住院医师体格检查技能干预及其行为改变的研究

摘要

目的 探讨改善住院医师基本技能及其行为持续改变的适宜方法,为住院医师基本技能规范化培训及其行为改变提供建议.方法 将某三级乙等医院2008-2010年参加工作的71名住院医师随机分为2组.干预组35人实施全身体格检查操作培训、书写住院大病历、定期督导评价、测量技能等干预措施；空白对照组36人,定期检查其全身体格检查操作技能.运用SPSS 13.0软件,采用混合效应模型进行重复测量方差分析,评价2组学员体格检查操作技能在干预前后改变的倾向、程度.结果 住院医师的全身体格检查技能总评分及头颈部、前/侧胸部、背部等各模块评分在于预前后差异有统计学意义(P＜0.05).结论 为住院医师提供的全身体格检查操作技能干预效果显著,能有效改变住院医师对患者全身体格检查行为,可为制定住院医师基本技能操作规范化培训方案提供依据.%Objective To give suggestions for residents' standardization training of basic skills and residents' behavior changes by discussing the appropriate approaches that could continuously improve residents' basic skill.Methods Totally 71 recruited residents in one of the 3b level hospitals from 2008 to 2010 were divided into control group and intervention group.Thirty-five residents in intervention group attended the physical examination training,medical record writing and were regularly monitored and supervised while 36 residents in control group were received regularly skill/behavior measurement.Data were analyzed by SPSS 13.0.Skill and behavior changing degrees and trends of physical examination between two groups were evaluated before and after intervention by mixed effect model to do ANOVA for repeated measurement.Results General scores and partial scores (head,neck,chest and back of the body) of physical examination were significantly different before and after intervention(P ＜0.05).Conclusions Interventions of physical examination for residents are effective and resident's behavior and skill were improved effectively.Intervention approaches could be considered as one of the standard training of elementary operation skill for recruit residents.