| Objective: To construct the milestone standards for cultivating medical professionalism in the "5+3" training model for clinical healthcare professionals.To understand the current situation of professionalism of medical students according to the milestone standards.and put forward suggestions for the cultivation of professionalism of medical students.Methods:1.The survey of the demand for professionalism training of physicians in China in the new era: In order to better realize the coordinated development of medical practice and medical education,it is necessary to understand the demand for the medical talents completing the "5 + 3" training model.Therefore,this study first clarified the professionalism needs of graduates who have completed the "5 + 3" training stage in the new era According to the "Evaluation index system of professionalism of Chinese clinicians",four first-class dimensions and nine second-class dimensions of physician professionalism were established,and semi-structured interview questionnaires were developed;20 directors of Internal medicine,Surgery,Gynecology and Obstetrics,and Pediatrics departments in five tertiary hospitals in Liaoning Province were selected,and 38 patients and 43 family members from Internal medicine,Surgery,Gynecology and Obstetrics,and Pediatrics departments of Shengjing Hospital Affiliated to China Medical University were selected.The data was analyzed using the research method of Phenomenology in Nvivo software.2.The construction of milestone standards for cultivating physician professionalism in the "5+3" training model for clinical healthcare professionals: Based on the results of the phase I requirements survey,the end point of the milestone standard is proposed and through literature research,the milestone standards of professionalism were preliminarily established;five medical education experts,five professionalism experts,five educational administration and ten clinical teachers were selected nationwide for two rounds of Delphi expert consultation,then determine the final milestone standard.Authority coefficient,positive coefficient,average,standard deviation,variation coefficient and Kendall W coefficient were used to analyze the authority,enthusiasm,concentration and coordination of experts' opinions.SPSS was used to analyze and manage the data.If p value is less than 0.05,the result is statistically significant.3.The preliminary application of milestone standards for cultivating physician professionalism in the "5+3" training model for clinical healthcare professionals: In order to understand the actual degree of medical students reaching the standard,this study selected a time node of the milestone standard as the preliminary application,and investigated the actual situation of medical students' professionalism at the end of the fourth year.According to the standard of the end of the fourth year in the determined milestone standards,21 descriptions were provided to the medical students.The medical students need to carry out self-evaluation according to their own actual situation,and each entry adopts the Likert 5-level assignment setting option,with the value range of 1-5.By stratified cluster sampling,188 valid questionnaires were collected from medical students of the fourth grade of China Medical University,with an effective response rate of 72.87%.Through percentage,mean value,item mean value,standard deviation,the score distribution and the actual professionalism level of medical students at the end of the fourth year were analyzed.Results: 1.The survey of the demand for professionalism training of physicians in China in the new era: Nine secondary dimensions were mentioned 16,9,32,34,70,32,21,31 and 44 times respectively,and the requirements of doctors' professionalism under the secondary code were summarized.2.The construction of milestone standards for cultivating physician professionalism in the "5+3" training model for clinical healthcare professionals: Through literature research,24 English articles,4 English guidance books,5 Chinese articles,2 Chinese books and 2 policy documents related to the milestone standards of physician professionalism were retrieved.The proposed milestone time nodes were: the end of second year,the end of fourth year,the end of fifth year,the end of first year of resident standardized training,the end of third year of resident standardized training,and the preliminary milestone standards of physician professionalism were established.Tn the first round of Delphi expert consultation,25 experts from home and abroad were invited to participate in the consultation,19 valid questionnaires were collected,and the positive coefficient of experts was 76%.In the second round,19 questionnaires were distributed,19 valid questionnaires were recovered,and the positive coefficient of experts was 100%.The authority of 19 experts on five time nodes and all dimensions and milestones was between 0.87-0.91.Through the first round of consultation,according to the expert opinion,the milestone time node " the end of first year of resident standardized training," was changed to "the end of one year and a half of resident standardized training",and the milestone indicators were modified according to the expert opinion;In the second round,the variation coefficients of the consent on the five time nodes and the milestone standards of professionalism were distributed between 0.00-0.24 and Kendall W coefficient was statistic significant,which indicated that the experts agreed with a high degree,which determined the final version of the milestone standards of physician professionalism.3.The preliminary application of milestone standards for cultivating physician professionalism in the "5+3" training model for clinical healthcare professionals: At the time node of the end of the fourth year,the full score rate of each milestone standard ranged from 40.4% to 64.4%;the full score rate of the "Sympathy,respect,communication and cooperation" dimension was 37.2%,which was the lowest,and the second dimension of "Communication" had a significantly lower full score rate of 39.4%;the mean value of the total score of professionalism was 92.41,the item mean value was 4.40 and the standard deviation was 13.42,the item mean value of dimension " Integrity,honesty and sense of responsibility " was the highest,and that of dimension "Pursuit of excellence" was the lowest.Conclusion: According to the background of medical education and practice in China,this study clarifies the demand for cultivating medical professionalism in the "5+3" training model for clinical healthcare professionals,and establishes the milestone standards of professionalism cultivation under the "5+3" training model for clinical healthcare professionals.Compassion,respect,communication and teamwork are the core competencies in the process of medical practice,which need to be strengthened in the process of clinical healthcare professional training. |
PDF Full Text Request