overall pass rate of grade 2013 was 82.6%(100 people).Among them,unit pass rate is 100.0%(18 people),social pass rate is 100.0%(7 people),degree pass rate is 78.1%(75 people).Pass-through rate per unit(100.0%)=pass-through rate of social people(100.0%)>pass-through rate of degree cohesion(78.1%)(x2=6.617,p=0.037).(2)The overall pass rate in 2014 was 95.9%(139 people).Among them,the passing rate of units is 98.1%(51 people),the passing rate of social people is 50%(1 person),and the passing rate of degree links is 95.9%(139 people).Pass rate of unit person(98.1%)>pass rate of degree link(95.6%)>pass rate of social person(50.0%)(X2=11.263,p=0.004).(3)The passing rate of units in 2015 was 97.3%(36 people),the passing rate of social people was 94.0%(63 people),and the passing rate of degree link was 100.0%(41 people).Academic degree link-up pass rate(100.0%)>unit pass rate(97.3%)>Social pass rate(94.0%)(X2-2.806,P=0.246).5.Logistic regression analysis showed:age(x2=17.781,p<0.001),grade(X2=11.854,p=0.001),gender(x2=103.995,p<0.001),education(x2=4.807,p=0.028),marital st atus(X2=144.993,p<0.001),status type(x2=97.632,p<0.001),type of identity(x2=97.632,p<0.00 1),time of obtaining medical certificate(x2=14.027,p=0.029).They h ave an impacts on the passing rate of resident standardized training.6.Interview results.Interview results of teaching teachers:(1)The clinical op eration ability of each teaching teacher is uneven,which leads to different effect s of training trainees.(2)Different teachers have different teaching abilities.(3)Most of the students' learning attitude is active,or a small number of students'learning attitude is not serious and attention.(4)In daily training,the standard of training is ambiguous,and the content of training and assessment will be par tially different.(5)The difficulty of the questions is similar.The results of interv lews with trainees:(1)The teaching level and importance of the teachers.(2)Th e importance attached to each professional base.(3)There are fewer opportuniti es for regular operation exercises for assessment.(4)Lack of scientific research guidance,in turn,affects the improvement of clinical skills.Conclusions:The overall passing rate of the final examination(?)is higher.Gra de,age,sex,educational background,marital status,and the time of obtaining the li cense of a licensed physician are important factors affecting the completion of the examination.The fourth station(clinical operation)in the final examination(?)of 6 stations is the one with the lowest passing rate.At the same time,for the problem of identity type which is widely concerned by medical education circles,the passing rate of clinical skills assessment of unit people is better th an that of social people,and that of social people is better than that of degree cohesion students.In the process of training,teachers pay more attention to the h omogeneity of teaching quality,and students pay more attention to the level of teaching and self-development of training teachers.